Age 25 – Pap Smear

These are two photos taken during a Papanicolau test (pap smear) done on a 25 year old woman 6 weeks postpartum.  A pap smear can detect potentially pre-cancerous changes (called cervical intraepithelial neoplasia (CIN) or cervical dysplasia), which are usually caused by sexually transmitted human papillomaviruses (HPVs). The test may also detect infections and abnormalities in the endocervix and endometrium.

In the top photo, you can see the metal speculum used to open this woman’s vagina and the wooden Aylesbury spatula used to collect a sample of the cells from the endocervix.  The spatula gently scrapes the area around the os in a circular motion to gather cells.  

The reddish area is called the “zone of transformation”  or squamocolumnar junction where the cervical tissue changes from one type of cell to another.  Though it may look inflamed, this is a normal appearance for some women.  This is the area from which the health care practitioner will obtain the sample for the pap test because it is the site where cell irregularities are most likely to be found.  The zone changes position at various times in one’s cycle, with age, pregnancy, or hormonal contraceptive use, sometimes tucking up into the cervical canal or blossoming outward towards the external os at other times, making it harder or easier to locate for the practitioner. When the zone is more external (as in this picture) some women may experience slight bleeding following a pap test or intercourse, simply because the capillaries are more exposed as well.

The bottom photo is of an endocervical brush being swiped in the os of the cervix.  The cells gathered on the brush and spatula will be wiped/smeared on a glass slide and examined in a laboratory or under a microscope to look for abnormalities.

91 thoughts on “Age 25 – Pap Smear

  1. Why is the opening of the cervix red? Is it from irritation from the scraping and swabbing, or is that what it looks like after someone’s had a child?

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    Chels Reply:

    Jes,

    That is called “cervical ectropion” or “cervical eversion”. What you are seeing is the endocervical epithelium (the layer of cells that makes up the surface of the inside of the cervical os) protruding out to the vaginal portion of the cervix. Think of putting hair up into a sock-bun where you roll everything inside-out; this is like the inside of the bun protruding out a little bit.

    It is a normal variation that is usually associated with higher estrogen levels such as during puberty, during pregnancy, and in women using a combined hormonal contraception. It’s not caused by the scraping/swabbing of the pap smear, and while some women do develop this during pregnancy, not everyone does.

    Cervical ectropion can, however, look like a neoplasm. So it is necessary to get a pap smear to make sure that it’s just normal cervical skin cells and not cancerous or pre-cancerous cell changes.

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    Maggie Reply:

    What you are seeing is the so called “zone of transformation” where the cervical tissue changes from one type of cell to another. This is not inflamed or irritated but a TOTALLY NORMAL appearance and in fact the correct spot where the health care practitioner will obtain the sample for the pap test. Interestingly, the zone changes position (and becomes easier/harder to visualize) at various times in one’s cycle, age etc. tucking up into the cervical canal at times and blossoming outward towards the external os at other times. When the zone is more external (as in this picture) some women may experience slight bleeding following a pap test or intercourse, simply because the capillaries are more exposed as well.

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    Jennifer Reply:

    At 6 weeks post partum many women are still bleeding similar to menstruation.

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    Katrina Reply:

    This appears like it is cervical ectropion/ectopy, a normal variety of cervical tissue where the tissue from inside the cervix is seen on the rim of the os. Can be related to adolescents, pregnancy or estrogen- containing contraceptives. A pap or cervical testing should not cause this redness, however with this cervical presentation, with cervical testing or manipulation of cervix (with penetrating vaginal sex) can cause mild bleeding.

    Cervical abnormalities and references also found in this website too
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031439/

    I’m a NP student and found this site with searching for cervical abnormalities and treatments, just finished my women’s health clinical, and I think this site is great! Especially the self-awareness and education about our reproductive anatomy! So many women came into the clinic and are so apprehensive about speculums and even birth control (vaginal rings) since this is such an unknown for them! Kuddos to this website and those behind it!

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    e Reply:

    The os is red because that part is the squamocolumnar junction…it is often red, but especially after dilation. Hope that answers!

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  2. Wow. Looking at these pictures, it seems like it is painful but I never feel a thing other than the speculum going in. I always wondered what it actually looked like and this is just the bee’s knees.

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    Nda YI Reply:

    Yes, you right! it seems very painful! that s why I was so scared to do pap smear. But forsake of healthy I encourage my self to do pap smear, and it was like `doing that` with my husband. I think it will be better to not see the picture before we try real pap smear… 😀

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  3. I think you ought to change pictures of sampling with aylesbury spatula as this is no longer used in liquid based cytology

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    Alx Reply:

    I work in a laboratory and some OB/GYNs still use the spatula and swirl it in the fluid as apposed to leaving the brush of the pap broom in the fluid. It’s all in preference.

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  4. Where I love they still use both sampling techniques, actually they have another two.

    Theres a swab like a large tongue depressor, a swab like a q-tip and these two.

    Every pap, I have felt all of them, and its excessively painful. I find female dr. s are much rougher as with the female twice she caused pain, and the man twice cause very little to practically none.

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  5. I always wondering what my cervix looked like and now I know. I agree with kaida female doctors do make a pap painful!! My obgyn is currently a male doctor who is really wonderful and I never feel pain from begginning to end during a simple pap smear!! big diff!!

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    lakeshia williams Reply:

    I have a female dr. And she is awesome she is very gentle and talks to me during the short process .. as far as a male dr. I don’t feel comfortable with him alone in the room with me

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    Randy Reply:

    I work for a physician’s software company and we implement all the time in OB/GYN..I was always told if your undressed doing a pelvic exam of any sort, it was law that a Med.Asst. or NP had to be in room with you, you could NOT be left alone.

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    Nda YI Reply:

    I think male or female obgyn is not related to make our pap pain or not. It is depend on the `quality` of the doctor. Although in my own experience, my female doctor was not so gentle in doing her job :-(

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  6. Hi, Kaida-
    Some women don’t experience pain during these procedures. Also, your statement regarding doctors is sexist- surely not ALL female doctors are rougher. That has just been your experience. I know many gentle female practitioners including doctors and midwives.

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  7. I have the opposite experience of docs – will always go to a female doctor if I have the chance! I’ve had much more painful pap smears with male doctors, but I agree it’s not possible to generalize. I think it’s up to each individual to find a doctor who seems sensitive and whom they can trust.

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  8. I read somewhere that a woman asked her male doctor why he seemed to be gentle with pap smears. He said something along the lines of “Well, if you punch me in the nuts, you know it would hurt, but you don’t know the type/amount of pain that I would experience. It’s the same thing with pap smears. I know it’s not comfortable, but I can’t experience it, so I just try to be as gentle as possible.”

    My female gynecologist is extremely gentle. I don’t experience “pain”, just discomfort. I like to believe she is as gentle as possible, especially knowing that she’s a woman and has had to experience the same procedure, too. It is very unfair to generalize; doctors should be treated as individuals, just like they should treat their patients.

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    jg Reply:

    it’s true though, I’ve been to 7 different ob/gyns, 3 of them women, all women were rougher, in fact one of them must hate women deep inside – that’s what came to mind when I was lying on my back. Needless to say, I use the services of a male ob/gyn now.
    Obviously, we have to differentiate here between stats and individual cases. I bet, if we did a survey, this would turn out true, but of course statistics have no information value as far as individuals are concerned.

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    Paul B. Reply:

    I attended a Pap smear “refresher” course some years ago where we were actually assessed on performing a Pap smear. In fact, the smear itself was not performed as it would be inappropriate to repeatedly traumatise the cervix of the volunteer (who was herself a nurse practitioner). I was however complimented on my gentle and respectful approach with the speculum.

    It certainly is my routine, to offer a mirror for the patient to visualise her cervix and vagina with the speculum in place, to continuously explain my actions (including the preparation of the slide and ThinPrep or such) and to respond to any indications of discomfort.

    It is a trifle difficult to explain exactly, but I tend to feel that many or most male doctors “respect” a woman’s genitals as having a sexual importance – indeed in much the same “respectful” way as they would (or should) approach their own wife (and yes, I have performed all but one Pap smear on my wife; I also recall an occasion of a Pap Smear Clinic a couple of years after we first qualified, when we were performing Pap smears “together” as it were, simultaneously in adjacent consulting rooms!).

    Female doctors (including to some extent, my wife) or Nurse Practitioners are on the other hand, deluged with women “preferring” a female examiner and frequently with a tale of woe in which they are often clearly at substantial fault. Such a combination of factors can cause the doctor or NP to be somewhat less than sympathetic, which may then be reflected in a more direct and “businesslike” approach to the examination.

    Very nice pictures of the Pap with ectropion demonstrated. Yes, the Ayres spatula is obsolete.

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  9. You have courage to post these images. I wonder if you have the courage to consider informed NON-consent to this procedure?
    All people are not idiots. We deserve to have the information, and then decide for ourselves if we want to participate in this.
    http://blogcritics.org/culture/article/unnecessary-pap-smears/
    By the way, I learned that having a pap-test is NOT required to get birth-control pills.
    Nice photos of cervixs, I’d like to keep ALL of mine thanks!

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    Molly Reply:

    I wish more of the medical community would go by the guidelines that are set by ASCCP, which states that a female doesn’t have to have a pap until age 21. These are the guidelines that I go by as a Nurse Practioner. But if a patient is sexually active she has to be tested for STD’s.

    The good thing about research like this is it helps us better understand the cervix and HPV. It research like this and pictures like this weren’t done then we would be still seeing a high incidence of Cervical Cancer.

    If you want to read about the research the was done on cervical cancer you need to read “The Immortal Life of Henrietta Leaks”.

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    Paul B. Reply:

    No Pap required until 21 (guidelines are being revised with a view to make that 25) or two years after first intercourse, whichever falls later.

    There is therefore, absolutely no reason for vaginal examination for any young girl requesting contraception with a view to becoming sexually active, which seems to be a common perversion practiced by American so-called “gynaecologists”. (“Droit du seigneur”)

    Cervical cancer is virtually invariably a result of persistent HPV infection and there are very few plausible ways of acquiring HPV in this area other than sex. Vertical transmission (mother to daughter at birth) has been postulated, but never demonstrated as an actual cause of cervical cancer.

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    Lina Reply:

    I would like to state that I’m 19, going on 20 years old and have cervical cancer. It is important to get it checked out. My first doctor said it’s unlikely I had anything wrong, and ignored my bleeding and cramping that happened all month long. My second doctor checked it out and listened to me and found it. Please don’t forget that it can happen at any age.

    Paul B. Reply:

    That is a most unfortunate situation indeed, to which I must necessarily be most sympathetic.

    It does not however speak against my comments above, for reasons which may be a little subtle.

    Firstly, in reference to the guidelines, there is necessarily an exception where sexual relations have started at a very early age and with many partners, which combination does carry such a greatly increased risk of cervical disease as to warrant Pap smears – beginning two years after initial sexual activity – even before the nominal “starting” age.

    Secondly, it remains that cervical cancer is sexually acquired and there is absolutely no need for Pap smears prior to sexual experience. {Exception – maternal DES exposure.}

    Finally, any woman presenting with symptoms such as bleeding that is evidently not menstrual, must be fully investigated by a gynaecologist and whilst such investigation may include a Pap smear, that does not by any means represent the totality of the investigation, in fact it is probably the least relevant part of such investigation. Cramping (pain with bleeding) would only occur in extremely advanced or aberrant cervical cancer and is more characteristic of other forms of uterine cancer which should not be confused with the type of cervical cancer which can actually be detected with a Pap smear. Adenocarcinoma of the cervix is generally not detected by a Pap smear but is probably the more likely type in a 20 year old.

    Lina Reply:

    Thank you I appreciate the clarification :) it helped me to understand your POV

  10. but i guess its kinda cool to see what your inside looks liek since we cant really capture this image on our own. i want to get into child birth do uu think i would see there cervix during this and how far up is it inside? is there any way people can check there own as show in this photo or something similar at home to see for healthyness?

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    Audrey Reply:

    You can feel your cervix if you place a clean finger into your vagina, it will feel similar to the tip of your nose.

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  11. I am a Womens Health Nurse.
    When doing a papsmear for a first time recipient i always ask if they would like to see their cervix. i carry a mirror in my outreach container for that purpose. I also ask most women if they have ever seen their cervix & if they would like to. i believe it is very empowering to see the body parts that are part of our femaleness… i also respect any answer i receive- if they choose not to thats their personal choice, so i never make anyone “do”anything they do not want to, including having a papsmear.
    also i prefer to use the words “the instruments gently touch the outside or the inside of the cervix” rather than use the word “scrape”(sounds a bit harsh to me)
    as for the male/female discussion- i would hope that the women providing paps are gentler. however i have heard arguments for both as “negative” as each other!! this may have to do with the outcome of “getting a satisfactory pap test result” “getting the endocervical cells” no justification for any woman experiencing “pain” or “bleeding for days afterward” if someone is too rough!! there is no need to be “rough”
    the cervix does have nerves that “feel”. the most common description is discomfort at the pubic bone area & a “funny tummy feeling”(like butterflies).these are normal responses to the cervix being touched- which makes the uterus contract-the feeling at the pubic bone, & the tummy feeling is related to the nerve supply from the sacrum of the spinal column which is related to the nerves from the belly button down- all this area is control by the sacral area of nerves. so these sensations are normal. & everyones interpretation of discomfort or pain is different as are their sensitivity of feelings in these areas.
    wonderful site!!! empowering!! thanks brigitte:)

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    Trisha Reply:

    I just recently had a horrible experience with an intern…that’s what brought me here…anyway…I’m glad to see some bleeding is normal during the brush swab…was a bit freaked out…I am 43 and my doctors have always had a very hard time finding my cervix…One Indian Doc even said to me..”He is hiding like a theif, but I will find him!”…So my question is why is that>?

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    Molly Reply:

    Each women is different. The cervix is never just right in the middle, it would make it a lot easier. Before you get your annual tell your provider that your cervix is hard to find. Also, it is so normal to cause bleeding with the brushes that are used. I usually tell my patients that they might have some spotting because of the brushes.

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    LisB Reply:

    That’s awesome, giving women the option to see their cervix during an exam. I’m 30, and didn’t know where it was/what it looked like until this week. Found it! Ha! I would have LOVED for my provider to ask me if I wanted a peek during an exam :)

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    Charlie Reply:

    Brigitte, that sounds great. If I ever get brave enough to return for a cervical smear, I will ask to see mine! (I have been put off having smears… I had a sample taken at hospital some years back when I was trying to find out if I had endometriosis and they cut my cervix with a scalpel to get a sample… even though I know that’s not what a normal smear is, it has made me too upset to want to do it again.)

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  12. To answer Miriam’s question: yes, normal, and PERFECTLY YOU!! Please do NOT let any one tell you different!

    This is GREAT site giving both information and strength to women. Please, PLEASE keep up the outstanding work!!

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  13. Pelvic exams are a sick sexist invention that identifies a disease very few women will actually die from. Womenhood is not a disease that needs to be monitored treated and cured. Read Male Practice: How Doctors Manipulate Women By Michael ?
    check out my video http://www.youtube.com/watch?v=pos8RHub2JY

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    Brittany Reply:

    wow I think your an idiot how in the world is it sick or sexist in the least bit?? guys get exams to. the gets there genitals checked and when there older the get prostate exams so I think you need to do a little more research before you say things like this.

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    Papsmear photos | Azwomeninblue Reply:

    […] Beautiful Cervix Project -Age 25 – Pap Smear »These are two photos taken during a Papanicolau test (pap smear) done on a 25 year old woman 6 weeks postpartum. A pap smear can detect potentially … […]

    Lorraine Reply:

    Hello –

    I came across your website while trying to find some answers to my condition.

    I am a 57 year old female who has never had children. I am in menopause, which has not been bad in itself. But my problem is that my os is narrowing and it makes pap smear exams very, very painful. I can only imagine that sex would be likewise. Is there a way I can stretch the os? Do I need hormone creams or be taking some kind of HRT?

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    Paul B. Reply:

    Technically speaking, it is not your “os” that is narrowing, because that is the opening of your cervix and you do not want to open that – a Pap smear simply samples what is at the opening of the cervix itself.

    What you are referring to is your “introitus” – the opening of your vagina itself. Two things keep this properly stretched, oestrogen and regular use – by having sexual intercourse (or “fingering” for that matter).

    I presume that you have had intercourse at least some time in the past, otherwise you would have no need for Pap smears at all.

    If you have no other menopausal symptoms requiring HRT, then patch or oral HRT would not be recommended, but an oestrogen cream (initially used daily for a couple of weeks, thereafter twice a week) applied specifically to the area of tightness would be an excellent idea, prescribed by your GP. {I have just last week prescribed this to a lady with a related problem – a urethral prolapse.}

    You will also want to gently and progressively dilate it to facilitate Pap smears and anticipated intercourse. Whilst dilators for the purpose might be obtained through medical supply companies, we have found it much more practical to visit one of the ubiquitous “sex shops” and select one or more inexpensive, unadorned, plain dildos that you judge to be appropriate, to be used with some lubricant (generally cheap at the supermarket).

    tanyetta Reply:

    Thank You for posting this. I have always wondered what the details were during paps. I have always held my breath, closed my eyes and prayed it was over in less than 5 seconds :)

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    LORETTA Reply:

    I showed my sis n law and she said wow. this site is incredable.

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    Loretta Reply:

    I’m just curious as to why something with bristles that looks like you would scrub dishes with it or something rough like wood would EVER be used…??!! I mean seriously a Q-Tip isn’t good enough? There’s no reason I should be “spotting” after this exam. I know that if a Q-tip was used instead of a rough bristled brush I wouldn’t bleed and wouldn’t be in pain during (and sometimes after) the exam. I know it would be just as affective too. They use q-tips for swabbing for DNA for heaven’s sake.
    Oh and as for seeing my cervix – I’m 25 years old, pregnant and have NEVER seen it. I have no desire to EVER see it. There is a reason somethings were put on the inside.

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    Susan Reply:

    The brush used is actually quite small – if you’ve seen those brushes that are made to clean around braces (they’re really small to get into those small spaces and brush out debris) – they are similar in size. They are also *soft* bristled, and (I’m guessing) are able to pick up more cells than a cotton swab. Anyway, this brush definitely wouldn’t be able to clean your dishes. 😉
    My guess is that the pain you’ve felt has to do with the doctor’s technique rather than the implements. I would communicate with him or her about the discomfort you’ve experienced and/or find a new care provider if they are not more sensitive and gentle.

    mariah Reply:

    hay everyone im 17 and i had my first pap smear a month ago……then 5 days later i had another onne………the reson why is because i was bledding for 49 days straight and they wanted to see if anything was wrong with my vagina i was scared as hell and the 1st one was a male doc at ecmc it hurt soooooo bad i yelled when he put it in me…..the 2ed one was a female and it didnt hurt as much but then she had to put her finger in me too……………it didnt hurt as much but anyways im better now and those vaginas look werid does mine look like that and btw im african american / black wel bye

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    Heather Reply:

    i would say everyone’s first pap smear is probably the most uncomfortable one. The fact that your second was only 5 days later might have had something to do with the fact that it was a lot less uncomfortable. And it is important to try to relax, as hard as it sounds. It will be less uncomfortable that way.

    Habeebah Sulaiman Reply:

    Am so happy i found ds website,am 30 nt marrid scared of sex coz i wz told is very painfful. Tanx 4 ur comments!

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    Maria Reply:

    omg so thats what they were doing. My first cervix exam was done by a student who didnt do it right, and i didnt know what was about to happen, second one i had was almost relaxing and done by a great doctor. apparently was difficult cuz i have an inverted cervix…i was wondering wtf they were doing down there xD

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    Joanna Reply:

    hey everyone, i’m 18 and I just had my first pap smear ever today. During the extreeeeeemely awkward and somewhat painful procedure, my cervix started to bleed. Is it common to bleed your first time, because my doctor was kind of taken aback by it (which was not 100% comforting). Has anyone else had that happen?

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    Heather Reply:

    others on this site have been saying that bleeding may occur and is nothing to be alarmed about

    sheena elaine Reply:

    I love to learn and view pictures thank you so much for the insight :)

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    Susanne Reply:

    38yr old virgin here. Yes, I get paps, because the doctors say I need screened anyway. I assume they don’t believe that I have never had any sexual contact of any kind.

    Anyway, the part of the pap that actually hurts me is the end of the speculum poking my innards. That hurts. The rest is just a bit uncomfortable (hooray for the pediatric speculum!). I’m sure I don’t help by clamping down with my muscles, but it feels like it will hurt more if I don’t. Any advice?

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    Heather Reply:

    the doctors always say that as hard as it sounds, you do need to try to relax so it wont be as uncomfortable

    Heather Reply:

    I gave birth in October 2007 and I had a LEEP procedure done in 2008. This past September (2011) we started trying to get pregnant again and several times I experienced sore breasts and cramping almost immediately after ovulation leading me to think I was pregnant but then my periods would always start right on time. In May my breasts were even quite swollen but my period started on time and the swelling went away. This past month we did not have sex during ovulation and I am not experiencing sore breasts or cramping at all. I’m starting to wonder if I have been mis-carrying all this time. Does that seem possible?

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    beautifulcervix Reply:

    Hi. Its possible. I highly recommend you chart your cycles- both your cervical fluid and your basal body temperature — you will get a whole lot of information from that and will know if you are miscarrying. Check out Garden of Fertility or Taking Charge of Your Fertility.
    http://www.beautifulcervix.com/resources/

    Mark Dowling Reply:

    Paul B.

    You said: “I have performed all but one Pap smear on my wife…” Why is this? Would you allow another doctor to perform a Pap smear on your wife? How does she feel about you performing Pap smears on other women? Do you even feel aroused when looking at women intimately?

    Just interested…

    Regards, Mark.

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    Neli Reply:

    A pap is nasty test all around, whether is performed by a male or female. I hate paps, but have to do it. I love being a woman!

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    Mark Dowling Reply:

    I’m hoping you can help me understand… I find it difficult to see how a hetrosexual male could ‘switch off’ from the sexuality of the sight before him when performing a pap/smear on a healthy young woman? I had presumed that we men are ‘hard wired’ to respond to the sight of a healthy woman, naked, with her legs apart before us? Hope you can help as I worry when my wife goes, thanks. Mark.

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    kacee Reply:

    Trust me, Mark. Perhaps it’s the feeling of a cold, metal speculum being rammed between our legs but there couldn’t be a bigger turn-off then that!! All sexual feeling gets driven far from our minds. I don’t think you have anything to worry about. Make sure your wife finds someone who is professional. And I don’t think the gender should matter.

    Clara T Reply:

    I am 23 and have been having irregular bleeding so when I went to my GP she suggested a smear, I was half way out of the door when she explained she meant there and then! I wasn’t expecting it or prepared (!!!) but let her do it as I was already there.

    This was my first smear and there I was (without a cloth or anything) half naked, very embarrassed and she put the speculum in. It broke!!!!! There was a massive snap and the plastic shattered!

    I have to say my GP was extremely apologetic and she is lovely but has anyone experienced a broken speculum before? It has rather put me off having another smear in future! Also there was a TONNE of blood on the little brush and she said something about a polyp.

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    Sarah Reply:

    Ok, so you only have to have a pap smear done only if you are sexually active? I am 17, my friend is 18 and she said she just had hers done, and I was wondering if I will have to have one soon, or if it is just for active women. Really nervous about the whole thing, so please someone make me feel a little better. :(

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    Sarah Reply:

    And another question, in the first picture, I see the patient is bleeding. Is that normal? Does everyone bleed when they have theirs done?

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    beautifulcervix Reply:

    No. Most women don’t bleed. This woman gave birth recently.

    bluesbird Reply:

    This is another question about tightness of the introitus that was addressed earlier:

    “Paul B. Reply:
    December 5th, 2011 at 9:07 pm

    Technically speaking, it is not your “os” that is narrowing, because that is the opening of your cervix and you do not want to open that – a Pap smear simply samples what is at the opening of the cervix itself.

    What you are referring to is your “introitus” – the opening of your vagina itself. Two things keep this properly stretched, oestrogen and regular use – by having sexual intercourse (or “fingering” for that matter).”

    I had a good healthy sex life until I began treatment for severe endometriosis in my late 30’s. I had Lupron treatment and 3 surgeries over a period of about three years, and finally had a complete hysterectomy (leaving cervix and vagina) and ovaries also taken out because of chocolate cysts. Through all of this I developed extreme pelvic pain and horrendous pain with bowel movements because my endo was in the peritoneum and cul-de-sac area and could not all be removed. Of course sex became painful and impossible. I already had fibromyalgia and the hysterectomy completely disabled me.

    A couple of years after the hyst I tried estrogen replacement but had to stop because my pain returned, so I assumed I could never take any hormone replacement. Then my ten year relationship ended and I did not have sex for four years. I did not have another pelvic exam either because frankly I was sick of dealing with it.

    I started dating a man and on two separate occasions we attempted interccourse and it was not possible for him to penetrate me, even after hours of foreplay and manual orgasm. There was definitely no problem with arousal or lubrication, I was just so tight it could not be done. This REALLY upset me after, because I did not know why and was thinking I can never have a sex life again. I thought it was because of scar tissue from the surgeries, and also the fact that my rectum seems to be in an almost permanent tight spasm. At this point I became afraid that even a pelvic exam with speculum would not work. I can insert something about as wide as an inch in diameter, but not much more.

    It has now been four years after this last experience and I have not dated and I have not seen an ob-gyn. I am so fatigued and in chronic pain anyway from the fibro that dating is not really possible. I NEVER knew until I came to this page today that lack of estrogen could cause this. Is there any hope for me?

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    bluesbird Reply:

    Oh, I forgot to add that I am now 56 years old, and have never had children, so my vagina has never been stretched that far! It has been about 14 years since my hysterectomy at age 42. Do I even need to still have pap smears at this point? I have never had a negative smear or any other problem except the endo. Since age 38 I only had one sexual partner for ten years, and then the one who could not enter me. Can topical estrogen rekindle my endometriosis the same way that taking it orally does?

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    beee Reply:

    I went for a pap smear the other day the Dr was quite rough and used a plastic speculum when she inserted it it felt uncomfortable and felt like it was scraping and when she opened the speculum it felt like it was pinching. She spent some time adjusting the lamp and when she finally went to insert the brush she found that my cervix was full of blood. She removed the speculum and blood was literally running out of me. The bleeding stopped about 15 mins after my appointment and I have never had bleeding before my appointment. Has this happened to anyone else because my Cr was really shocked and didnt offer any explanation.

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    W Reply:

    Owing to hormonal balance issues (specifically, low on estrogen), I’ve been experiencing unusual amounts of female-parts-related dryness and generalized itching – no STIs, infections, yeast, etc – and also, much to my dismay, some narrowing and tightening of my vaginal opening and vagina itself.

    That said, having to do a PAP smear nowadays = potentially painful (which it never was before, but maybe I just have had good doctors) because of lack of natural lubrication and the tightening/losing of elasticity of my vaginal area and because of this, I decided to masturbate the night before my PAP exam to help get my own lubrication going and to help ‘loosen’ my vagina area so it wouldn’t be so tight.

    The end result was rather embarrassing; I nearly orgasmed during the manual part of the exam where he was examining my ovaries. On the other hand, the speculum insertion – though not entirely comfortable – was not painful and I hardly noticed the swabbing of my cervix.

    With everything okay (save for hormonal level issues, but my doctor is hesitant to address this as my family has a history of hormone-related cancers), I don’t have to have another PAP done for a few years now as I am no longer sexually partnered-active.

    That said, one of the things recommended to me in regards to tightening of the vaginal entrance and even canal is to continue the self-love to help keep things going.

    Though I never would have thought of owning one before, I now own two dildos – a double-ended one of a more narrow girth on one end with also a G-spot hitter and Kegal/PC exerciser on the other end, and a thicker girth one that I use after my body’s been warmed up a bit – and yes… giving my female parts regular attention really has helped to alleviate some of the problems I’ve had associated with hormonal level issues.

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    Paul B. Reply:

    “a disease very few women will actually die from”

    So it does not matter if they do?

    Unbelievably ignorant!

    {Some countries have very high levels of cervical cancer due both to poor medical care and widespread promiscuity. Pap screening has resulted in a massive reduction in cervical cancer incidence which as with immunisable diseases, means that people can now believe that prevention is apparently not a priority.}

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  14. They always struggle to find my cervix for my smear! Most recently I went around Day 10 for the smear and the nurse eventually found it – said it was ‘small’ and ‘facing the vaginal wall’. I’ve had one child (I’m 34), by section, and am TTC so hopefully this doesn’t mean much!
    Any ideas anyone?

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    Paul B. Reply:

    The semen will find its way!

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  15. Agree with Cassandra. Especially as I know that pelvic exams are only done on asymptomatic American and Canadian women. Don’t know why your female organs are so different to the rest of the world’s.

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  16. It is a very bad idea to have a pap smear 6 weeks after giving birth, you’re very likely to get a false positive due to trauma to the cervix and hormonal changes.
    A competent and responsible Dr would not test a woman shortly after giving birth – you should wait at least a year. (if you choose to have smears)
    Never agree to a smear while pregnant, you’re very likely once again to get a false positive.
    See: “Abnormal smears in pregnancy” CancerResearchUK site.
    Sadly the 1% lifetime risk of this cancer, combined with an unreliable test and greedy doctors means few women will keep an intact cervix. Most women by the time they’re 50 will have lost some healthy cervix with this testing. Low risk women have a near zero risk of getting cervix cancer.
    Even 5 yearly screening from 30 carries a 35%-55% lifetime risk of biopsies, almost all are false positives. This test would not be approved today without express informed consent.
    This cancer occurs as frequently as mouth cancer (“Screening” by A Raffle and M Grey) another rare/uncommon cancer. Yet most women now assume the cancer is common because of the high rates of false positives. Before testing few women had even heard of cervical cancer, since testing, all women who test share the burden through testing and false positives/biopsies, over-treatment.
    Do your research and protect your beautiful cervix from harm. the in-tact cervix is rapidly disappearing due to cervical screening and false positives.

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  17. I just got my self-examination kit, and I have a beautiful OS & Cervix! I am going to track my cervix for the next 30 or 35 days…..how exciting…. all hail the mighty cervix….

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  18. Cervix during orgasm as viewed on PBS five years late night: we all think of the cervix as a passive gatekeeper, a hunk of grissle that does little till it magically dialates during childbirth. Au contraire! This PBS film clip of the cervix during mutual orgasm was amazing! The cevix morphed into what only could be described as a marine sea slug that reached out and sucked/vacuumed up/ the semen and retreated back into her uterin lair. I did not personally see this PBS/Science channel documentary. My wife saw it, and, because she was miffed at me at the time, she did not wake me, nor did we have a DVR. I almost believe her, but she is famous for spoofs and practical jokes. I hope someone out there can confirm the PBS/Science channel documentary actually was broadcasted, or at least confirm that the cervix plays this important role in human Darwinian natural selection.

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    Beck Reply:

    i think the programme you are talking about is called The Human Body, it is a series that was on television as well, it now comes on DVD. You are right the cervix did dip up and down into the pool of semen it was quite amazing. Your wife is telling the truth.

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    Chanel Reply:

    Your wife is right about this one. There is also a video that I watched when I was taking Human Sexuality called “The Biology of Love” that shows the cervix during orgasm as well.

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  19. A common sense would tell us that if the dormant virus responsible for cervical cancer is present at the spot of the test it can get rubbed in to the cervical mucosa walls and actually trigger the cancer. Why is it that the USA do the most pep smears and have the highest cancer rates? Also the genital mutilation done on USA baby boys and with nothing left to protect the glans than it feel as a sand paper to the cervix as so many female report can also contribute to this cancer. Why is it that in my native Europe they do not circumcise or do so many pep smears they have less of this cancer? Paul

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    Paul B. Reply:

    Much as I sympathise regarding the hideous and barbaric practice of circumcision, there is no reason to imagine that the abrasion – as real as it may be – of a Pap smear or for that matter, the penis, would contribute toward cervical cancer.

    The USA does not have “the highest cancer rates”, they are similar to other counties in comparable socio-economic groups. There is no doubt whatsoever that more effective screening – and proper treatment – massively reduces the incidence of cervical cancer but that it is a sexually-transmitted disease and so it has a higher incidence in regions and countries where there is more widespread sexual activity with less use of condoms.

    The virus is not “dormant”. It is acquired – through sexual contact which on the cervix means penetrative intercourse – an infection occurs, the body’s immune system attempts to clear it and in most cases succeeds over a period of many months. If it fails to clear the virus, it becomes indolent and can then progress to cancer, but again not in all cases. There are other “promoters” for cancer of which the single most dramatic is smoking and acquiring more than one serotype of the virus is likely another; but there has never been any suggestion at all that Pap smears might do so.

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  20. So, do most women have visible SCJs? I have always been able to feel my cervix, but I’ve never seen it…and I’m thinking about following your photograph how-to. I’m 19, almost 20 and I check it at least once a month to make sure I don’t feel anything abnormal (I am a nursing student and a notorious hypochondriac :) ). I do have Nabothian Cysts that come and go, but recently felt an area around the inner rim of my cervix (the opening that leads to my uterus), that feels like different tissue..almost a gradient. I have no history of abnormal pap smears, as well as no known history of HPV. At what age does the SCJ change? Or does it ever change or grow outward? Could my SCJ have grown out further just recently, or could it be abnormal?

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    Molly Reply:

    I am a Nurse Practitioner and the tissue that you are feeling is Columnar epithelium, which is normal. When you cervix is changing at your age, squamous columnar epithelium starts covering the columnar epithelium. This is what we see with an ectropian. The SCJ will continue to move inward. Very normal what you are feeling. If my patients knew what i see on there cervix’s when I do a pap or colposcopy I think they would freak out.

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  21. Interesting. I have always found paps to be extremely uncomfortable, but I do like to have the test done for my own peace of mind and to serve as a baseline for comparison in the future. In my personal experience, I have found the two male OBs I have gone to were much gentler than the female OB I used to see.

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  22. since i live iin england there is a very high risk of dying from cervical cancer and since three have died in my family i choose to have them . not having them just means if you do have it then they dont catch it early enough and you DIE . awesome website keep the good work up

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    Rene Reply:

    Cervical cancer is a sexual disease, it’s coming from HPV, Human Pappilom Virus.
    Find it out by Google and ask your doctor.

    Here in Holland this woman start from here 30 years old start with cervix creeningsprogram by the goverment, they invite every 5 years for a sreening

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  23. From my personal experience, I would have to say that male doctors have always been more gentle with me than the female doctors. I will only see male doctors now for this reason.

    As to the “scraping” call a spade a spade…it’s scraping. You can say collecting as well…but in order to collect, you have to scrape.

    I hate paps! They hurt regardless who is performing them.

    I do love the website as it is very informative! Thanks!

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  24. Thankyou for this wonderful website – education removes fear – for a long time after my Lletz procedure I felt ashamed and tainted – a doctor even said to me that I had sinned with CIN – It was only through reading and research, educating myself about HPV that I have come to a good level of acceptance and understanding about my diagnosis and given myself back some self esteem – I now have a wonderful and supportive husband, two little boys and have been clear for seven years. I stick to yearly pap checks – and am so grateful of the photographs which have given me another level of understanding about my experiences and my body – Thankyou to all that have given of themselves to this site you will reach and help so many – it is a true gift Thankyou x

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