Pelvic Exam vs. Pap Smear: Which One is Right for You?

Pelvic exams and Pap smears are two essential procedures that are critical to women’s health. They are often performed together, but they serve different purposes. Understanding the differences between a Pap smear and a pelvic exam is essential because this knowledge empowers you to actively participate in your reproductive healthcare.

What is a Pelvic Exam?

A pelvic exam is a physical assessment of a woman’s reproductive organs. This includes the vulva, vagina, cervix, uterus, and ovaries. The exam is performed by a healthcare provider and is an important part of women’s routine healthcare. It helps detect physical abnormalities that could indicate health issues such as infections, sexually transmitted diseases, or cancer.

The healthcare provider visually and manually assesses the external and internal reproductive organs during a routine pelvic exam. The external physical exam involves a visual inspection of the vulva, while the internal visual exam involves the insertion of a speculum into the vagina to examine the vaginal walls and cervix visually. 

The healthcare provider may also perform a bimanual exam and insert one or two gloved fingers into the vagina with one hand pressing on the abdomen to feel the size and shape of the uterus and ovaries. 

During a pelvic exam, your doctor will:

• Check for abnormalities: The doctor will examine the size, shape, and position of the uterus, ovaries, and fallopian tubes to identify abnormalities or masses, such as cysts, fibroids, or tumors.

• Assess the cervix: The doctor will examine the cervix for any signs of infection, inflammation, or abnormal cells that may indicate cervical dysplasia or cervical cancer.

• Screen for sexually transmitted infections (STIs): Doctors may collect samples, like a cervical swab or a urine sample, to test for common STIs such as chlamydia and gonorrhea.

• Check for pelvic inflammatory disease (PID): By assessing the pelvic organs, the doctor can look for signs of PID, an infection of the female reproductive organs, which can lead to complications if left untreated.

• Evaluate the vaginal walls: The doctor may examine the vaginal walls for signs of irritation, infection, or other issues.

• Assess pelvic floor health: The exam can provide information about the strength and integrity of the pelvic floor muscles, which support the uterus, bladder, and bowel.

• Check for prolapse: Prolapse is the descent or dropping of pelvic organs. During the exam, Doctors can assess for uterine, bladder, or rectal prolapse signs.

What is a Pap Smear?

A Pap smear, or Pap test, is a screening procedure for cervical cancer. It involves the collection of a sample of cells from your cervix - the lower, narrow end of your uterus that connects to the vagina. The collected cells are then tested for precancerous or cancerous cells.

The Pap smear is the best way to detect cervical cancer early when it is more likely to be treated successfully. It can also detect cervical cell changes that suggest a higher risk of cancer development in the future. Detecting these cells early with a Pap smear is your first step in halting the possible development of cervical cancer.

Pap smears are typically performed during a pelvic exam. After the speculum is inserted into the vagina and the cervix is visible, a small brush or spatula gently collects cells from the cervix. The sample is then sent to a lab for testing.

Pap smears also detect human papillomavirus (HPV), a sexually transmitted virus that can cause cervical cancer. Some types of HPV are considered high-risk because they are strongly associated with cervical cancer.

Pelvic Exams vs. Pap Smears: How Often Do You Need Them?

In the past, it was recommended that women have an annual pelvic exam, including a Pap test, as well as a breast exam during their visits to the OB/GYN for cervical cancer screening. However, current guidelines from the American College of Obstetricians and Gynecologists (ACOG) indicate that while routine visits to the OB/GYN remain crucial, yearly Pap tests are no longer recommended. 

ACOG suggests having a Pap test every three years for women aged 21 to 29. Women between the ages of 25 and 29 can consider getting an HPV test, but the Pap test is still preferred.

There are three testing options for women aged 30 to 65: a Pap test and an HPV test every five years, only a Pap test every three years, or only HPV testing every five years.

Women over 65 can stop getting cervical cancer screenings if they have never had cervical cancer or abnormal cervical cells. You can also cease screenings if you have had two or three negative screening tests consecutively, depending on the type of test.

However, there are some exceptions to these guidelines. Women with a history of cervical cancer, HIV-positive individuals, those with weakened immune systems, or those exposed to diethylstilbestrol (DES) before birth may require more frequent screenings. Even if you’ve had a hysterectomy or received the HPV vaccine, following the guidelines is essential, as the vaccine doesn’t protect against all types of HPV.

Despite the change in Pap smear recommendations, women must visit their ob-gyn for a pelvic exam at least once a year. These routine checkups provide an opportunity to discuss various health concerns, such as sexual and reproductive health, birth control, pelvic pain, abnormal bleeding, and testing for sexually transmitted infections (STIs).

Additionally, your OB/GYN visit is an excellent time for a breast exam, to discuss your vaccination needs, get a blood pressure check and other general medical issues, ensuring comprehensive care for your overall health.

Make Your Pap Smear and Pelvic Exam More Comfortable With Nella

Open communication with your healthcare provider is crucial for a positive pelvic exam experience. If you feel discomfort during pelvic exams or have anxiety about the exam, discussing using the Nella Speculum with your doctor may be beneficial.

The Nella Speculum has transformed the pelvic exam experience. It is a modern speculum designed by women for women and is backed by OB/GYNs. It is made of a comfortable, medical-grade polymer, is temperature-neutral, smooth, and as narrow as a tampon and provides quiet operation. This innovative tool is patient-preferred and has been used on more than one million women, making pelvic exams less stressful and more comfortable.