by Amy Nicole Miller, Manager of Women’s Health Services

Many of us get pap smears (paps) as part of a general healthcare routine, but sometimes we don’t always understand why the test is an essential part of our bodies’ care. Paps are used to screen for cervical cancer. Anyone who has a cervix should get a pap. Finding a provider that you feel comfortable with and affirmed by can be hard, and we’re here to help you explore ways to navigate that difficulty.

Read on to learn more about navigating paps, finding a provider you trust, and more information on cervical cancer.

What causes cervical cancer?

Most cases of cervical cancer are caused by human papillomavirus (HPV), a virus that enters cells and causes them to change.

HPV is passed from person to person during sexual activity and can be spread through oral, anal, and vaginal sex. An HPV infection can often display no symptoms, leaving most people unaware they are infected. However, some people display symptoms in the form of warts. Most HPV infections go away on their own.

There are more complex cases of HPV that require medical treatment. These are often known as “high-grade.” These strains of HPV, if left untreated, are more likely to lead to cancer, including anal, throat, testicular, and vaginal.

How is cervical cancer screening done?

A cervical cancer screening includes a pap smear and, for some people, an HPV test. Both tests use cells taken from the cervix. Screening involves the collection of cells during an internal pelvic exam, which typically takes 2-3 minutes.

Everyone’s pap looks different. What makes you feel the most comfortable is what’s important.

  • If you have never had a pap before, getting one for the first time might cause you to feel a little anxious. It’s ok to talk with your provider about this. They might have solutions that can help ease your anxiety.
  • If you’re going to a provider for the first time for a pap, you don’t have to have one during your first session. It’s ok to build up a relationship with them over time.
  • You can also ask your primary care provider if they can perform a pap smear. Most providers have training to do so.

For the actual exam, you will undress from the waist down and lie on your back on an exam table with your knees bent. Your feet might be in footrests or they might not. It’s all about your comfort. A sheet will be provided for you if you wish to cover your legs.

Your healthcare provider will insert a small speculum inside your body through the frontal pelvic opening. A speculum is a tool that presses against the walls of the internal canal to hold it open so your provider can use a small brush to take a sample of cells from the cervix. While each provider uses different brushes, they are generally a soft waxy bristle material. At Howard Brown Health, we do not use metal speculums. We use disposable plastic ones for your comfort. The collected sample will be sent to a lab for review, and your provider will get back to you with the results within two weeks.

In addition to the pap screening, your provider will likely want to conduct a pelvic exam. They will look at the outside of your pelvic area to check for signs of cysts, genital warts, and other conditions. In what’s called a “bimanual exam,” the provider inserts one or two gloved and lubricated fingers into the frontal pelvic opening while pressing gently on your lower abdomen. This exam provides information about the size, shape, and health of your internal organs. This portion of the exam also typically takes 2-3 minutes. If you aren’t comfortable or ready to have this exam yet, it’s ok to tell your doctor. If you prefer, it can be something to work towards over time.

We all experience pap screenings and pelvic exams differently.

For some individuals, this exam can be scary. This is due to many reasons including previous trauma, gender dysphoria, and lack of trust in traditional healthcare settings. For others, it can be just slightly uncomfortable.

If you are nervous or uncomfortable, let your provider know and ask for what you need.

Discuss any hesitations or concerns you may have to ensure you are on the same page. Ask your provider as many questions as you need before during or after the exam. Some people find it helpful to listen to music, read a book, watch a movie, or to bring someone with them. Whichever relaxation technique works for you is best. If you’re experiencing anxiety, ask your provider about the availability of medicine to help you relax. Finally, know that you can stop the exam at any time.

It’s recommended that anyone with a cervix follow these guidelines for getting a pap smear:

People ages 21–29 years should have a pap screening every three years. HPV screening is not recommended.

People ages 30–65 years should have a pap screening and an HPV screening (co-screening) every five years. It is also acceptable to have a just a pap screening every three years.

People living with HIV may require more frequent screening. Work with your medical provider to find what works best for you.

Where can I get a pap test?

Howard Brown offers screenings at all of our locations. Contact us at 773.388.1600 to schedule your appointment at any of our locations across Chicago. Several of our locations have walk-in options available as well. Click here to find out more about those locations.

Our TGNC-friendly Women’s Health monthly drop-in, SexuWellness offers walk-in paps with providers from a range of identities who have experience with paps and trauma-informed care.

SexuWellness is the 4th Friday of each month from 5 to 8 p.m. at our Rogers Park location at 6500 N. Clark St. January’s SexuWellness will provide a space for more informal conversation about paps – including anal paps and more!

How much does a pap cost?
At Howard Brown Health, all medical services are offered on a sliding-fee scale to those who are eligible. Most major insurance plans are accepted. We even have insurance navigators to assist you if you have any questions.