Many women know these terms but are fuzzy on the details. Here’s what you need to know.
A pap smear and a pelvic exam are not the same thing. Although many women and physicians think of them as a single event, in reality they are both parts of the annual female exam.
The pap smear is a brushing of cells from the cervix, or opening of the uterus. These cells are then evaluated in a laboratory to look for abnormal cells. The goal is to pick up precancerous diseases of the cervix, which can be successfully treated, thereby preventing cervical cancer. Sexually transmitted diseases can also be diagnosed and treated through information gained from the same pap smear.
A pap smear does not test for uterine or ovarian cancer. This is where the pelvic exam comes into play. The pelvic exam occurs after a pap smear or in a separate exam all by itself. This is when your doctor or health care provider examines the skin of the vulva, vagina and cervix, looking for any suspicious lesions. These may represent skin cancers or vulvar diseases. He or she will also perform a bi-manual exam, which means the pelvic organs are felt between the physician's hands. This allows us to feel for pelvic masses. We are feeling the uterus, the ovaries, the bladder and the rectum. An enlargement or mass in any of these areas may prompt further testing. If the uterus or ovaries feel enlarged an ultrasound is generally ordered to see if that enlargement is normal or if a mass is present. If a mass is present, what is it? It may be readily identifiable as a benign uterine fibroid, or a simple ovarian cyst. Any questionable mass should be removed.
Do You Need a Pap Smear Every Year?
It has been suggested by ACOG (American College of Obstetricians and Gynecologists) as well as the USPSTF (US Preventive Services Task Force), that certain women do not require a pap smear every year. This is indeed true. If you are over the age of 30, in a mutually monogamous relationship and have never had an abnormal pap smear, you may be such a patient. The same is true of you have had a hysterectomy that was not done for an abnormal pap smear. Even if you are one of these patients, and you and your doctor agree that you can skip your pap smear, you cannot skip the pelvic exam.
Never, never, never, skip your pelvic exam.
It should be done every year as part of your physical, even if you have had a hysterectomy with removal of the ovaries. We are looking and feeling for more than just your uterus and ovaries. If your ovaries remain this is just another reason you should have this exam.
You would never tell a man that he didn’t need his prostate checked anymore. Don’t let anyone tell you to neglect your pelvis. All women need a pelvic exam every year.
Again, to recap: never skip a yearly pelvic exam and only skip a yearly pap smear with your gynecologist’s approval.