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Why You Must Get Regular Pap Smears and What to Expect

When was the last time you had a pelvic examination and Pap smear? If you are sexually active or over the age of 18, it is important to be checked out annually by your family doctor or gynecologist as part of your regular physical.

The Pap smear (Papanicolaou smear) became a commonplace part of a routine physical examination for women in the 1950's and is used primarily to detect and prevent cervical cancer. Under a microscope, abnormal, pre-cancerous cells can be discovered early, as can malignant (cancerous) cells that are not yet visible to the naked eye. The advantage of finding abnormal cells early is that treatment may begin before cervical cancer even develops. In the event that cancerous cells are found, early treatment may keep the cancer localized before it spreads, which means a greater probability for a full recovery for most women. Some forms of endometrial cancer may be additionally be detected by using this method.

Normally, to begin the examination, the doctor will ask you a series of questions. Besides your medical history, the doctor will need to know the date of your last period. You may also be required to give the date of your last sexual encounter. This information may be taken into account if there is any swelling or tenderness present and will help the doctor make a proper assessment of your organs.

Next, the physician will generally wish to perform a few routine checks. It is standard procedure that your weight and blood pressure be taken. Usually the doctor also asks for a urine sample. (It helps to drink a few glasses of water about an hour before your appointment!)

Many women feel nervous or are embarrassed about having pelvic examinations and Pap smears done. This need not be the case because it is a simple, painless, procedure routinely done by your clinician. When you go, the doctor will ask you to undress from the waist down and lie on your back on the examination table. Don't worry; they give you a sheet to cover yourself with. Often, the doctor will begin with a breast examination. The doctor will ask you to undo your bra and will simply do a manual examination of your breasts to feel for any unusual lumps.

Immediately following is the pelvic examination; a nurse is often present to pass things to the doctor and to assist with the examination. To begin, you must place your feet in the stirrups (foot rests) of the examination table, which will require you to bend your knees and open your legs. The first part of the exam is purely visual; the doctor will simply look at your vagina, labia and clitoris for visible signs of infection, rashes, sores, swelling, or other potential problems.

Next, the doctor, who should wearing rubber gloves, will perform a manual exam of your internal organs. Inserting two fingers into your vagina, the doctor will use their other hand to press gently down on your lower abdomen and will feel the size and shape of your uterus, ovaries, fallopian tubes and cervix. You will feel a slight pressure, but it is not painful in any way, although some women claim that they get a vague sensation that they have to urinate. Using this method, the doctor will be able to detect tumors or tenderness that may be a sign of infection. The doctor will then also insert a finger into your rectum; this is simply a different angle in which to examine your internal organs.

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