What Constitutes a High-Risk Pregnancy?
Some pregnancies need closer attention than others. Knowing what makes a pregnancy high-risk helps you feel more informed, more prepared, and more confident about the care you need.
My Pap Smear Was Abnormal. Now What?
In the United States, around 3.8% of women undergoing a Pap smear get an abnormal result. Learning that your Pap smear is abnormal will likely fill you with dread. Most women immediately think of cancer, but here’s what’s important for you to know: an abnormal Pap smear doesn’t mean you have cervical cancer.
Pap smears help us detect changes in cervical cells early, often long before they become serious. At Dunwoody OBGYN, Alvin Sermons, MD, and Lisa Price, MD, help patients understand their results and take them through the next steps.
What an abnormal Pap smear might mean
A Pap smear checks for cell changes in your cervix, which is at the opening of your uterus. During your visit, we gently collect a small cell sample and send it to a lab for review.
If the lab finds cervical cells that don’t look as they should, your result may come back as abnormal. These changes can range from very mild (atypical squamous cells of undetermined significance) to more concerning ones, such as high-grade squamous intraepithelial lesions.
An abnormal result tells us that your cervix needs a closer look. It doesn’t give a final diagnosis by itself.
Causes of abnormal Pap smears
Several things can cause abnormal Pap smear results. The most likely cause is human papillomavirus (HPV). HPV spreads through sexual contact, and it’s extremely common. Most sexually active people get HPV at some point, often without knowing it.
In many cases, immune system activity clears HPV naturally; however, some types of high-risk HPV can cause cervical cell changes over time. These changes may lead to cervical cancer if they don’t receive monitoring or treatment.
Other possible causes of abnormal Pap results include:
- Inflammation or irritation
- A recent infection
- Hormonal changes
- Recent sexual activity
- A yeast or bacterial infection
- Changes after menopause
Sometimes, the lab can’t read the sample clearly, in which case you may need another Pap smear.
Next steps after an abnormal Pap smear
Your next step depends on your age, your Pap result, your HPV result, and your health history. We review these details carefully before recommending anything.
Many mild changes go away on their own, especially in younger patients. Therefore, we may advise repeat testing in several months or a year. This gives your body time to clear HPV or heal from irritation while we continue to monitor your cervix.
If your results show higher-risk changes or if you test positive for high-risk HPV, we may recommend a colposcopy procedure.
Colposcopy explained
A colposcopy allows us to examine your cervix more closely. During this in-office procedure, you lie on an exam table just like you do for a Pap smear. We use a specialized magnifying tool called a colposcope to examine the cervix.
The colposcope stays outside your body. We may apply a mild solution to the cervix that helps abnormal areas stand out. If we see an area that needs more testing, we take a tiny tissue sample, called a biopsy.
You may feel pressure, cramping, or a quick pinch during the biopsy. Most patients return to normal activities the same day, though mild spotting or cramping can happen afterward.
A biopsy gives us more detailed information than a Pap smear. If it shows low-grade changes, we may continue to monitor you because many of these improve without treatment.
If the biopsy shows higher-grade changes, we may recommend treatment to remove the abnormal cells before they progress. Common treatments include a loop electrosurgical excision procedure (LEEP), which removes a small amount of cervical tissue to extract abnormal cells while preserving healthy ones.
Lowering your risk of an abnormal Pap smear
You can’t prevent every abnormal Pap smear, but you can lower your risk of cervical cell changes.
Keep up with routine Pap smears and HPV testing based on your OB/GYN’s advice. Use condoms to reduce HPV exposure.
Avoid smoking, since smoking makes it harder for your body to clear HPV. Ask about the HPV vaccine if you haven’t received it or didn’t complete the series.
Most importantly, don’t skip follow-up care after an abnormal result. The follow-up matters just as much as the screening test.
An abnormal Pap smear can feel unsettling, but it can also provide valuable information. It helps us spot possible problems early, monitor changes, and treat abnormal cells before they become more serious.
We support patients through every step, from Pap smear results to follow-up testing and treatment when needed. If your Pap smear came back abnormal, schedule a visit by phone or online with Dunwoody OBGYN’s board-certified gynecologists so we can explain your results, answer your questions, and help you move forward.
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