If you’re old enough to get an annual gynecological exam, then you’re probably already familiar with Pap smears. The Pap test (this term can be used interchangeably with “Pap smear”) is commonly conducted at a gynecological checkup, and is “primarily a screening test for abnormal cells of the cervix, and also HPV (human papillomavirus),” says Dorothy Bestoyong, DO, an OB/GYN based in Orlando, Florida.
During a Pap smear, the doctor will use a metal or plastic instrument called a speculum to look inside your vagina and to reach the cervix. The doctor then collects a few cells and mucus from the cervix and the surrounding area with a tiny brush. The cells are then sent to a laboratory for further examination. While Pap smears don’t hurt, the opening of the speculum can cause some discomfort and pressure.
At the laboratory, the cells can be tested for HPV — a sexually transmitted infection (STI) that can cause cervical cancer — and checked for other possible abnormalities that could become cervical cancer if not treated appropriately.
So, yes, Pap smears are synonymous with cervical cancer screenings. But considering an HPV test usually takes place at the same time as a Pap test (it can be done using the same sample from the Pap smear), it seems natural to ask if Pap smears also test for STIs.
Do pap smears test for STIs?
As mentioned above, HPV is a very common STI, but it’s important to understand that an HPV test and a Pap smear are actually two different tests. A Pap test looks for abnormal cells and cell changes caused by high-risk HPV, but it doesn’t test for HPV itself. An HPV test specifically looks for high-risk types of HPV on your cervix.
The other thing to remember about Pap smears and HPV tests is that neither can directly confirm a cancer diagnosis. They are screenings that will give your doctor a better idea if you need to go for further testing or treatment. Rest assured that an abnormal result does not automatically mean cancer, and that treatment can prevent cervical cancer from developing in many cases.
There are a few STIs, however, in addition to HPV, that can be detected from a cervical swab like a Pap smear: Tests for gonorrhea, chlamydia, and trichomoniasis can be conducted from cervical swab samples.
But, a Pap smear “will not detect STIs like HIV, syphilis, hepatitis B or C,” says Dr. Bestoyong. Those specific infections “need to be evaluated through blood work.”
So if you think you might have an STI, it’s best to discuss your concerns with your healthcare provider, and they can direct you toward the correct form of testing.
When should I get tested for an STI?
The two main reasons for requesting an STI test, according to Dr. Bestoyong, is “if there is a known exposure” or if you’re noticing symptoms like “abnormal vaginal discharge or irritation.”
Other common STI symptoms can include:
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Bumps, sores, or warts on or near your vagina, mouth, or anus
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Swelling or severe itching near your vagina
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Vaginal bleeding when not menstruating
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Painful sex
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Painful and/or frequent urination
Even though some STIs can be detected via a cervical swab, it’s critical that you not rely on your scheduled Pap test to confirm a possible infection. If you’re concerned you may have an STI, make sure you inform your doctor and directly ask to be tested. As previously noted, some STIs need to be confirmed via blood work.
How often should patients get a pap smear?
How often you get a Pap test depends on your age and medical history, so talk to your doctor if you’re not sure, and also to determine the best course of action for you.
Dr. Bestoyong offers these guidelines:
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Ages 21-29: Every three years. She also says “HPV testing alone can be considered for those 25-29 years old, however, Pap tests are preferred.” According to the American College of Obstetricians and Gynecologists (ACOG), the reason why Pap tests are preferred over HPV testing or “co-testing” is due to the common presence of HPV in this age group. Since these particular infections tend to dissipate on their own and don’t cause lasting changes in cervical cells, ACOG recommends sticking with Pap smears only.
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Ages 30-65: Either a “co-test” of a Pap smear and HPV test every five years, or continue with Pap smear only every three years or HPV testing alone every five years.
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If you’re older than 65, you may not need Pap/HPV testing anymore. Speak to your physician to be absolutely sure.
Listen to your body
Since most women don’t need to get Pap and/or HPV tests regularly, it’s even more imperative that you speak to your doctor if you think you may have an STI. These kinds of exams aren’t part of your annual gynecological wellness visit, so you’ll need to ask your provider to get tested even if you’re scheduled for a Pap smear. Depending on your symptoms, your physician will be able to recommend the right type of testing — be it via cervical swab or blood work — and treatment.
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram or Twitter.