Women's Health

A PAP smear (Papanicolaou test) is a quick screening that collects cells from your cervix to check for abnormal changes, including precancerous cells, cervical cancer, and HPV-related changes. It's one of the most effective cancer screenings available.

• Ages 21–29: PAP smear every 3 years (HPV testing not routinely recommended)
• Ages 30–65: PAP every 3 years, or PAP + HPV co-test every 5 years, or HPV test alone every 5 years
• After 65: may stop if recent screenings are normal, discuss with your provider
• After hysterectomy: may not be needed if cervix removed and no history of high-grade lesions, ask your doctor

Guidelines may differ for those with HIV, prior abnormal results, or DES exposure, your provider tailors timing to you.

• Takes only a few minutes during a pelvic exam
• You'll undress from the waist down and lie back with feet in stirrups
• A speculum gently opens the vaginal walls; a small brush collects cells from the cervix
• Mild pressure or pinching is normal, sharp pain is not. Speak up if uncomfortable
• Light spotting after is normal
• Avoid intercourse, douching, tampons, and vaginal products 24–48 hours before
• Try not to schedule during your period if possible

• Normal (negative): no abnormal cells, continue routine screening.
• ASCUS (Atypical Squamous Cells of Undetermined Significance): slight changes, often from inflammation or HPV. Usually followed by an HPV test or repeat PAP in 6–12 months.
• LSIL (Low-grade Squamous Intraepithelial Lesion): mild changes, often HPV-related. Often resolves on its own; may need colposcopy or follow-up testing.
• HSIL (High-grade Squamous Intraepithelial Lesion): more significant changes that could progress to cancer if untreated. Requires colposcopy and often a biopsy or treatment (LEEP, cone biopsy).
• AGC (Atypical Glandular Cells): less common, requires further evaluation including colposcopy and possibly endometrial sampling.
• Cancer cells present: immediate referral to a gynecologic oncologist, early detection brings excellent outcomes.

An abnormal PAP does not mean cancer. Most changes resolve or are treated easily when caught early, that's the whole point of screening.

In your 20s

• Annual well-woman exam + pelvic exam
• PAP smear every 3 years starting at 21
• STI testing (chlamydia, gonorrhea yearly if sexually active; HIV at least once)
• Blood pressure, cholesterol baseline, BMI
• Mental health check-in
• Skin cancer self-checks

In your 30s

• PAP + HPV co-test every 5 years (or PAP every 3)
• Annual well-woman exam
• Thyroid panel, fasting glucose/A1c, lipid panel, vitamin D
• Clinical breast exam; baseline mammogram if high risk or family history
• STI testing as appropriate
• Eye exam every 2 years; dental cleanings 2×/year

In your 40s

• PAP + HPV every 5 years
• Mammogram every 1–2 years starting at 40 (earlier if high risk)
• Full lipid panel, A1c, thyroid annually
• Bone density baseline if risk factors
• Skin check with dermatologist
• Perimenopause symptom check-in

In your 50s and beyond

• Continue PAP/HPV per guidelines until 65 if normal history
• Annual mammogram
• Colonoscopy starting at 45, then per provider
• Bone density (DEXA) at 65 (earlier if risk factors)
• Shingles, pneumococcal, flu, COVID, Tdap vaccines as recommended
• Hearing test, eye exam annually
• Heart health: lipid panel, blood pressure, A1c

Keep a record of your screenings, dates, results, follow-ups, so you and your provider always know where you stand.

Suggested format: Date · provider · result (Normal / ASCUS / LSIL / HSIL / etc.) · HPV result · follow-up plan · next screening due.