The 7 Scary Conditions That Pap Smears Don’t Test For
By Megan Flemmit, photography by skadyfernix / Freepik
Make sure all your bases are covered.
By now you probably know that having regular pap smears is a must. They can be a bit uncomfortable, but they’re absolutely crucial when it comes to the early detection of cervical cancer.
Pap smears test for pre-cancerous cells on the cervix and the Human Papilloma Virus (HPV). Gynaecologist, Natalia Novikova, says 80% of sexually active people will have HPV at some point in their life. “Healthy people clear HPV viruses within 18- 24 months of acquiring them”, she says. “But in rare situations abnormalities in the cells of the cervix caused by HPV may progress to pre-cancerous and cancerous cells.”
Before you breathe a sigh of relief when your results come back normal, there are a few conditions that pap smears don’t test for, including certain sexually transmitted infections (STI’s) and other cancers. These conditions can be affect your reproductive health if left untreated. Novikova recommends doing extra tests to ensure that your reproductive health is in its best shape.
Chlamydia is one of the most common sexually transmitted infections. Symptoms include abnormal discharge, tummy pain, pain during sex, burning sensation when urinating. However up to 70% of women have no symptoms and may not know they have the infection. “If left untreated for a long period, chlamydia can cause infertility in women”, explains Novikova.
Gonorrhoea is another STI women should be aware of. While the incidence of gonorrhoea is highest among black women in South Africa, all sexually active women should be tested for it. As with chlamydia, symptoms of gonorrhoea are often absent. “Women who are having unprotected sex should be tested regularly,” says Novikova. “Left untreated STI’s can cause infertility, ectopic pregnancies and pelvic inflammatory disease.” Scary, right?
“A PCR test for chlamydia and gonorrhea can be done on the same specimen as the pap smear,” explains Novikova. “It’s the most reliable test,” she says.
Genital Herpes and Syphilis are two other STI’s that are not picked up by your regular pap smears. Both of them can be diagnosed by using a swab to collect fluid, which is then tested. While syphilis can be successfully treated with antibiotics, only the symptoms of genital herpes can be treated.
Ovarian Cancer is often referred to as the silent killer. It causes more deaths than any of the other reproductive cancers. About 250 000 women around the world are diagnosed with it every year.
Both cancers can be diagnosed with an ultrasound, a pelvic exam and a biopsy test. “Women who have experience any symptoms (abdomindal pain, irregular bleeding, bloating) should see a gynaecologist for a check-up,” Novikova recommends. Currently no screening test exists for either of the cancers. While those who have family members who have developed either uterine or ovarian cancer should consider genetic testing to determine if they too are likely to develop the condition, Novikova says that genetic testing is not required for the general population. “Whilst genetic testing is a viable option for some women it is not without consideration and counselling support,” she says.
Polycystic Ovarian Syndrome (PCOS)
PCOS is one of the most common causes of female infertility. It’s diagnosed when a women presents with two of the following criteria:
- Irregular periods or infrequent periods – this indicating the ovaries don’t regularly release eggs (ovulate)
- Blood tests showing high levels of “male hormones”, such as testosterone and
- Scans showing you have polycystic ovaries.
Novikova says if left untreated PCOS increases a woman’s risk of developing other health problems later in life. “Women who with PCOS are at an increased risk of developing type 2 diabetes, depression, high blood pressure, high cholesterol, sleep apnoea and uterine carcinoma.”