The Abnormal Pap Smear: What Causes It & How to Treat it

Your gynecologist just called you and said you had an abnormal pap smear. You probably have a lot running through your head, including “Do I have cervical cancer?” and “What are the things that can cause an abnormal pap smear?”

As scary as the diagnosis may sound, don’t panic just yet. Before you jump to conclusions and start thinking of the worst-case scenarios, let’s discuss the actual causes of abnormal pap smear and then how to treat it.

First off, what does an abnormal pap smear mean? Keep reading to find out.

What is an Abnormal Pap Smear?

An abnormal pap smear means that changes in your cervical cells have been detected. When this occurs, your doctor will first test them to make sure it isn’t a false positive.

Once it is confirmed that the results are correct, your doctor may suggest a colposcopy for a closer look so they can offer you the best results and treatment options available.

Do I Have Cervical Cancer?

No, not entirely! While a pap smear is in fact one of the best ways to discover cervical cancer, it doesn’t always mean you have cancer. In fact, there are several other possible reasons why you have abnormal results.

While some infections that you can uncover through a pap smear could be linked to cervical cancer if they go untreated, it does NOT mean you have cancerous cells.

So, what are the other causes of an abnormal pap smear?

Common Causes of Abnormal Pap Smear

When someone gets the call from their doctor that their results are abnormal, it’s completely understandable to get nervous. 

But, before jumping to the worst-case scenario, like cervical cancer, it is important to understand there can be many causes. These include:

• Human Papillomavirus (HPV)
• Cervical Dysplasia
• STIs
• And more

Let’s take a closer look at the things that possibly cause an abnormal pap smear.

Human Papillomavirus (HPV)

HPV is a sexually transmitted infection that should be treated as soon as it is detected to stop precancerous cervical cells.

Cervical Dysplasia

Cervical dysplasia is commonly caused by HPV and is an abnormal cervical cell change. Sometimes it can resolve itself without treatments; but, if it doesn’t after two years, these cells will need to be removed.

Pre Cervical Cancer

If detected early, these precancerous cells can be removed before they progress to cervical cancer. That’s great news for you!

Trichomoniasis or Other STIs

Trichomoniasis is caused by a protozoan parasite that can be transmitted through sexual intercourse. It can be detected by a pap smear and your results will come up as abnormal.

Other Possible Causes

While an abnormal pap smear result can be serious and mean you need treatment, it can also be caused by other things such as:

• Recent sexual intercourse
• If you inserted a tampon
• Lab error
• Menstruation
• Pregnancy
• Use of vaginal products

These aspects can affect the accuracy of your pap smear, leading to an abnormal result, and is why additional testing is always recommended.

Types of Abnormal Pap Smear Tests

In order to be sure of which treatment option will be best for you, your gynecologist will run some examinations and tests to better understand what the cause is.

Here are some of the exams you may expect to receive if you need further testing.

Colposcopy

A colposcopy may be suggested based on the type of abnormal pap smear you have. This is a non-surgical procedure where your gynecologist gently places a speculum inside your vagina to carefully inspect your cervix under microscopic guidance.

Here’s the good news: a colposcopy feels just like a pap smear and doesn’t involve downtime.

Biopsy

If a biopsy had to be done during the colposcopy, it means that your gynecologist saw an area on the surface of your cervix that has abnormal features.

The amount of the biopsy of tissue taken is the size of a fingernail clipping. It is then sent to an off-site lab and results are often received back within two weeks.

One common biopsy performed is the Cone biopsy, where a cone-shaped tissue is taken for further examination. This type of biopsy will be discussed later in the article. For now, let’s discuss the type of treatments available for your abnormal pap smear.

How to Conduct Further Tests on an Abnormal Pap Smear

The type of treatment your gynecologist will recommend depends on several factors, including the severity of change to your cells, your age, and medical history. Here are some common treatment options your doctor may recommend.

Cell Removal

While there are many effective treatment options, by removing the cell you are able to send it off to get examined. This can help you better access the abnormal cell.

Once the cells are thoroughly examined and you receive more accurate results, then further treatment options will be explored.

Cone Biopsy Surgery

During this procedure, your gynecologist cuts a cone-shape sample of your tissue to examine in a biopsy. This surgery takes no more than twenty minutes, but the recovery process could last up to six weeks.

On the bright side, you will receive more accurate results that could lead to life-saving treatment options.

Large Loop Excision of the Transformation Zone (LLETZ)

Using a thin wire, your gynecologist will use an electric current to cut away the abnormal cell while simultaneously sealing the wound. This procedure takes about fifteen minutes and the recovery process should not last more than four weeks.

Needle Excision of the Transformation Zone (NETZ)

This procedure is similar to LLETZ, but with a thin needle wire. The reason one may use this instead of LLETZ is if the cells are inside a passage.

How to Treat Abnormal Pap Smear

Once your test results come back and your doctor thoroughly analyzes them, you will be guided to the best treatment options for you.

Depending on the type of medical issue you are dealing with, your doctor might recommend the following treatment options.

Hysterectomy

In this procedure, your uterus and parts of your cervical cells are removed, which will stop any possibility of cervical cancer. This procedure is best for those who have had abnormal cells before or the cells are severe.

This is often recommended for women if they are past menopause or if they do not want to have any (more) children.

Note: It is important to take estrogen after a hysterectomy to prevent adverse symptoms.

Destroy the Cells

Aside from a hysterectomy, the second treatment option is to destroy the abnormal cells entirely. This allows space for new healthy cells to grow back in their place.

Your doctor may recommend a number of ways to destroy the cells, including:

• Cold Coagulation: This procedure involves a heated probe to destroy the cells
• Freezing the Cells: During this treatment, your gynecologist uses a cold probe to freeze the cells
• Laser Therapy: During laser therapy, your abnormal cells are burned away with a light beam

Depending on the type of treatment you receive, you can expect the following results.

What to Expect After an Abnormal Pap Smear Treatment

Just like any other surgical procedure, you may experience some post-procedural symptoms. While every patient and treatment is different, there are common symptoms you may experience.

Post-Surgical Pain

After your treatment, you may experience some slight pain. This is normal and can be treated with painkillers such as ibuprofen. If your pain continues past a week, you should see your gynecologist.

Bleeding or Discharge

Bleeding and discharge can occur after treatment for about four to six weeks depending on the treatment method.

If the discharge or bleeding lasts longer than what your gynecologist suggested, then you should contact them right away.

While it is recommended to get these treatments in between periods, if you have to get the treatment during your period, then heavy bleeding should be expected.

Get a Pap Smear with Whole Health JC

As we mentioned before, pap smears can uncover many different cervix issues. The sooner the abnormalities are detected, the easier it is to treat them.

That is why it is important to regularly see a gynecologist for a pap smear, especially if you are sexually active.

Looking for a gynecologist you can trust and feel comfortable with? Dr. Jennifer Su can help you take control of your cervical health.