The Pap smear is a simple test that women have been getting for decades as part of a gynecological exam. It’s used to help prevent cervical cancer or detect it early. Dr. Katie Au, one of our OB-GYNs with special expertise in cervical cancer screening, told us everything we need to know about this test.

How is a Pap smear done?

We place a speculum in the vagina and use a brush to swab cells at the opening of the cervix. Later, we view these cells with a microscope to make sure they are normal. Abnormal cells can be a sign of human papilloma virus (HPV) infection, cervical pre-cancer, or cervical cancer.

We can also test for HPV at the same time using the same cells or a second swab of cells. This is called a co-test.

How often do women need a Pap smear?

The official guidelines recommend cervical cancer screening for average-risk women ages 21 to 65.

• 21-29: every three years, co-testing is not recommended
• 30-65: every five years with co-testing or every three years without co-testing. You can also have an HPV test every five years.
• 65+: Pap smears are no longer needed if you are at average risk and have no history of abnormal results

If you are at higher risk, talk with your provider about how often you should be tested.

Myths about Pap smears

1. If I have never had sex, I don’t need a Pap smear.

MYTH. For most women, Pap smear screening should start at age 21, regardless of sexual history.

2. I don’t need a Pap smear once I’m in menopause.

MYTH. Most women enter menopause in their 50s but routine Pap smears should continue through age 65.

3. I should shave, wax, or douche before my vaginal exam.

MYTH. Please don’t! Shaving or waxing can cause skin irritation and your provider doesn’t expect or need you to do it. We never recommend douching for any reason.

At the Center for Women’s Health, our OB-GYN, midwifery and primary care teams all provide preventive care, including cervical cancer screening. Call 503-418-4500 if you’re seeking preventive care.