Abnormal Pap Smears | Santa Fe OBGYN

If you’ve been told your Pap smear came back abnormal, it’s completely normal to feel a little nervous. But here’s the good news: an abnormal Pap result doesn’t mean you have cancer. In fact, most of the time, it means something minor was picked up—something we can monitor or treat early. At Santa Fe OBGYN, we’re here to guide you through what it means, what to expect, and what comes next—step by step, with clarity and compassion.

When you receive a call from our office asking you to come in to discuss an abnormal pap smear we understand your immediate concern and need for information. Please be aware that it is important that we discuss these results in person so that we are clear on the information we give you and can spend time to discuss your questions and concerns.

When abnormal Pap smear results occur, the experienced team at Santa Fe OBGYN provides compassionate, comprehensive follow-up care to thoroughly evaluate any concerns and determine the most appropriate next steps for each patient’s individual situation. Our caring and experienced OBGYNs and women’s healthcare staff prioritize clear communication and personalized care plans that may include additional testing, monitoring, or treatment options designed to protect your long-term health and well-being.

Abnormal Pap Smears
Santa Fe OBGYN

If you’ve been told your Pap smear came back abnormal, it’s completely normal to feel a little nervous. But here’s the good news: an abnormal Pap result doesn’t mean you have cancer. In fact, most of the time, it means something minor was picked up—something we can monitor or treat early. At Santa Fe OBGYN, we’re here to guide you through what it means, what to expect, and what comes next—step by step, with clarity and compassion.

When you receive a call from our office asking you to come in to discuss an abnormal pap smear we understand your immediate concern and need for information. Please be aware that it is important that we discuss these results in person so that we are clear on the information we give you and can spend time to discuss your questions and concerns.

When abnormal Pap smear results occur, the experienced team at Santa Fe OBGYN provides compassionate, comprehensive follow-up care to thoroughly evaluate any concerns and determine the most appropriate next steps for each patient’s individual situation. Our caring and experienced OBGYNs and women’s healthcare staff prioritize clear communication and personalized care plans that may include additional testing, monitoring, or treatment options designed to protect your long-term health and well-being.

Abnormal Pap Smears

What Is a Pap Smear?

A Pap smear is a screening test that checks for abnormal changes in the cells of your cervix. These changes are often caused by the human papillomavirus (HPV), a common virus that most people are exposed to at some point in their lives.

Pap smears help us detect early signs of:
• HPV-related cell changes
• Cervical dysplasia (precancerous changes)
• Cervical cancer (rare, especially when caught early)

What Is an “Abnormal” Pap Smear?

An abnormal result simply means that some cervical cells looked different from what we’d expect. It does not automatically mean cancer or even precancer. Types of abnormal results include:

• ASC-US: Atypical cells of undetermined significance
• LSIL or HSIL: Low- or high-grade squamous intraepithelial lesions (cell changes possibly linked to HPV)
• AGC: Atypical glandular cells
• Positive HPV test: High-risk HPV types were detected
Each of these results has different follow-up recommendations, which we’ll walk you through in detail.

What Happens After an Abnormal PAP Smear?

Depending on your result, after an abnormal Pap smear, our OBGYNs may recommend:

A repeat Pap smear in 1 year – if the changes are mild and often clear up on their own
HPV testing – to help us understand your risk level
A colposcopy – an in-office procedure to take a closer look at the cervix
A cervical biopsy – if we see areas that need more information

Whatever the next step is, we’ll explain it thoroughly and make sure you feel supported every step of the way.

What Is a Colposcopy Like?

If you need a colposcopy, don’t worry—it’s a simple, non-surgical in-office procedure.

• We use a special microscope to examine your cervix
• A gentle vinegar solution helps highlight any abnormal cells
• If needed, we may take a small sample (biopsy) for lab testing
• You can return to your normal activities the same day

It’s usually quick, and while it might feel a bit uncomfortable, it shouldn’t be painful. We’ll let you know exactly what to expect before, during, and after.

Cryotherapy

Cryotherapy is a freezing technique using nitrous oxide (liquid nitrogen) to treat persistent abnormal cellular changes of the cervix. The procedure is usually performed in the office and requires no anesthesia.

If your pap smear continues to have mild abnormal changes, we might recommend treating this by freezing the surface abnormal cells of the cervix to remove the abnormal cells and allow healthy cellular healing.

LEEP

LEEP Procedure is a treatment for high grade dysplasia. It is done in the office with a local anesthetic block of the cervix. We use a wire loop electrode to remove the surface abnormal cells of the cervix. The procedure is tolerated very well and no down time is needed, however, many patients prefer to make their appointment at the end of the day and go home after the procedure. We are removing a 5 mm depth biopsy of the surface of the cervix to remove all the abnormal cells. Due to a small preterm labor risk associated with LEEP, we do recommend cervical length ultrasounds in pregnancy.

Abnormal Pap Smears

Abnormal Pap Smear

There are three different categories of abnormality in the pap smear that are based on the level of cellular change that has occurred. Normal squamous cells have a small nucleus and a characteristic appearance. Atypical cells have a slightly larger nucleus within the cell. Atypia is a step in the progression to abnormal cells or dysplasia, however, atypia can also be caused by having sexual intercourse prior to a pap, use of tampons prior to a pap, or a vaginal infection such as yeast at the time of the pap smear. Menopausal women can also have an atypical pap smear due to lack of estrogen in the vagina.

Dysplasia is a term used for abnormal cellular appearance in which the squamous cells of the cervix have a much larger nucleus and abnormal cellular appearance. We characterize abnormal pap smears as having either low grade or high grade dysplasia. Low grade dysplasia will often heal on its own in 70% of cases. High grade dysplasia is less likely to heal without treatments that are done in the office setting.

When we identify abnormal cells by pap smear, we proceed to a more accurate test called colposcopy. Colposcopy is done by looking at your cervix under a microscope to identify abnormal appearing cells or blood vessel changes of the cervix. When we see areas of concern, we take small pinch-biopsies of these areas and send the tissue to a pathologist who is able to more accurately evaluate the cellular abnormalities.

The procedure is very well tolerated in the office. You might want to take two ibuprofen tablets 200 mg prior to the procedure, but you would return to routine activity after the procedure. We do advise pelvic rest, no tampons or intercourse for 5 days after the procedure to avoid infection of the biopsy sites.

Human Papilloma Virus (HPV)

HPV is a virus that is transmitted via sexual activity. There are dozens of different strains of HPV virus and they fall into low risk and high risk categories. Low risk HPV is associated with genital warts. High risk HPV is associated with abnormal pap smears with HPV 16 and 18 being the higher risk types. HPV is very common and has no symptoms of a sexually transmitted disease. There is no vaginal burning, itching, or discharge. Often, the first time you will know you have HPV is at the time of pap testing. HPV is not a routine test for STD screening, it is primarily done in combination with the pap smear. Men are not routinely tested for HPV, but they are carriers of the virus.

If you are positive for HPV, we will not be able to tell you when you contracted HPV. The virus can be present for years, although, it is thought that HPV will clear from your system within a few years. There is no specific treatment for HPV, however, we do recommend optimizing your immune system function to help your body clear the virus. This consists of a healthy diet, routine exercise, regular sleep patterns and stress reduction.

The Gardasil HPV vaccine is recommended for individuals aged 9 to 45 years. Gardasil protects against 90% of the high risk strains, so there is still risk of contracting the HPV strains that it is not effective against.

A diagnosis of HPV is very stressful for many patients as they worry about their own personal health as well as the potential to transmit the virus to a partner. Unfortunately, it is thought that condoms may not be protective against HPV due to the small size of the viral particle. We understand your concerns and want to reassure you and your partner that this diagnosis is concerning, but with monitoring and evaluation, it is unlikely that there will be any long term consequences from this diagnosis. The virus will often clear from your system spontaneously and with recommended monitoring, we will identify and treat the cervical cellular changes caused by HPV before there is progression to cervical cancer.

Abnormal Pap Smears | Santa Fe OBGYN

Abnormal Pap Smears Santa Fe OBGYN

Abnormal Pap Smears

What Is a Pap Smear?

What Is an “Abnormal” Pap Smear?

What Happens After an Abnormal PAP Smear?

What Is a Colposcopy Like?

Cryotherapy

LEEP

Abnormal Pap Smears

Abnormal Pap Smear

Human Papilloma Virus (HPV)

Abnormal Pap Smears
Santa Fe OBGYN