What is a Pap test?

The Pap test, also known as Pap smear, checks for changes in the cells of your cervix. The cervix is the lower part of the uterus (womb) that opens into the vagina (birth canal). The Pap test can indicate if you have an infection, abnormal (unhealthy) cervical cells, or cervical cancer.

During a Pap smear, Dr Cook takes a sample of cells from your cervix to be tested and examined. A Pap test is safe with no known medical risks.

Why is a Pap test Performed?

A Pap test can save your life. Pap tests can

  • find the earliest signs of cervical cancer

  • detect infections

If diagnosed early, the chance of curing cervical cancer is very high as treatments can prevent most cases of cervical cancer from developing.

Getting regular Pap tests is the best thing you can do to prevent cervical cancer. In fact, regular Pap tests have led to a major decline in the number of cervical cancer cases and deaths.

Do all Women need Pap Tests?

It is important for all women to have annual Pap tests, along with pelvic examinations, as part of their routine health care.

You need a Pap test after age 18-20 years or within 12 months of commencing sexual activity

Currently a pap smear is done every 2 years . This recommendation will change according to new guidelines in 2017.

Women aged 70 can talk to their doctor about stopping after at least 3 normal Pap tests and no abnormal results in the last 10 years.

How to prepare for a Pap test?

Many factors can invalidate test results by washing away or hiding abnormal cells of the cervix. So Dr Cook suggests that for 2 days before the test you avoid:

  • Douching

  • Using tampons

  • Using vaginal creams, suppositories, and medicines

  • Using vaginal deodorant sprays or powders

  • Having sex

Make sure to empty your bladder just before your examination. Dr Cook will suggest you schedule a Pap test when you do not have your period. The best time to be tested is 10 to 20 days after the first day of your last period.

How is a Pap test done?

Dr Cook can do a Pap test during a pelvic examination. It is a simple and quick test. While you lie on an examination table, Dr Cook puts in an instrument called a speculum into your vagina to see the cervix. When Dr Cook performs the procedure the areas being examined are lumps, sores inflammation, or other abnormalities of the external genitalia. A small disposable swab or soft-bristled “broom” is used to remove cells from the entrance to the canal that connects the cervix with the uterus.

The cell sample is placed on a glass slide which is sent to a laboratory for examination under a microscope.

While usually painless, a Pap test is uncomfortable for some women.

What do abnormal Pap test results mean?

Abnormal Pap test results usually do not mean you have cancer. Most often there is a small problem with the cervix. Some abnormal cells will turn into cancer if left untreated for a long period of time, but early cell changes can revert back into normal in most of the cases.

By treating these unhealthy cells, almost all cases of cervical cancer can be prevented. If you have abnormal results, then consult with Dr Cook about what they mean.

Although every effort is made to educate you on pap smears and take control, there will be specific information that will not be discussed. Talk to Dr Cook about any concerns you have about pap smears.


Pap smear or Pap test is conducted as part of a woman's routine health examination, after the age of 21 years. It is not a diagnostic test, but is a screening tool used to detect any abnormal cells in the cervix.

Abnormal Pap smears may indicate the presence of infection or abnormal cells called dysplasia. An abnormal Pap smear may not necessarily denote cancer. These results highlight the requirement of supplementary testing to identify and confirm an underlying problem.


An abnormal pap smear may indicate any of the following:

  • Dysplasia (abnormal cells that may be precancerous)

  • Atrophy or vaginal dryness especially after menopause

  • An infection or an inflammation

  • Herpes

  • Trichomoniasis

  • Recent sexual activity

  • HPV (Human Papillomavirus) infection


Usually, abnormal cells do not produce any symptoms. Even the presence of HPV in an abnormal Pap smear is asymptomatic. Therefore, a regular Pap smear is beneficial in early detection of any abnormalities.

An abnormal Pap smear secondary to a sexually transmitted infection may induce the following symptoms:

  • Abnormal discharge from the vagina, such as change in the amount, colour, odour or texture

  • Abnormal sensations such as pain, burning, or itching in the pelvic or genital area during urination or sex

  • Sores, lumps, blisters, rashes or warts on or around the genitals



Colposcopy is a procedure in which a special magnifying instrument called a colposcope is used to look into the vagina and into the cervix. The colposcope gives an enlarged view of the outer portion of the cervix.


Colposcopy is done when there are abnormal changes in the cells of the cervix as seen on a Pap test. Further, it may be done to assess problems such as genital warts on the cervix, inflammation of the cervix, benign growths or polyps, pain and bleeding.


During a colposcopy, you will lie on your back with feet raised just as you do when you have a regular pelvic examination. A colposcopy takes 4 minutes to perform. Dr Cook uses an instrument called a speculum to hold the walls of the vagina apart. Then the colposcope is placed at the opening of your vagina.

A mild solution may be applied to the vagina and cervix with a cotton swab. This allows abnormal areas to be seen easily.  Dr Cook will look inside the vagina and cervix to locate any problems. If there are any abnormalities, Dr Cook may take a small tissue sample called a biopsy.

You may feel a mild pinch or cramp while the biopsy sample is taken. The tissue is then sent to a laboratory for further study.


Dr Cook will talk to you about any problems detected during colposcopy. If a sample of tissue was taken from your cervix (biopsy), the laboratory results should be ready in 2 weeks.

Most women feel fine after colposcopy. You may feel a little lightheaded and if you have had a biopsy, you may have some mild bleeding. Talk to Dr Cook about how to take care of yourself after the procedure and when you need to return for a check-up.


There may be a risk of infection when you have a colposcopy. Mild pain and cramping during the procedure and mild bleeding afterwards are common. This most often happens when a biopsy is done. If there is heavy bleeding, fever, or severe pain after the procedure, contact Dr Cook immediately.


If the results of the colposcopy reveal a high grade abnormality (CIN II or III) then a LLETZ (Large Loop Excision of the Transformation Zone) is performed. Dr Cook will perform this as a Day Stay procedure. It involves removing the abnormal cells from the tip of the cervix.

A cone biopsy is performed depending on the type and depth of the lesion.

This specimen is sent for histopathological examination. Complications are uncommon and include infection and bleeding. Most women will experience brown vaginal loss for about three weeks. It is advised that you avoid swimming, intercourse, baths and the use of tampons for this time to minimise the risk of infection.


A Pap smear during pregnancy is very safe. In case of an abnormal Pap smear, a colposcopy can be performed during pregnancy. However, further treatments are delayed until the birth of the baby