Pap and Pelvic: the 2 Ps and When You Need Them

Many women assume the Pap test and pelvic physical exam go together, but that's not always the case. Both are important tools your provider uses to diagnose conditions and detect cancer, but they are not one and the same.

The Pelvic Exam

What: This physical exam checks for medical problems with your pelvis, vagina, and pelvic floor. It's helpful for detecting problems with bladder function, sexual function, or other issues with your pelvic anatomy.

How:

• You'll be asked to change into a gown and lie on the exam table.
• Your outer anatomy (vulva) will be examined for redness, swelling, sores, or other abnormalities.
• Your provider will insert a speculum (duck-bill-shaped instrument) into your vagina to separate the vaginal walls to visualize your cervix.
• A manual exam will be performed to feel (palpate) organs that cannot be visualized (uterus and ovaries). This is done by inserting two lubricated gloved fingers into your vagina and pressing gently with the other hand on the outside of your lower stomach to check for tender areas and unusual growths.
• This exam can cause some discomfort, so your provider will talk you through the entire process. Be sure to speak up if you are uncomfortable or feel any pain.
  When: If you are not experiencing problems or symptoms, you don't need a pelvic exam every year. Ask your provider how often you should have this exam.

The Pap Test

What: This test screens for precancerous and cancerous changes of the cervix by taking a sample of cells from the cervix for lab testing.

How:

• You'll be asked to change into a gown and lie on the exam table.
• Your provider will insert a speculum (duck-bill-shaped instrument) into your vagina to separate the vaginal walls to visualize your cervix.
• A sample of cells will be collected from your cervix using a small brush.
• The cells are placed in a vial and sent to a lab for testing.
• This exam can cause some discomfort, so your provider will talk you through the entire process. Be sure to speak up if you are uncomfortable or feel any pain.
  When: In the past, Pap tests were done yearly, but this standard has been changed due to the potential for false positive results and unnecessary further testing. Your provider may recommend more frequent testing if you have an abnormal Pap test result.
• Women should have Pap tests every three years starting at age 21.
• Starting at age 30, you can have a Pap test every 5 years if your previous Pap test was normal and your human papillomavirus (HPV) test was negative.
• Age 65 is when you can stop having Pap tests if all previous test results are normal.

The Takeaway

The Pap test and pelvic exam are essential tools for keeping you healthy, so be sure to stay on schedule. If you are at all uncomfortable, tell your care provider. Steps can be taken to ease the process for you. Even if you do not need a pap or a pelvic exam every year, you should still see your provider every year for a physical.

Ask your provider whether you should have a pelvic physical exam - and talk with your provider about whether and when a Pap test is appropriate for you. Then be sure to follow up on any abnormalities in the pap test.

For additional questions or concerns, reach out to your OB/GYN provider.