What do my Pap smear results mean?

By Courtney Snavely, Co-founder


So you’ve been swabbed. Your doctor calls you with the results, but you can’t make heads or tails of them. “Abnormal? ASCUS? COLPOSCOPY?!” — these words are scary sounding and hard to pronounce, don't worry — we've been there (many times). Whether you're trying to make sense of your recent results, or trying to learn what to expect, we're here to help you break down all of those acronyms.


What even is a Pap smear?

A Pap smear is microscopic examination of the cells of your cervix. Lab technicians look for any changes in your cells, irregularly shaped cells, or in some cases the presence of HPV.


The Pap Smear results:

Normal

Exactly like what it sounds! You’ve got quite the healthy cervix.


Unsatisfactory or inadequate

It’s not you, it’s your sample. This either means they weren't able to gather enough cells to analyze, or the cells they did collect weren't the right ones. A Pap smear tests endocervical cells because they are in the part of the cervix where changes that could lead to cancer occur. What this means is that you'll probably need to go in for another test, or your doctor may have to take some extra steps in the procedure to make sure they get enough endocervical cells.


Benign changes

You’re basically normal. Probably just a teensy infection that is causing an inflammation of your cervical cells. Have a follow-up pelvic exam to figure out if you need antibiotics to squash the infection.


ASCUS

This stands for “Atypical Squamous Cells of Undetermined Significance.” Get it now? Us either. What it really means is your cells aren’t shaped the way they usually are. They’ll do some additional tests to determine if HPV is causing the weirdness.


ASC-H

The "H" on the end of this acronym means "high-grade changes," and your cells are not typical. The likely culprit: HPV. Do NOT freak out! HPV is common. SUPER COMMON. So common that it is estimated 80% of women and 90% of men will have an HPV infection at some point in their lives. If this is your result, you will need to have a colposcopy (more on this to come).


LSIL

AKA “Low Grade Squamous Intraepithelial Lesion.” In more simple terms: you most likely have HPV. But I cannot repeat this enough, HPV is SUPER COMMON. What this means — you will have to go back for a pap smear every year until your results are no longer abnormal. You also might need a colposcopy depending on your doctor’s opinion.


HSIL

This means “High Grade Squamous Intraepithelial Lesion,” but let's just call it, “more serious than low grade, but still not cancer.” Your cells are changing, but monitoring and treatment can significantly reduce the risks of cancer. It is highly recommended you get a colposcopy if this is your Pap result.


AGC

“Atypical Glandular Cells” — it is what it sounds like. It means there were changes in the glandular cells of your cervix, which could indicate HPV, cancer or serious lesions in your cervix. You will need a colposcopy.


Cancer

I saved this one until the end, because it's scariest but most rare outcome. If your Pap results indicate you have cancer, you’ll want to make an appointment with a specialist (oncologist) right away. The earlier the treatment the better, which is why it’s so important to stay up to date with your Pap smears!


My Pap was irregular, now what?

Your doctor will either recommend an HPV test (most cases they’ll do that automatically), a follow-up Pap in a year, or, in some cases, a colposcopy.


TF is a Colposcopy?

Not a colonoscopy. That is very different. It sounds scary, but all they are really doing is a pelvic exam where your cervix is the star. The doctor will use a speculum and a large magnifying glass (don’t worry — it stays outside of your body!) to get up close a personal with your cervix. A vinegar swab is used sniff out the unhealthy cells. If anything looks a bit off, the doctor might take a biopsy (tiny sample of your cervical cells) to make sure every thing is A-OK.


As someone who has had one, I can attest that it doesn’t feel very comfortable. However, it takes about as long as your annual exam, and in the majority of cases, will provide you with that sweet, sweet peace of mind.


Some words of advice

  • Do NOT look at your cell sample if they take a biopsy — some things are better left unseen, you know?

  • Expect cramping and brown (even black, depending on the solution they use) discharge. Wear a pad the days following the procedure.

  • Most importantly: do NOT have sex within 48 hours of your colposcopy. Your cervix is exposed and extremely vulnerable to irritation.

How can I have the healthiest cervix?

Think of your annual exams like your extended family; most of the time you don’t have to worry about it, but once a year — maybe during the holidays? — it's probably a good idea to check in. Your cervix is precious; make sure to schedule any follow-up appointments, and be proactive about your preventive care!



Tested positive? You're not alone.

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