In my mid-20s, I had my first major health scare: My gynecologist informed me of the abnormal results of my recent Pap smear. As I learned, there are many abnormal Pap smear causes, not all of which are serious. In my case, however, I was diagnosed with HPV and cervical dysplasia. Early detection led to a full recovery, and I am still thankful for the abnormal Pap smear that saved my life.
As the U.S. National Library of Medicine (NLM) explains, Pap smears are a screening tool used by your gynecologist to detect any abnormal cells on your cervix. A scraping of cells on the cervix can tell your doctor whether there are any abnormalities that should be tested further. One of the most common reasons for a Pap test is screening for cervical cancer.
However, as NLM reports, an abnormal Pap test result does not automatically mean that you have cancer. An abnormal result can also indicate other problems or something as simple as the onset of your period. After finding an abnormal result, your doctor will explain what the Pap indicates and the further testing or treatment you need.
1. Human Papillomavirus
One of the most common abnormal Pap smear causes is the presence of human papillomavirus (HPV). According to the Centers for Disease Control and Prevention, HPV is one of the most common sexually transmitted diseases (STDs). It can affect both women and men, and generally it doesn't show any signs or symptoms. This is why, if you are diagnosed with the virus, it is important to discuss it with your sexual partner. In many cases HPV will clear up on its own without treatment and not lead to other health issues. However, in some cases it can lead to the development of certain types of cancer, including cervical cancer.
When I was diagnosed with HPV, it had already developed into cervical dysplasia and required immediate treatment. My doctor explained that if I had only been diagnosed with HPV, he would have simply continued to screen me with additional Pap smears until it went away.
2. Cervical Dysplasia
As NLM explains, cervical dysplasia is not cancer but rather an abnormal change to the cells on the surface of the cervix, which, if left untreated, can lead to cervical cancer. There are many stages of cervical dysplasia. If you have a mild- or low-grade dysplasia, your doctor may simply choose to monitor you for the time being with follow-up exams until any further changes occur. For more advanced stages of dysplasia, your doctor will likely recommend removing the cells.
After an abnormal Pap smear in my 20s, my doctor recommended an additional biopsy, which confirmed my advanced cervical dysplasia. The cells were removed in an out-patient surgery called a cone biopsy (a more extensive biopsy procedure). I was on bed rest for a week to recover, and for the two years following I received additional Pap smear tests every six months to be sure that there was no recurrence. It was then that I realized the great importance of routine gynecological exams. I've had an annual Pap test ever since.
3. Cervical Cancer
If you are diagnosed with cervical cancer, it will likely be through an abnormal Pap smear test. Cervical cancer tends to have few symptoms until the more advanced stages. NLM explains that while cervical cancer is common worldwide, it is much less so in the United States thanks to early detection through Pap smears.
Cervical cancer is a slow-growing cancer, NLM says. As long as I have routine exams, my doctor reassures me we're likely to detect abnormal or precancerous cells early enough to remove them before they can develop further. I was lucky enough to have my cervical dysplasia detected and treated before it developed into cancer. Since then, I firmly believe that early detection is the best way to prevent cancer.
4. Trichomoniasis and Other STDS
Another one of the more common abnormal Pap smear causes, especially in women aged 16 to 35, is the sexually transmitted disease trichomoniasis. As NLM explains, trichomoniasis can cause many symptoms, such as the following:
If you are experiencing any of these symptoms, it's a good idea to schedule a Pap smear test to confirm whether or not you have the disease, which requires an antibiotic treatment. This STD can affect both women and men, so be sure to discuss your results with your sexual partner.
It's important to remember that a Pap smear test evaluates the risk of cervical cancer. Other common STDS, such as herpes, chlamydia and gonorrhea, require additional testing. If you are experiencing any unusual symptoms or have had unprotected sex, you should discuss your testing options with your doctor.
5. Vaginal Infection
According to the U.S. Department of Health and Human Services, an abnormal Pap test result can also indicate that you might have a vaginal infection. If you do have an infection, you may be experiencing such symptoms as vaginal itching and odorous discharge, the Mayo Clinic reports. My doctor recommends a form of treatment depending on the type of infection that I have, and may perform a follow-up screening test to rule out any additional problems.
6. Harmless Abnormal Pap Smear Causes
As the U.S. Department of Health and Human Services explains, there are many harmless reasons that a Pap smear can come back abnormal, including a lab error. If you have recently had sexual intercourse, this can affect the cells of the cervix. Having recently menstruated or being close to the start of your period can also cause cervix changes. Using tampons and even taking a bath prior to your test can affect the results too.
When I was pregnant with my daughter, my obstetrician performed a Pap smear as part of the routine prenatal exam. The test came back abnormal. This was scary, but in the end there was no indication of disease, infection or cervical dysplasia. My doctor wasn't concerned and simply had me tested again after giving birth, at which point it came back normal.
There are a few things I do to make sure my Pap smear test is as accurate as possible. To prevent a false abnormal result, I avoid the factors I mentioned above at least 24 hours before getting a Pap test. I also try not to schedule my exam immediately before or after menstruating.
There are many abnormal Pap smear causes, so I remind myself not to panic before I have a chance to discuss the results with my doctor and determine next steps. Regardless of the results, Pap smears shouldn't be something to fear. After all, they can be lifesavers.