All about the smear and vagina care

Kanisa George

How important is the smear? Why must we do it? And is it as bad as they make it out to be?

As a young woman I constantly heard from many sources (often unsolicited) about the importance of maintaining feminine health.

"Down there health" for many means subscribing to a balanced diet, adequate rest and conforming to a weekly exercise plan. Above all, women and healthcare providers believe that frequent screening is one of the key ways to manage vaginal health.

Without a doubt, a healthy vagina is an integral part of women's overall health. Of course, aesthetic appeal is essential, and none of us even want to entertain the idea of a putrid scent drifting around in our nether regions. Still, poor vaginal health can cause far more psychological problems than we realise. Vaginal problems can affect fertility and the inability to reach our highest pleasure point. This, in turn, can cause embarrassment, stress and the oh-so-dreaded "man and woman problems."

In this vein, screening and proper vaginal care are recommended to protect vaginal health. At the top of the list is the often-dreaded pap smear. A pap smear or pap test is a diagnostic procedure used to test for cervical cancer in women. The process involves collecting cells from your cervix — the lower, narrow end of your uterus at the top of your vagina and analysing them for abnormal growth or characteristics.

As the fourth most common cancer in women worldwide, cervical cancer is responsible for approximately 83,000 new cases and 35,000 deaths annually in the Americas. Notably, it is the second leading cause of cancer incidence and mortality among women in Latin America and the Caribbean. A report from the World Health Organisation showed that almost all cervical cancer cases (99 per cent) are linked to infection with high-risk human papillomaviruses (HPV), an extremely common virus transmitted through sexual contact. What's interesting about the development of cervical cancer is that most cases can be prevented with effective primary (HPV vaccination) and secondary prevention approaches, such as screening for and treating precancerous lesions. Furthermore, studies show that even when diagnosed, cervical cancer is one of the most successfully treatable forms of cancer as long as it is detected early and managed effectively.

Although abnormal cells can go undetected, consistent testing is crucial as cervical cancer takes several years to develop, so chances are if one test doesn't detect the abnormal cells, the next test most likely will. Because frequent testing increases the chances of detection, it is recommended that women above 21 get screened for cervical cancer every three years. And those between the ages of 30 and 65 every five years, along with HPV testing. For women over 65 years' healthcare practitioners suggest stopping routine pap testing if the previous tests for cervical cancer have been negative.

Now, what should you expect on a visit to the vagina doctor? While everyone's pain threshold is different, it is not common to experience pain during a pap smear procedure. Most women report discomfort, and some described a slight pinch-like feeling during the procedure.

Pain during a pap smear is usually a sign of a gynaecological issue such as vaginismus, endometriosis or other problems that typically have nothing to do with the procedure. Other papers suggest that it could also be a sign of psychological trauma associated with penetration or unresolved issues of sexual abuse.

Cervical cancer screening aims to obtain samples for testing, so proper scheduling is critical. It is best to schedule your smear procedure on none period days and at least two days before the exam to avoid vaginal intercourse, douching, tampon usage or any vaginally applied medicine. According to the Mayo Clinic, doing any of these things within two days of your test may obscure or even wash away potential abnormal cells and must be avoided before your procedure.

Most women are usually fine after a smear and can return to everyday life. However, it is not uncommon to experience a bit of bleeding, fever, chills or abdominal pain. If bleeding is excessive, it is recommended to consult your physician as it could signify something serious.

In the past, when I thought about vaginal screening, I only ever considered the smear test. Perhaps it's because of the considerable emphasis placed on it in my formative years, or maybe due to ignorance. But sadly, I wasn't alone. Many of my female contemporaries seem to focus all their attention on pap smears and rarely consider anything else outside of this gynaecological exam, unless emergent. Besides cervical cancer screening, it is imperative to maintain annual wellness exams. This can include urine tests to check for infections and an ultrasound scan to look at your internal organs, such as the ovaries, womb and cervix. Don't forget the highly recommended pelvic exam, which looks for any growths or abnormalities on your external and internal reproductive organs, including the vagina, uterus and ovaries, as well as the bladder and rectum.

Vaginal health is important to not only our overall health, but it impacts fertility and the type of sex life we'll ultimately lead. So do you and your future self a favour, schedule an appointment, don't forget about the smear and maintain healthy lifestyle practises. Your lady part would thank you in the end.