9 Things No One Ever Tells You About Pap Smears

"Cervical screening, sometimes referred to as the ‘smear test’ or ‘pap smear’, is often associated with diagnosing cancer, however the test is actually about the prevention of cancer," NHS doctor, sexual health advocate, and youth education expert Dr. Jennifer Dhingra tells Bustle. "The test looks at the health of the cells in the cervix, to see if there are any abnormal changes."

It's during this test that, according to Dr. Dhingra, human papillomavirus (HPV), which can cause changes to cervical cells, can be detected. But what happens if it's detected? Your doctor is just going to keep an eye on it, because everyone, well, almost everyone has HPV.

As sex educator Emma McGowan previously wrote for Bustle, "Think of [HPV] as the common cold of the genitals: You’ll very likely contract one or more strains of the virus at some point in your life. And, like the common cold, most strains will do little to no real damage."

But that doesn't mean you shouldn't stay on top of your OB/GYN visits. Keeping yourself healthy means being proactive in every sense of the word.

"Early detection of abnormal changes allows the cells to be monitored, or treated before they become cancerous," Dr. Dhingra says. "Cervical screening offers the best protection against cervical cancer."

Although there are over 100 strains of HPV, 12 of those "high risk" strains can cause cancer, and only two of those 12 strains — HPV-16 and HPV-18 — cause most cancers.

"Over 90% of cervical cancers are caused by HPV infection," Dr. Dhingra says. "HPV is a group of viruses, with over 100 types, which can infect different surfaces of the body, such as the throat or genital area. Some types of HPV can cause genital warts, whereas a small number of high-risk types can be linked to certain cancers such as cervical cancer, but also cancers of the penis, anus, and throat."

Still, you can't assume that a positive HPV result will automatically lead to an eventual cancer diagnosis, or even a genital warts diagnosis.

"HPV tends not to cause any symptoms, and the body is usually able to clear it naturally," Dr. Dhingra says. "However, in some cases, the body is unable to clear itself of HPV, which means that overtime, there may be an increased risk of developing abnormal changes in the cells, which may lead to cancer."

It's important here to emphasize some cases. Just because your friend's body cleared out her HPV, it doesn't mean your body will automatically do the same. Getting your Pap smear every three years if you're aged 21 to 29, or every five with an HPV test if you're over 30, can keep you on top of this information.

There's a few ways you can protect yourself from cancer caused by HPV. The first is by getting vaccinated for HPV. For a long time Gardasil 9 only worked in preventing nine different strains of HPV and was only approved for people between nine and 26 years of age. However, as of late last year, Gardasil 9 was approved for people between 27 and 45 years of age.

You can also, of course, practice safe sex. Although it should be noted that condoms do not 100% protect against HPV. Why? Because you don't even have to have intercourse to contract it or transmit it. A fact that contributes to why so many people end up with HPV.

"HPV may be transmitted during sex, or skin on skin contact, with another person," Dr. Dhingra says. "As well as penis and vagina sex it can be transmitted though anal or oral sex, or by sharing sex toys. It is a very common infection, and the majority of people will have been exposed to it at some point in their lives."

While it's very responsible to use condoms — and you should! — using condoms doesn't negate your need to get regular Pap smears.

"Some women think that they've had a Pap test just because they had a pelvic exam, or a speculum exam," gynecologist Dr. Caryn St. Clair tells Bustle. When it comes to health exams, sometimes if you don't ask questions, you won't really know what's what.

"The Pap test is collected with a little brush that is swept across the outer and inner cervix," Dr. St. Clair says. "It's important to ask your doctor whether or not you're getting a Pap test that day and how you will be notified with your results."

There's no shame in asking questions or in even being confused. And if any doctor does make you feel bad, then maybe it's time to find a new one. It's your body and your health. You have every right to know and fully understand what's happening, how it's happening, and what you can expect the end result to be.

If you've never had a Pap smear before, don't worry — they're really quick! Like quicker than a quickie quick!

"It’s normal to feel a bit apprehensive before going for cervical screening, however it is usually a very quick procedure, performed by a health care professional (usually a nurse) who has been well-trained in the field," Dr. Dhingra says. "You book for a smear test at your GP (general practitioner) practice, just like you would with any other appointment. On the day, the healthcare professional will explain to you what the test involves, and then allow you to undress, from the waist down, behind a screen. The test itself usually only takes a couple of minutes, and involves inserting a speculum (a smooth plastic tube) into the vagina." The speculum allows your doctor to view the cervix and take a small sample of cells that will be tested and examined.

"Some people may experience spotting or very light bleeding after the test, [but] this should go away in a matter of hours," Dr. Dhingra says. "Though the majority of people won’t experience pain from the procedure, sometimes the speculum may feel a bit uncomfortable. If you do experience pain, you can ask to stop the procedure at any point."

But the best way to decrease the possibility of pain is to relax, as difficult as that may sound. If you're tense, your vaginal muscles will be tense too, which can make test feel a little painful.

Like any test, there's a waiting time on obtaining the results of your test. That waiting time is about two weeks. Then the results will either be sent to your home address or, if your health care provider has an online health care portal, you can get your results there, too.

"If the test detects abnormal changes in the cells of the cervix, or is positive for HPV, you might be called back for earlier screening (usually the test is every three years) or asked to go for another type of test called colposcopy," Dr. Dhingra says. "Colposcopy is a simple procedure, similar to cervical screening, which allows closer examination of the cells of the cervix, and sometimes a biopsy may be taken. If the cells are found to be abnormal, it allows them to be monitored or treated before they develop into cervical cancer."

But again, not all abnormal cells develop into cervical cancer. So even if your colposcopy does come up positive for abnormalities, it just means things need to be watched.

"Finding cervical cancer through screening is rare," Dr. Dhingra says. "And the more people are screened, the more they are protected from developing it."

"Try to avoid sex, douching, tampon use, and being on your period a day or two before your Pap in order to avoid obscuring results," Dr. Angela Jones, Astroglide’s resident sexual health advisor, tells Bustle.

Sometimes — if not most of the time — when you make your appointment, the person on the other end of the phone won't ask you about your menstrual cycle. Although a doctor isn't very likely to send you away if your period has just started or ended when you have your Pap, there's a good chance they'll make you come back again because they won't be able to get a good reading on your results. So do yourself and your doctor a favor, and try to schedule your Pap anywhere from 10 to 20 days after the day of your first period. Even if you have an irregular period, this 10-day gap should give you enough wiggle room.

In the last few years, women's pubic hair has become a topic of conversation. (Not sure why men's pubic hair isn't discussed and/or shamed, but I digress.) Whether women decide to go completely bald or rock a full bush, it's these conversations that have likely led to people wondering if they should groom before their Pap smear or any OB/GYN visit.

"When you have an upcoming appointment with your doctor that will include a pelvic exam and possibly a Pap test, just take a normal shower — no need for douching, waxing, etc.," Dr. St. Clair says. "Pubic hair is normal, and we will not be upset that you ran out of time for [grooming]."

Basically, whatever you have going on down there on your pubic bone isn't going faze your doctor at all.

"Even if your previous results were normal, it is important to keep going back for regular cervical screening," Dr. Dhingra says.

What's considered "regular screening, depends on your age. For those between 21 and 29 years of age, it's recommended to have a Pap smear every three years, according to Dr. Greves. For those over 30 who have had normal Pap results, it's recommended that every five years, along with an HPV test, is OK. But while this is the case, all women should go to the OB/GYN at least once a year.

"As women, we have many different things to discuss, like our periods, how to prevent pregnancy, sex, pain, etc.," says Dr. Greves.

In between appointments, you can stay on top of your cervical health by being responsible about sex.

"Using barrier methods of contraception, such as condoms or oral dams, reduces the risk of getting HPV," Dr. Dhingra says. "It is also possible to be re-infected with HPV. Though the HPV vaccination provides protection against the most common types of HPV that cause genital warts and cancers, it does not protect against all types."

Pap smears are an essential part of maintaining a happy and healthy body. What's also part of that is understanding exactly what a Pap smear is. If you still want to know more about Pap smears, ask your OB/GYN at your next visit, and don't be afraid to just keep asking.