What to Expect if You Have an Abnormal Pap

Women from age 21-65 are encouraged to get a regular pap smear.  What is a pap smear? It is a test where your doctor will swab your cervix to look for abnormal cells.  This is usually done during a normal pelvic exam that you have at your OBGYN yearly appointment.This test can be done every three years instead of yearly unless you have a test that does not come back to normal.

After your doctor swabs your cervix usually the results come back in about a couple of days. If your doctor calls and says you have had an abnormal pap, there is no reason to panic yet. Abnormal pap does not automatically mean cervical cancer.  There are lots of reasons that can lead to an abnormal pap. What it means when your doctor says abnormal pap, means that there have been abnormal or unusual cells on your cervix. The most common reason of unusual cells are caused by HPV (human papillomavirus).  This can be either mild, moderate or severe, depending on what your doctor finds will depend on how he proceeds with treatment.

Though HPV is a common reason for abnormal cells it is not the only reason. 

ASCUS or atypical squamous cells of undetermined signature.  Squamous cells are cells that grow on the outside of a healthy cervix.  ASCUS are abnormal squamous cells, if these are found your doctor will usually follow up with an HPV test to see if the virus is found, if it is not there is no reason to worry.  

Squamous intraepithelial lesions are pre-cancerous cells. There are two types of these cells.  Low grade or high grade. Low grade cells are cells that will not likely change into cancerous cells for several years.  High grade cells are cells that are more likely to change to cancerous cells sooner.  

Atypical glandular cells are cells that produce mucus on your cervix.  If these are abnormal, your doctor will need to run more tests. 

Adenocarcinoma cells are cells that are most likely cancerous.  

Abnormal cells are just one cause of abnormal pap smear.  Other reasons can be inflammation, infection, herpes, trichomoniasis, or HPV.  Depending on the reason of the abnormal pap will depend on how your doctor proceeds with treatment.  If your doctor doesn’t believe there are any cancerous cells they may suggest repeating a pap again in a year. With no other intervention.  Other things your doctor may want to do further tests to check for HPV, a colposcopy and biopsy, a LEEP procedure, or cryosurgery. 

A colposcopy procedure is when your doctor will take a colposcope, this is like a big magnifying glass that will help your doctor see your cervix more clearly.  Your doctor will use a speculum to open up your vagina just like during a normal pelvic exam. A small light will be inserted into your cervix, that will go back to the colposcope so that your doctor can see into your cervix.  Then during this your doctor will swab a liquid on your cervix that will highlight anything abnormal. If your doctor cannot tell what the abnormal areas are then they will take a biopsy to have tested. This is a quick and easy procedure done normally in the office.  You can go back to your normal life afterwards. You may feel some discomfort or some bleeding but as long as it doesn’t come excessive there is no reason to worry.  

LEEP (loop electrosurgical excision procedure) procedure is the removal of abnormal cells in the cervix.  Your doctor will take a small loop wire that has an electric current that will burn the abnormal cells, the loop acts like a surgical blade. This can be done in the office and usually takes about ten minutes from start to finish.   Your doctor will use a colposcope to use to see inside of your cervix, then will insert the loop through the colposcope to scrape away the abnormal cells. Any removed cells will be sent out for testing. Some mild cramping and brownish discharge is normal after the procedure.  

Cryosurgery another remedy for abnormal cells in the cervix, is the use of extreme cold to kill the abnormal cells. This is usually done by using liquid nitrogen.  Your doctor will use a scope that they can then use to see inside your cervix, as well as help administer the liquid nitrogen to destroy the abnormal cells. After the cells are targeted they will freeze, die and then be reabsorbed by your body.  There are lots of risks with cryosurgery, including blisters, damage to healthy tissue, infection, loss of sensation, pain, scarring or ulcers. This procedure is usually done in a surgery center or at a hospital. You may be released the same day after the procedure but depending on your doctor you could be kept in the hospital for a couple of days. 

An abnormal pap smear is not a reason to panic.  Your doctor will have a plan and after having more tests done you will know more.  Best case scenario for having an abnormal pap is to just have to repeat the pap smear in a year.  Make sure you have your yearly exams with your doctor to make sure you catch the abnormal cells.