When should a cytology be done? one of the most common questions that women have in adulthood. It is unknown when to start having this type of test, if once sexual intercourse has started or not, how to be prepared, or know what happens next. The head of the Gynecology and Obstetrics service at Hospital Quironsalud Málaga, Andrés Carlos López, clarifies these questions.
What does this test consist of? It is a triple take from the bottom of the vaginal sac, from the external part and from the internal part to make three types of reading, the hormonal reading, and thus know the cycle of the woman; the second, the bacteriological, to see if there is any type of infection such as fungi or garnerella; and the third, which is the most important, to see the morphological alterations of the cells and to know whether or not there is some type of dysplasia or alteration of the cells.
According to the expert, the cells are sometimes altered by inflammation, by allergies, but other times they may be by the human papillomavirus (HPV). “So is when have altered cells. The important thing is to find out if it is or not because the follow-up is different from the search for precancerous cells. For this reason, there is time to provide a solution and they are precursor cells,” he points out.
“80% of the cervical cancers They are because they have never had a Pap smear. They have become cancer until they show no symptoms and when they do, it is late. One thing is the prevention of the neck and another the early diagnosis of cancer, which is done with Pap smears “, he adds.
Thus, it indicates that cytology in a woman with dysplasia, or tissue abnormalities, will have to be seen with altered cells. What’s more, she maintains that there are low or high grade injuries. “If they are low-grade self-removingbut if they are high-grade, a biopsy or a larger perforation or conization is done and often this is enough,” he adds. In the case of a deeper lesion, the uterus can be removed or a hysterectomy performed, but it is a “very extreme solution”. When to go?
“Years ago it was said that from the third year of relationships or from the age of 18 you had to go to the gynecologist to have a Pap smear done, but today it is very difficult for cervical cancer to appear before the 25 hence it is convenient to start them at this age”, underlines the specialist at Hospital Quirónsalud Málaga.
In her opinion, all women should undergo an HPV test at age 30, which if negative would have to be repeated five years later. “For women, they should all undergo a 30-year-old HPV test and then go every five years instead of annually. It will be launched in Spain soon,” she points out.
Of course, López warns that girls who have relationships from the age of 15 should not wait 10 years, until they are 25. “It is unbalanced and we will have to start earlier, although each community also maintains its characteristics, a different cohort is vaccinated from others about HPV,” he says. For this reason, she insists that, as a general rule, women should go for the first time to have a cytology after the age of 25, and some for their personal characteristics beforesuch as those who have an immunodepressant disease such as AIDS or a kidney transplant, or because they have started relationships at a very early age.
Although the periodicity can change According to each scientific society, the recommendation of the Spanish Society of Gynecology and Obstetrics (SEGO), in low-risk patients, is that a cytology be done at most 3 years after having started sexual relations, then every year for two years. and, if the results are negative, the screening can be spaced to once every three years. Tips for the test to go well
The expert indicates that, normally, to do the cytology you should go to the specialist without the period, since the bleeding creates a hematic background that prevents the doctor from seeing the cells. “The same happens with an infection that is with reddening of the mucous membranes or an increased discharge or with discomfort. In these cases the cytology will not be assessable and it is the same thing, bothering the women twice. The ideal thing is that they go in the best conditions,” he adds.
about having relationships in the days before, the doctor indicates that “there is no impediment” but if there have been no intercourse the cells are not contaminated with sperm or seminal fluid. “For example, there are women who are used to irrigating themselves with a knob, and they do it before the test, but it is discouraged,” he adds.
As to whether it is possible to do this test being pregnantthe gynecologist indicates that It is a good moment for this, but not because of being pregnant, but because they go to the specialist many times. In addition, she points out that in menopause you also have to have Pap smears, although there is a problem. “If it is established for a long time, the vagina atrophies because it lacks hormonal stimulation and the basal cells can be confused with dysplastic cells,” she points out.
Andrés Carlos López concludes that, sometimes after a cytology, if the neck is eroded when scraping to take the sample, a little blood can be stained, “but no type of care or treatment is needed and relations can be maintained in the the same day”.