Those awkward lady appointments explained

Some may remember 2012 for the Summer Olympics, rumors about the world ending or the third Batman film. But I say it should go down as the year of the Pap smear.

A change in Pap smear (cervical cancer screening) guidelines was issued earlier this year. I’m sure some of you ladies were celebrating the news because it means fewer of those awkward, dreaded appointments.

But remember, a Pap smear is different from a pelvic exam, which you’ll still need once a year.

Confused? Let me explain more.

Pelvic exam vs. Pap smear test:  

The pelvic exam is the only tool to detect ovarian cancer. I check for anatomy issues, skin changes, polyps that could result in irregular bleeding, concerns with the uterus, signs of infection, etc. Most health care providers recommend a pelvic exam yearly.

A Pap smear is different. It’s an exam of the cervix that screens for cervical cancer and tests for Human Papillomavirus (HPV), the leading sexually transmitted infection. HPV is passed from one person to another via vaginal, anal or oral sex.

According to the U.S. Centers for Disease Control and Prevention, in 90 percent of cases, the body’s immune system clears HPV naturally within two years, particularly in adolescents. But some HPV infections are not cleared and can cause diseases such as cervical cancer.

The new guidelines:

The new guidelines relate strictly to Pap smears and won’t replace the need for your annual pelvic exam.

But the revisions could result in fewer Pap smears, depending on your age and cervical cancer screening results. The new guidelines are as follows:

  • If you are between the ages of 21 and 65 and have a history of negative Pap smears (cervical cancer screening results), you will only need to be screened every three years.
  • If you are over the age of 30, your doctor may choose to push the screening to every five years.
  • Ladies 65 and older can discontinue Pap smears if prior screenings have shown no indicators for dysplasia, cancer or HPV infection.

Why the change?

Because of the HPV-cervical cancer link and the increasing number of cases, many women who tested positive for HPV were undergoing surgical procedures without allowing their own immune system to do the work first. For young women, these surgeries can potentially lead to complications with future pregnancies.

Granted, as a health care provider, it’s hard to discover an abnormal test and not act aggressively on those findings.

Both the Pap smear and pelvic exam are essential to a woman’s health. Like them or not, they can make a difference in living a long, healthy life.


  1. Rhonda says:

    What are the guidelines for women like me…age 49 and have had a complete hysterectomy (no uterus, cervix or ovaries). I get annual mammograms but what about paps/pelvic exams?

  2. Karen says:

    I have never known which guidance to follow … I had a hysterectomy more than 5 years ago, dr ‘took’ everything but the ovaries based on my age (44) and the fact that there wasn’t a need to remove them. So how often do I need to have a physical exam and a PAP smear? I will be the first to admit that I HATE to go, not because of the exam itself but the fact that my doctor has to keep reminding me that I am overweight, how I should lose weight, and all that stuff. That’s his job, I know, but can he just mention it once and then get on with life? Anyway, I am curious about the frequency. Thank you!

  3. Kara says:

    Interesting blog. I hate the idea that my old doctors highly aggressive treatment of my abnormal pap may be the cause of my problems now. I always felt it was a bit much but I was young and afraid of discussing options with my doctor. Now I know better!