Pap Smear vs. Pelvic Exam

Pap smears and pelvic exams are often done during the same visit, but they serve different purposes.

A Pap smear collects cells from the cervix with a swab or soft brush to detect Human Papillomavirus (HPV) or precancerous or cancerous cells. A pelvic exam is a physical assessment of the vagina, cervix, uterus and ovaries to check overall reproductive health.

While a Pap smear is generally recommended every three years depending on age, a pelvic exam should be performed annually.

“Keep in mind that even if you don't need a Pap smear every year, we still recommend annual well- woman visits to discuss your health, address any concerns and stay up to date on preventive care,” says Victoria Schooler, PA-C, a board-certified Physician Assistant at Henry Mayo Newhall OB-GYN. “Your provider may recommend more frequent screening if you've had abnormal results or other risk factors.”

Well-woman visits may also include blood pressure checks; cholesterol and diabetes screenings; clinical breast exams and mammogram orders; conversations about contraception, menstruation, menopause symptoms and fertility; and lifestyle and mental health evaluations.

The American College of Obstetricians and Gynecologists recommends that women 21 and older, regardless of sexual history, see a healthcare provider for routine pelvic exams. For Pap smears, general screening recommendations are:

• Ages 21-29 should have a Pap smear every three years
• Ages 30-65 should have a Pap smear alone every three years plus HPV test every five years
• Over 65 may no longer need Pap smears provided certain criteria are met (i.e., adequate prior screening, no history of cancer), but this should be discussed with a healthcare provider

According to Schooler, patients should avoid vaginal lubricants, intercourse and douching for 24 to 48 hours before a Pap smear or pelvic exam.

“If you are currently having a menstrual period, it is usually best to reschedule your Pap smear, especially if bleeding is moderate or heavy, as blood can interfere with the test results. Light spotting may be acceptable for some patients, so feel free to call our office if you are unsure whether to keep your appointment.”