[MERGED] Pap Smear

[Shine]

Hellowee, Doc Ira! :)

I'm currently writing a paper regarding Pap smear and I need some information regarding its introduction in the Philippines. Statistics would also help. In addition, would also like to find out how receptive the Filipina are to this test. Thanks!

[Ira]

I really don't have any data about the history of ob-gyne in the Philippines, sorry--but as for receptivity of patients, they're all receptive--after all, you wouldn't go to an ob-gyne for an internal exam and possible PAP smear if you're not willing to have your physician undergo an exam, would you? PAP smear isn't painful, anyway. I've personally never encountered a single patient who refused a PAP smear during my rotations in ob-gyne.

[Shine]

Hellowee, Doc Ira!

Thanks for the reply. Anyway, got hold of some information from PGH and DOH. :)

[thin_1]

is it true that at 18 a woman/girl should have a pap smear?

[kahumbu]

It is advisable for sexually-active young women to have a Pap smear at least once every 3-4 years.

Pero, syempre, it is not commonly done here in the Philippines.

[Shine]

Hellowee! :)

Ideally, a woman should undergo Pap Smear when she reaches 18 years old or whenever she becomes sexually active ... whichever comes first. Pero in the Philippines, as Kahumbu pointed out, Pap Smear is not that popular so some are advised to go undergo such test when they reach 25 years old.

[0000zErOcOoL0000]

:ahh:
forgive my ignorance... but what does that Pap Smear thing really do for the ladies/women, doc? heard before that its some kind of a check-up. but i'm wondering what's so different about it. kindly enlighten my thoughts, please.

[Ira]

A Papanicolau smear (Pap smear for short) is done by an ob-gyne as part of a complete gynecologic examination. The doctor uses a long cotton swab and uses it to swab the vaginal canal, the ectocervix and the endocervix, then smears these 3 samples on a glass slide. These smears will be examined under a microscope to check whether the cells obtained are normal or abnormal (e.g. inflammation, infection, atrophy, premalignant cells, etc.).

[0000zErOcOoL0000]

:cool:
geee! well, that seems to be not so usual for a check up... if you don't mind, how long is the cotton swab? and does this check up kinda... you know... mmm... affect the "virgin" thang? thanks a lot, doc!

[Ira]

The cotton swab is not the regular Johnson's buds you use for your ears. It's about 6 inches long in my estimation, give or take an inch or two. Due to medicolegal issues like tearing the hymen accidentally, virgins are not subjected to PAP smears.

[adsy]

when is the right time of the month to have a Pap smear? is it 2 weeks before or 2 weeks after your period? kailangan ba talaga eksaktong 2 weeks? di pwede kung tapos na lang agad ang period mo?

[Ira]

The best time to have a Pap smear is 2 weeks after the end of your menses, although it's still okay to have a PAP smear during times you don't have menses--just that the cell yield may not be adequate and the results may be inaccurate, and you might end up having to repeat it. Do not douche, use vaginal creams or lubricants for two days prior to the test, and do not have intercourse within twenty-four hours of the test because it could cause inaccurate test results.

[gumacanian]

are premalignant cells always treated successfully if a woman is tested every 3 to 4 years?

[Ira]

It's advisable that women, especially sexually active ones, have their Pap smears done yearly. The thing with malignancy is that it characteristically grows fast that undergoing pap smears every 3-4 years may be a little too late to catch potential problems before they become full-blown. Premalignant lesions (dysplasia), however, are almost 100% curable if caught early and treated immediately and properly.

[DELISYUS]

i used to really abhor the idea of going to one....imagine cold steel inside your.....but....i lived thru my pap smear.....and it's no big deal really, just have a really sensitive doctor examine you.....yung tipong, he/she will make you comfortable...

oh yeah.....a tip....learn to manage those muscles.....kasi the tendency is to be so stressed by the practice kaya magko-contract ang muscles mo down there.....mas masasaktan ka lang!!!

[Anck-Su-Namun]

Originally posted by Ira
Due to medicolegal issues like tearing the hymen accidentally, virgins are not subjected to PAP smears.

Hypothetically, if you're still a virgin at 30, you're NOT supposed to undergo a Pap smear?

[Ira]

It's up to you if you want to undergo a pap smear or not if you're still a virgin at 30 years old. This "no pap smear for virgins" rule is only enforced because of Philippine society's obsession with hymens--you don't see this problem in the Western countries. It makes no difference whatsoever for ob-gynes if one is a virgin, as long as they sign a consent form allowing the physician to perform a pap smear on them. Mahirap nang mademanda.

[bottle_cap]

i read somewhere that it is advisable for girls to have pap smear even if they are not sexually active... what is pap smear?

[Ira]

A Papanicolau smear (Pap smear in short) is a cellular specimen removed from the cervix and placed on a slide as a routine screening for cancer and cancer risk, precancerous lesions, as well as a variety of infectious conditions. What the ob-gyne does is she collects cells from the cervix by swabbing it with either a long, sterile cotton pledgette (a long, cottonbud-like object) or a cervical brush, then she mounts it on a glass slide, fixes/preserves this, and sends the slide over to the laboratory for reading.

It's adviseable for females who have had a history of even one sexual contact that they undergo an annual Pap smear as a screening for gynecologic health. If you're a virgin, you don't really have to have a Pap smear done, although if you want to it's perfectly fine. A lot of local ob-gynes would be hesitant to perform a Pap smear on a virgin since there is really no big indication for doing this, so you'll have to sign a waiver for this. If your baseline/1st Pap smear is fine, a second one is done after a year, and if that is still okay, rescreening can be done at 1-3 year intervals, depending on what your ob-gyne recommends.

[bottle_cap]

hey thanks for the info Ira!

by any chance... would you know a particularly good gyn??? ive been readin a lot about cancer, etc. so....

[Ira]

I know several ob-gynes. What city would be most practical for you to visit an ob-gyne? I might know someone practicing there.

[anghel]

Hi doc ira! i also need a good ob gyne. iyong tipong aalagaan ka at di ka peperahan lang (you know what i mean, because i had some bad encounters in the past).

i want an ob gyne na pwede akong alagaan hanggat sa mag-conceive na ako...

do you know good ob in phil.heart center or veterans memorial hospital (i guess, that's the nearest respected hospitals for me. i live in novaliches kasi eh.).

thanks doc.

[Ira]

Please e-mail me privately so I can send you some names.

[hunted_one]

What if the girl is still a virgin but receives oral sex. Does she need a pap smear? Just asking.

[Ira]

There is really no right nor wrong answer for this. STDs can also be transmitted thru oral sex, but doctors don't ask for a Pap smear anyway when they're considering STDs. A Pap smear isn't the gold standard for diagnosing what type of infection you have, although it can tell you whether or not there is any abnormality in the cervix's cells. In the US, a lot of ob-gynes advise that females 18 and above, whether there is any sort of sexual contact or not, undergo a baseline Pap smear, because 10% of bad Pap smear results do not seem related to sex. But as I've said, a lot of local ob-gynes would be hesitant to perform a Pap smear on someone who has an intact hymen unless a waiver is signed, for legal reasons. However, let's say a virgin who's had a history of oral sex wants to be certain about her gynecologic wellbeing and doesn't care about having her hymen broken thru Pap smear, then she should ideally have a Pap smear once she hits adulthood.

[dizzyr]

Originally posted by hunted_one
What if the girl is still a virgin but receives oral sex. Does she need a pap smear? Just asking.

is he a cebuano?

[Sexy_Samantha]

I had my first ever pap smear in a clinic somewhere along Buendia. This is not an OB-GYNE's clinic. Just a clinic who has services such as pregancy tests, pap smears, and the like.

My first understanding of pap smear is that it checks if you have cervical and breast cancer as well as checking if there is a problem with your mattress (tama ba spelling?). But the only thing adminstered to me was the test for cervical cancer wherein a long cottonbud was inserted into my you-know-what. I asked the girl if she will be checking for lumps in my breast. Hindi na raw. Akala ko SOP na yung pag-check sa ***** during pap smears. Hindi ba?

Another thing, she advised me to wash my genitals with 'maligamgam na tubig with one tablespoon of iodized salt'. I said, can I just use Lactacyd? She said, it is the same as lactacyd. Di pa ako gagastos kasi asin at tubig lang. Safe ba ang asin at tubig? Tamang gawain ba na gawin syang vaginal wash???

Hope I get some answers.

[Ira]

Papanicolau smears check only check for cell changes in your cervix. It can detect inflammations, precancerous and cancerous conditions before they even progress. It's not used for breast cancer screening. Nope, breast cancer screening is not included when you ask for a pap smear, but you can ask your physician to do breast exam on you.

As for salt water, It can be used as a vaginal wash in lieu of lactacyd because of its antiseptic effects, but I haven't heard of any doctor prescribing this in a long time because there are already commercial vaginal washes available. It's safe, but if the salt concentration is too strong, it may cause drying and irritation. If you have no problem shelling out a little money for vaginal wash, personally, I'd just advice that you use those.

[Sexy_Samantha]

Ira,

Thanks for the reply.

I'll just buy Lactacyd instead of the salt solution. Just to be safe from infections. :)

[Tigger]

When is the right time to start getting one?

[h0neybi]

As far as i know.....as soon as you get sexually active....

[mckoolit]

pardon my innocence.. or ignorance.. para san po ba ang pap smear?

[eyedoc]

Pap smears consist of cells removed from the cervix which are specially prepared for microscopic examination. The cells are removed by a gynecologist by brushing or scraping the cervix during a pelvic examination. The removed cells are evenly spread on glass slides. These are then be sent to the pathology laboratory to be stained, examined under a microscope, and interpreted.

Pap smears are used primarily to detect cancer of the uterine cervix or precancerous conditions - abnormalities of the cervix that may lead to cancer.

According to the College of American pathologists, every woman who is 18 years of age or older or who is sexually active should have a Pap test every year. Even women who are past their child-bearing years should have annual Pap tests.

[mckoolit]

thanks eyedoc *okay*

uhmm.. another question though.. kelangan pa rin ba magpa-pap smear if more thant 18 na but still a virgin?

[brynjar]

I am 24. Never been to an OB-Gyne before (actually, I never go to a doctor unless kailangan ko ng reseta for a stronger medicine).

I read somewhere that you should have your 1st pap smear when yoo become sexually active. Eh, I'm not naman... but a friend told I should have a pap smear every year?

Is this true? Nahihiya kasi ako...

[pexxerdoc]

Originally posted by brynjar
I am 24. Never been to an OB-Gyne before (actually, I never go to a doctor unless kailangan ko ng reseta for a stronger medicine).

I read somewhere that you should have your 1st pap smear when you become sexually active. Eh, I'm not naman... but a friend told I should have a pap smear every year?

Is this true? Nahihiya kasi ako...

Huwag kang ng mahihiya dito, brynjar. Your anonymity here (and confidentiality in any doctor's office) is secure naman.

It's true. Generally, pap screening is recommended for all women who are 18 years old or over or who are sexually active. (For example, a sexually active 16 year old girl should have a Pap smear.)

Although the recommended frequency of testing is usually once per year, a woman's doctor may recommend more frequent Pap smears based upon her personal medical history.



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[riAbaby]

ako once a year ang pap smear. first pap smear ko nung 21 ako...hiya din ako nun sobra. pero saglit lang naman yung exam. saka mabuti na *** nagpapa-tingin diba.

[bee_tin]

anu ba ginagawa dun? i'm 20 yet i never had one pap smear pa....

[pexxerdoc]

Originally posted by bee_tin
anu ba ginagawa dun? i'm 20 yet i never had one pap smear pa....
Pap smear?

Madali lang yan. Your doctor, usually an OB-GYN (kung lalake, always with an assistant-nurse) inserts a speculum gently spreading apart the vaginal walls, allowing the cervix to be examined. The speculum may be plastic or metal and may be warmed with water or lubricated with a vaginal lubricant (such as K-Y Jelly). The cervix will be checked for damage, growths, inflammation, unusual discharge, or discoloration. A Pap smear will be taken using a small brush and a wooden spatula to gently collect a sample of cervical cells. You may have some staining or bleeding after the sample is taken. Sometimes a sample of the cervical mucus is taken with a cotton swab to be tested and cultured for sexually transmitted infections such as gonorrhea or chlamydia.

http://a876.g.akamai.net/7/876/1448/v00001/images.webmd.com/images/hw/media63/medical/hw/nr551438.jpg The cervix is the lower part of the uterus that opens into the vagina. It is also called the neck of the uterus.
http://a876.g.akamai.net/7/876/1448/v00001/images.webmd.com/images/hw/media63/medical/hw/h5550939.jpg
The Pap test (Papanicolaou test or Pap smear) is used to screen women for cancerous and precancerous cells of the opening of the uterus (cervix). The Pap test is very reliable for detecting early abnormal cell changes that could lead to cervical cancer. A Pap test may also detect infection, such as yeast infection, but this is not the main purpose of the test.

A small sample of cells from the surface of the cervix is collected by a health professional. The sample is then spread on a slide (Pap smear) or mixed in a liquid fixative and sent to a lab for examination under a microscope. The cells are examined for abnormalities that may indicate cancer or changes that could lead to cancer. Any abnormal cells are classified according to their degree of abnormality.

How It Feels

A pelvic examination is more comfortable if you and the health professional are relaxed during the procedure. Breathing deeply and having a light conversation with your health professional may help you relax. Holding your breath or tensing your muscles will increase your discomfort.

When the speculum is inserted for the internal examination, you may feel some pressure or mild discomfort. Try to relax your legs and hips as much as you can. You may experience pain or irritation, especially if you have a vaginal infection. If a metal speculum is used, the metal may feel cold and hard. The speculum may be warmed with water or lubricated with a vaginal lubricant, such as K-Y Jelly, before inserting it into the vagina.


Reference: WebMD (http://my.webmd.com/hw/healthy_women/aa80229.asp#tp16628) "Copyright (c) 1996 - 2004, WebMD, Inc. All rights reserved"


Also, betin_ako, kung kailangan mo,

You can ask more personal questions via the Internet to Dra. Cynthia F. Fernandez (http://www.rxpinoy.com/askadoc/fernandez/) or Dra. Martha Millar-Aquino, (http://www.rxpinoy.com/members/AM024GYN/) both members of www.rxpinoy.com.

Their disclaimer: " ASK-A-DOC IS is NOT FOR EMERGENCIES AND TIME-SENSITIVE SITUATIONS. Since these physicians offer to share their knowledge in the spirit of public service, and have active practices, it may take a few days to over a week for a reply to reach your inbox. If you or your loved one feel any pain or discomfort, seek real world medical attention immediately.

This service should not be used to get an official diagnosis or second opinion. The Internet is a not the venue for medical consultation, since a mere written description of symptoms is rarely adequate. Real-time interaction, physical examination, diagnostic tests, or some combination of these, are needed."

My disclaimer: I don't know anyone of these doctors nor do they know me. Am not a Gynecologist but I have done many pap smears routinely.

To all PExers, I wish you all happy and safe holidays! :)


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[curiousjane101]

Just need advice. I havent gone to any gynecologist and I might need to go to one sooner or later. What are the things to be considered when chosing a gynecologist?

[zetia]

i think you need to consider gender... is it ok if your gyne is male? take note magagaling din sila. next is their experience and expertise....

[Phooey]

I think every healthy doctor-patient relationship begins with trust. Is this someone you will be comfortable following up with in the future? Do you feel your concerns legitimately addressed or does he/she dismiss them offhand? Its hard to know the answers to these questions before actually meeting your OB, but they are things to keep in mind when deciding on any health care provider.

Age and experience is a double bladed sword. Youth can imply less experience, but with greater familiarity with newer data and procedures. Youth can also gives you the sense of continuity of care. A relatively young doctor would for example allow for longer period of care and comfort over the long term than perhaps compared to a doctor close to retirement age. If a family is just starting out their family they would benefit from growing with their doctor.

The benefits you would gain from management of standard cases with an OB (regular Prenatal, Vaginal/Caesarian Delivery, Pap smear, infections, etc) are marginal at best, at a much higher cost. If your case is more complicated say something like multiple miscarriage, genetic problems etc consult at a specialist might be recommended. But a workup with a regular OB first is advisable.

[powerpuff]

hi!

i just want to know what are the things that can be found out on a pap smear? std? cancer cells?

thanks :)

[zetia]

Pap smear is use to determine some cellular changes around the cervix, not necessarily cancer. can also detect HPV, most common form of STD that can cause cervical cancer. if the result is positive for abnormality then u r a candidate for another diagnostic test.

[K_r_a_m]

not just the cervix, it also determines changes in the vaginal walls. it also identifies infections and cancer cells.



:zzz:

[powerpuff]

thanks a bunch :)

[BabyBoy's_girl]

I'm planning to have my pampsmear..How much would it cost me?and what should I consider ic choosing an OB Gyne?

[smilewarrior]

Good morning. Please wait for the reply of the physicians. These might help:

Pap smears consist of cells removed from the cervix which are specially prepared for microscopic examination. The cells are removed by a gynecologist by brushing or scraping the cervix during a pelvic examination. The removed cells are evenly spread on glass slides. These are then be sent to the pathology laboratory to be stained, examined under a microscope, and interpreted.

Pap smears are used primarily to detect cancer of the uterine cervix or precancerous conditions - abnormalities of the cervix that may lead to cancer.

According to the College of American pathologists, every woman who is 18 years of age or older or who is sexually active should have a Pap test every year. Even women who are past their child-bearing years should have annual Pap tests.

i think you need to consider gender... is it ok if your gyne is male? take note magagaling din sila. next is their experience and expertise....

I think every healthy doctor-patient relationship begins with trust. Is this someone you will be comfortable following up with in the future? Do you feel your concerns legitimately addressed or does he/she dismiss them offhand? Its hard to know the answers to these questions before actually meeting your OB, but they are things to keep in mind when deciding on any health care provider.

Age and experience is a double bladed sword. Youth can imply less experience, but with greater familiarity with newer data and procedures. Youth can also gives you the sense of continuity of care. A relatively young doctor would for example allow for longer period of care and comfort over the long term than perhaps compared to a doctor close to retirement age. If a family is just starting out their family they would benefit from growing with their doctor.

The benefits you would gain from management of standard cases with an OB (regular Prenatal, Vaginal/Caesarian Delivery, Pap smear, infections, etc) are marginal at best, at a much higher cost. If your case is more complicated say something like multiple miscarriage, genetic problems etc consult at a specialist might be recommended. But a workup with a regular OB first is advisable.

[marbles]

I'm planning to have my pampsmear..How much would it cost me?and what should I consider ic choosing an OB Gyne?

Government hospitals charge for less than 200 bucks, I am not sure of the rates of private OBGyne practitioners. Remember that the physician needs to see you for consult too, hindi pwedeng pap smear lang (midwives however, are a different matter). You can have your pap smear done by family physicians, general practitioners, and obgynes, of course.

Before you have your pap smear done, make sure of the following:

you do not have your menstrual period on the day of the procedure
abstain from sexual intercourse for at least 24 hours prior to the procedure
do not use vaginal douches, creams, lubricants, etc. Vaginal medications are okay (if you have been prescribed one by your doctor)
vaginal contraceptive foams, jellies, gels, etc.


There might be some discomfort during the procedure which is normal. If, however, you feel pain in the vaginal area, you should tell your physician.

Expect minimal spotting 1-2 days after the procedure.

Before you leave the clinic, ask your doctor how long it takes to get the results back (usually 1-2 weeks). Make sure to get the results of your pap smear and talk with your physician regarding the results, that way you'll have peace of mind.

It's recommended that you have pap smears once a year until you have 3 normal smears (in 3 consecutive years). After that, you can have it every 3 years.

Choosing an Obstetrician-Gynecologist
There are no strict rules about choosing an obstetrician-gynecologist. It mainly depends on the trust and physician-patient relationship that you will develop. You can try asking for recommendations from relatives and friends or try browsing the Parenting 101 forum for some recommendations and comments by other PExers.

If you are or think you are pregnant, it's best to choose an Ob whom you can trust, one who can understand your concerns, provide appropriate management, and one whom you can ask questions and explains to you in terms you can understand. Initial consultation fees may be high but may be gradually decreased (it depends, I think) during future visits. Take also into consideration, the obgyne's professional fees (aside from hospital costs) for doing a vaginal, assisted, and caesarean delivery. You can also ask if he/she has clinics in other hospitals and if he/she is a consultant at the hospital where you opt to deliver.

[netcruise]

hi! my friend just got her pap smear result, and the report says there were organisms present >> coccobacilli... will just ask what this is... thanks!

she's 2 months preggy pala by the way... will it have an effect on her baby? tried to check the net but the info is very limited about this bacteria.. thanks again!

[chelle07]

i also have my papsmear and result says that i had candidiasis. saan po ba ito nakukuha? and is it also a reason bakit hindi umook yung uti ko? thanks...

[Tjmd]

candidiasis is a fungal infection...usually very very itchy.
An antifungal medication is available. See your OB. No, its not the culprit in UTI.

[chelle07]

candidiasis is a fungal infection...usually very very itchy.
An antifungal medication is available. See your OB. No, its not the culprit in UTI.


How to prevent candidiasis?

[Tjmd]

its very hard to prevent it. The fungi is practically everywhere, including in our large intestines. But it grows in the vagina when the conditions are right. The exact conditions for candidal growth are unknown.Some individuals are however more susceptible to candida. There's really not much to answer on how to "prevent" candida. Only how to cure it.

[aaaa8]

Hi doc! I had Urinary Tract Infection for two weeks and now I don't know if it is already cured. I undergone for pap smear, ultrasound, blood test and urine test. Sa ngayon, may bago na naman akong nararamdaman doc. Pag nag poo-poo ako mahapdi at may lumalabas na dugo hindi naman masyadong marami, more than one week na din ito pero ngayon paminsan minsan na lang kaya di muna ako nagpapacheck-up ulit. Ano po kaya ang dala nitong sakit na ito? How can I cure this doc? Please help me. Thanks..

[swissknife]

Hi doc Ira! I go with my bestfriend for her pap smear last saturday. The doctor found out that she has bacterial viginitis. Her lab result will be on next week.

She also told me that her boyfriend got itchy days after they had sex (a week before her test). My bestfriend got worried about this. My question is, Where did she get it and how it will treat it. & how will I help her... pls. help my friend doc Ira.

[Chimera101]

hi! question lang po.......is it okay to visit your OB if you have your period? :)

[Tjmd]

its ok to visit your obgyne during your period.
Preferably though it would be best when your period is over.
But if you are seeking medical attention for an urgent medical problem,
Any OB will see you regardless if you have a period or not.

[CoolCucumber]

Huwag kang ng mahihiya dito,
It's true. Generally, pap screening is recommended for all women who are 18 years old or over or who are sexually active. (For example, a sexually active 16 year old girl should have a Pap smear.)



I'm a 25 year old virgin. So that means I don't have to do this, no?


:rpflag:

[Tjmd]

to my knowledge no.

[xthine_md]

According to the ACOG (American College of Obstetricians and Gynecologists) the first pap smear should be 3 years after first sexual intercourse or by age 21..whichever comes first.

So CoolCucumber by all means schedule an appointment with you Gynecologist for your first pap smear =)

[BiTteR_GoDdEsS]

when u start smelling something foul down there.. i guess thats the best time for a Pap smear..

ive done this before and its really awkward.. 1. because your OB will come face to face with your vagina and 2.the metal thingy inserted inside you..

[kahLeez]

uuuhhhmmm...doc, i dont know if im on the right thread but anyway, i'm having a dilemma.. i had my period 2 weeks ago.. and for the past 2 days, i noticed that im having discharges but only in minimal amount but causes stain in my undies. its kinda brownish but with blood.. it bothers me because this happened for the first time..

do i need a papsmear?

what does this imply?:depressed:

[apathy22]

Hi Doc! Could you recommend a good Ob-gyne around Makati? :D

I've been planning to have a pap smear for some time now, pero natatakot po ako sa speculum. :mecry:

How much do you think would a breast exam cost? :)

[flyleaf]

I just had my pap smear ang found out that I have an infection. My doctor said it isn't sexually transmitted but how come my partner was diagnosed to have an STD in his urinalysis when in fact, I just also had my urinalysis a while ago and my doctor said malinis naman daw ihi ko, i don't have STD or UTI. Yun nga lang sa papsmear ko my lumabas na infection which according to my doctor, hindi sya sexually transmitted. Sooo, how come nagkameron ng STD yung parter ko? how come hindi ako nahawa? Or one of our doctors had misinterpretation?

[omeng]

just bumping this old thread and would like to see experts opinions on some pending questions. thanks.