Going to see the gynecologist can be a super vulnerable experience. Not only are you openly chatting about your body and sexual history with another person, but then there’s the oh-so-enjoyable pap smear — a procedure where your OB-GYN collects a sampling of cells from the cervix to check for anything abnormal that could be indicative of cervical cancer. The U.S. Preventive Services Task Force (USPSTF) recommends screening for cervical cancer in women age 21 to 65 years via a pap smear every 3 years or, for women age 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years.
The most common sexually transmitted infection in the United States (an astounding 42.5 percent of U.S. adults between 18 and 59 reported an HPV infection between 2013 and 2014, according to the Centers for Disease Control and Prevention), HPV is named for the warts that some of the more than 150 related viruses can cause. While both men and women can get HPV, only women are tested regularly for it, as it can also cause cervical, vaginal and vulvar cancers.
“Roughly over 79 million Americans have HPV, typically in your teens to 20s but also many people over the age of 30,” Navya Mysore, MD, family physician and office Medical Director at One Medical in New York City, tells SheKnows. “Over 80 percent of individuals who are sexually active have had HPV at one point in their lives, perhaps knowing or not knowing at all.”
Despite the popularity of abnormal pap smears, they can still be frightening and unnerving for any woman. Because an abnormal pap shouldn’t be taken lightly, it can make women feel ashamed.
“Many women are often left thinking that if I do get an abnormal pap smear, then I must have cervical cancer,” says Mysore. “I would estimate one in three women I see in my practice have a history of abnormal pap smears for many reasons. Penetrative sex before a pap smear can, in rare cases, cause the cells to appear more inflamed than they really are. Hormonal changes during your period or right before can also cause those changes, and rarely it could also be a possible lab error.”
Typically, an abnormal pap leads to a follow-up pap smear within a year, then a colposcopy—a type of cervical cancer test that lets your physician get a close-up view of the cervix, according to Planned Parenthood. During the colposcopy, physicians apply a vinegar and iodine solution which allows them to see where cellular change may be happening on the cervix, says Mysore.
“Based on what we see, we will then decide to take very small biopsies that we send to the laboratory to determine if the cellular changes are normal, mild, moderate or severe changes,” she says. If a physician does see severe changes, they’ll proceed to what’s called a LEEP procedure, where suspicious looking cells are removed with a laser.
The good news? “Normal to mild changes rarely progress to cervical cancer,” says Mysore. “Once you start to get normal results with your subsequent pap smears then you go back to the regular screening schedule.”
Been there, done that? We connected with seven women* who had abnormal pap smears to hear about their experience.
* All names have been changed to protect these women’s privacy.
“I was in college and my gynecologist called my parents’ house while I was away. She left a message telling me to call back ASAP. She couldn’t give my parents any details because of HIPPA, but why they didn’t call my cell phone is beyond me. My parents freaked out and thought I was pregnant. I called them demanding to tell me what happened and they wouldn’t tell me until I saw them in person. I was a flight away from home and it had to wait a month until I was headed back home for break. [My doctor] told me in person that I had abnormal cells that could turn to cervical cancer. Whatever else she told me after that, I don’t remember.
I felt horrible. Ashamed. Stupid. Sad. Embarrassed. Regretful. Basically all negative emotions. I only had one colposcopy and after that my OB-GYN recommended a LEEP procedure. After going back every six months for two years, I’ve had no new abnormal cells grow back. Since then, I have not had an abnormal pap (seven years later) and feel relieved and good about it. I hope that it stays in my past.”
“The OB-GYN back in college called me to let me know that I had an abnormal pap. She gave me the entire lowdown on the number of different strains out there as well as my chances of not having it be a dangerous strain. She kept insisting that this virus is typically fought off and, since I was young, I had a higher chance of ‘fighting this off’ in no time.
I felt scared and worried. My mother’s a nurse and she always told me about the vaccine but [I never got it]. I kept thinking that I screwed up. I was beyond scared to tell my boyfriend at the time, and I kept wondering where this came from, how this happened, who else has this and who could I talk to about this that wasn’t just a healthcare professional.
Thankfully, they did not find anything alarming, I did not feel OK until my next annual [appointment], praying that the results would come back normal. Once [they came back normal], there was a part of me that still wasn’t relaxed. However, once I started to open up about my worries to my older cousin and other friends, they told me personal stories of how they went through the same situation and how almost all of them did not have it any more. Having the ability to hear from other people like me that had to go through this scare and just understand how ‘normal’ it is to have an abnormal pap was actually calming.”
“My stomach dropped when I saw my OB-GYN’s name on the caller ID. A doctor calling doesn’t typically mean good news. When she told me my test came back abnormal, my initial thought was well what does that mean? Am I going to get cervical cancer? I had heard of people having abnormal paps before, but I honestly didn’t know exactly what that entailed. My doctor did a good job of explaining it, but I was honestly still worried up until I went back for the colposcopy and got my results back.
I was nervous that I didn’t know what was going on, especially since I wasn’t really educated on why this happens or what it means. Up until then everything had been a routine checkup, in and out in an hour. But now there was this, and it seemed like a pretty big deal.
I felt sweet relief when she called me to tell me that the colposcopy didn’t show anything. While I waited for the colposcopy results, I spoke to many women, all of whom admitted to having an abnormal pap smear at one time or another, too. I learned a lot more about cervical cancer and the importance of early detection. It was scary, but I’m happy it ended up being nothing, and I felt lucky to have a strong group of women to support me through it.”
“I went in for a checkup because I was having strange pains and cramps, similar to the ones I get when I have my period. Sex with my boyfriend at the time started to strangely hurt. My OB-GYN brought me in and did a pap smear. She called me on the phone — I was at work at the time — and she explained to me that my pap came back abnormal. She talked to me about HPV, and the likelihood of that being what caused the abnormal pap. I remember being very scared, and all I kept thinking was that I have an STD.
I felt so ashamed. I could not even tell my mom. I remember crying that whole week and Googling everything I could to find out answers to all the questions I had that I just could not ask the doctor on the phone at the time. I confided in my college roommate, and she confided back to me that this happened to her a year earlier and was too afraid to tell anyone.
At the time, I hardly understood what HPV was and how common it is in women. I scheduled a colposcopy. It was a bit painful and left me very queasy. When the results came in from the biopsy they were negative. I had to go in more frequently the next couple years for pap smears because of the abnormal one. Since then — thankfully — I have been fine. Since then, I’ve learned that most of my friends had the exact same experience as I did, and all of them were also afraid to talk about it.”
“I had gone in a few weeks back to get my IUD out because it was giving me a lot of unnecessary pains, so the doctor decided to do a pap smear right then. He called me to let me know that I had HPV and needed to come in for a colposcopy. I’d only been with my husband for a little over a year (we dated for eight months and had been married for six months at that time), so telling him that I probably got HPV before we met and now had a dangerous issue from — it made me spiral for a few weeks. He was and is very supportive, but I felt at the beginning that it was a punishment.
After the colposcopy I was told I have Cervical Dysplasia Stage 2 or CIN 2, which is not terrible — but it isn’t great either. They use the phrase ‘pre-cancerous’ a lot, and that sounds really scary when you’re told over the phone. Am I going to die? is basically your first question.
My main concern at the beginning was that the doctors wanted me to get a LEEP procedure. I went to a naturopath and she informed me that cervical dysplasia can be reversed (this was also confirmed by my OB-GYN). She told me to take a bunch of supplements and to basically make changes in my lifestyle. I have a colposcopy at the end of March to see if there’s been any progress or not.
After six months, I’m ok with this and no longer see it as impending death. Pre-cancerous cells take years to develop, but it’s good to keep an eye on them. I’m not done with this just yet, but I will continue to get checked and look for the best course of action.”
“I went to see a new OB-GYN, and the experience was horrible all around. Long story short, she made comments about my BMI getting close to that of an overweight person after I told her my period history, which included years without my period due to an eating disorder. I got a phone call at work from the office receptionist, mentioning that my tests had come back abnormal and to call immediately.
I called back and couldn’t get through to a nurse or doctor. I spent the rest of the day panicking. When I got a hold of her, the OB-GYN told me that someone else had also reviewed my case, and I would need to get a colposcopy as soon as possible. In that moment, I can only define my feelings as shame as guilt. I was ridiculously emotional and embarrassed — especially after breaking up with the person I dated for most of my teens and all of college. I was coming off a year of a lot of sexual exploration and, admittedly, some irresponsibility. All of my thoughts revolved around HPV and cervical cancer. I was afraid if I ended up with it I would have to tell every partner for the rest of my life and would be considered ‘damaged.’ I imagined having to tell my parents and them dealing with that realization.
When I found out it was OK, I was relieved and also emotionally exhausted. For me it was a wake up call to use more protection and a kick in the butt to find a doctor who made me feel comfortable and secure.”
“My first pap came back abnormal at age 20. I’ve had one every year since and have only had three normal results. Each doctor (I’ve had numerous from moving around a lot), seemed to be pretty nonchalant about it. I truly believe your doctor makes or breaks your experience.
Oddly enough, I felt way more ashamed once I was with a steady partner (who is now my husband) than when I was single. My latest OB-GYN told me that my husband could very well have cheated on me, which is why I got infected again. I was mortified. For a long time, it honestly made me want to stop being sexually active. It made me afraid of my own body. What infuriates me is that men can have HPV too, but are shielded from the shame because they can’t get tested. This part of the anatomy is especially vulnerable for women because it’s tied to childbearing and natural female and maternal instincts. It’s also tied to the shame we regularly receive for being sexually active. Think about it: Nobody is ashamed to say they have a cavity.
Since I haven’t had a normal pap in years, I can only imagine what life would be like if I wasn’t so stressed out every time I head to the gynecologist. I imagine I’ll feel incredibly relieved yet also frustrated that I’ve spent so many years stressed about cervical cancer and confused about my body. But I also trust that it takes time to clear up. A friend had abnormal paps and colposcopies throughout the entirety of her 20s and finally had her first normal pap at age 33! So, I feel like there’s hope.”
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