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Your First Pap Smear: What to Expect

Recently, I found myself sitting in the campus clinic, avoiding eye contact with some other student while staring at my blank phone screen. I had been in a week earlier for a routine STD test (all good) when my doctor asked me about previous Pap smear tests.

“I’ve never had one,” I responded after some thought. My doctor reviewed my medical history and explained that because I was now 21, I should definitely schedule my first Pap test. That feeling one gets when asked if they want the flu shot that they have so intentionally avoided stirred in my gut, and I found myself making the decision I wanted to instead postpone. To prevent myself from putting that responsibility off any further, I had the receptionist schedule my appointment for the very next week (although I did try to call and get out of it the day before). I had lots of questions and consulted the almighty Google. I also asked the gynecologist on campus a gazillion questions, and here is what I learned.

What is the Pap smear test?

The test many of us women have heard about throughout our adolescence is a quick procedure that tests for cervical cancer. The campus gynecologist collected some cells from my cervix, put the sample into a small container, and wheeled it away. The test is really important, clearly, for early detection of cancer. If discovered, I would be able to seek treatment ASAP. If there were some abnormal results, I would go back for further testing and stay ahead of the situation. It takes around 1-3 weeks to get the results.

The test is not a pelvic exam, in which a doctor checks the reproductive organs (with two or three fingers and some lubricant), although a Pap smear will usually be done during one’s pelvic exam. The test is not a STD/STI test. It is wise to schedule an appointment in which all can be tested (urine, blood, cell samples), or during an annual checkup.

Does the test hurt?

Yes, a little bit. The whole thing starts with the gynecologist explaining the procedure and then leaving the room. I was instructed to remove all of my clothing, cover my upper half with a shirt-thing made from tissue paper material, and had an additional thin sheet to cover my lower half. I sat at the end of the operating table and waited, cold and uncomfortable. When the doctor came back, she had me scoot forward to the very edge of the table, and then placed my feet on two stirrups. Joy. For those who are squeamish with this type of stuff, it’s okay. It’s normal. Just remember that the test is a part of taking care of your body – protecting your present and future self. It’s not like the doctor hasn’t seen it before – don’t feel ashamed or embarrassed. Your body isn’t just a temple, it’s a whole freaking world. 

The gynecologist will then use a speculum. This thing is probably the most intimidating component of the test. It is a medical tool used to open the walls of the vagina. Healthline describes the contraption as “duck-bill-shaped,” which is pretty accurate. Sometimes doctors lubricate them, others run them under warm water. The speculum is then slowly inserted, the bill/blades opened, and voila - the doctor has a better look into the wonderful ecosystem that is your vagina. This thing didn’t feel too great. I thought to myself, well I’ve had bigger, it shouldn’t hurt, but my body wasn’t naturally lubricating itself for this metal duck. It initially felt uncomfortable, but I wouldn’t say it was painful. Of course, this will vary from person to person.

The cell-collection occurs after the speculum has been put in place. Your gynecologist will have a swab and stick combo that are used on your cervix. They are used separately and only for a few seconds, but with each there is a strange cramping/discomfort/pain from that area of the body. It is not unbearable, but was more uncomfortable to me than normal menstruation cramps. This, thankfully, was over in less than a minute, and once the speculum was removed there was no remaining discomfort or pain. In other words, it was quick, easy, and did not prevent me from walking over to Caribou right afterwards. 

 How often should I get a Pap smear?

Your gynecologist will definitely ask a bunch of questions that may change the frequency of this test, but usually your first Pap smear should occur after you turn 21. If your results come back normal, your doctor will likely recommend getting that test every three years. Although a Pap smear test is usually performed during a pelvic exam, they do not need to happen as frequently. Pelvic exams are typically part of one’s annual checkup with their gynecologist. As we get older, our doctors will recommend different testing times depending on risk factors and medical history. Typically, the testing will occur from ages 21-65. Always feel comfortable to ask your doctor questions about when to schedule your next exam!

What should I do (or not do) before my test?

I was taking a shower the morning before my appointment and looked down, wondering if there was something I needed to do…I hadn’t asked when scheduling my appointment. When bringing it up to my doctor later that day, she reassured me that there wasn’t any strenuous preparation required on my part. Pretty much, I should avoid intercourse beforehand and douching (never douche). Really, avoid putting anything (medicines, spermicidal foams, certain lubricants) in your vagina for about two days before your test. These things could mess with the results.

If you know your menstruation cycle, try to schedule your appointment when you know you won’t be on your period. If it happens, that’s okay. The test can still be done, but your results may end up affected. Ask or call your doctor before the procedure if you have any concerns. Also, relax. Take a deep breath. It’s all good and it will pass - the discomfort, the pain, the worry. It will pass.

What if I don’t have insurance/my insurance doesn’t cover it?

A Pap smear test is commonly covered by most insurance plans, but I always like to call and check with my provider whenever I make a doctor’s appointment for something new. The campus clinic is a quick and convenient option for college students. That is where I went. If your insurance plan ends up not covering the expense, or you do not have any insurance, find a local Planned Parenthood and check their website to see if that location provides the service. The Planned Parenthood located in Mankato, MN, does have this service. Book an appointment and get that test done! Try not to postpone the test like I did. It is not something I will look forward to, but is an essential part of self care. We women can handle it.