Birth Control and Pap Smear

[AlwaysCaring]

Is getting a pap smear required if you want to get on birth control?

Was it for you?

Will the doctor prescribe it without the person getting a pap smear?

Why? Or Why Not?

[Ditzy Mermaid]

I think it all depends on the doctor and the person. For instance if you are 21 or over and have never had one done then they probably are going to do one because it's required at the age of 21. If you are sexually active already and haven't had one in a couple of years they might give you one just to make sure everything is okay.

[FireHeart]

You don't have to have a pap smear until you're over 21. I'm not sure if it's the same in all places, but in Virginia that's the law. I know in some places it's 18. If you're sexually active getting one might be something to talk to your doctor about, however I don't think it would be a requirement for getting birth control. It wasn't for me, I just talked to my doctor and let her know why I wanted to be on birth control, we talked about any concerns about side-effects, how the birth control works, different methods of birth control and then afterwards I got a prescription for the pill. It was by no means nothing hard to get.

[BreathingIn]

Over 21 I think it's required, especially if you're sexually active.

They're not bad at all and it takes a minute. It doesn't hurt (it shouldn't), and you really don't feel anything.

Research doctors in your area online, thoroughly.

[BeautifulDisaster95]

Originally Posted by AlwaysCaring

Is getting a pap smear required if you want to get on birth control?

Was it for you?

Will the doctor prescribe it without the person getting a pap smear?

Why? Or Why Not?

When I got my birth control it was not required. It depends upon the doctor who is doing your birth control but you do have say in whether or not you would like a pap smear if you do not, that is okay. But it is a good idea to have one done and it isn't so bad, promise.

Take care!

[Coffee.]

Is getting a pap smear required if you want to get on birth control?
Not in most countries.

Was it for you?
No.

Will the doctor prescribe it without the person getting a pap smear?
They did for me.

Why? Or Why Not?
They can do an exterior pelvic exam, and for most people under 25 (especially if they're not sexually active), if the exterior pelvic exam comes up clear, it's a waste of time to get the sample and do all the tests.

[Kindred]

I had no smears, or observations or anything when I was put on birth control. I was asked a few questions but that was it. Simple stuff like "Do you bleed during sex?"

[Always *]

There is a standard practice around pap smears which is in that they don't usually do them until a woman is 21. That is, however, assuming that the said woman is not sexually active and that she isn't on birth control. For example, it used to be the standard practice to do the pap smears at 18, which they stopped doing because women that young are so low risk, including those who are sexually active. But it was also standard practice to do a pap smear 1 year after becoming sexually active, and as far as I know they haven't changed that rule just because now they are saying to do 1 at 21 instead of 18 because you should do 1 at 21 regardless of your sexual history/activity (I think it is recommended even if you are a virgin). I think you are also supposed to get a pap smear when you get a new sexual partner (or if you are like me, the 1 year conveniently occurred between partners since they let you get a pap 1 time a year unless something is wrong). However, even that rule has changed - because i am low risk I was told that I don't need to get a pap for 3 years now, even if I am sexually active, because a lot of the things that they can detect on a pap that are high risk (ex. cancer) are so slow growing that it would take a few years just to show up, so unless it is indicated (ex. you have symptoms) you can carry on.

With birth control, however, a lot of clinics require a pap. I don't really know why, but I think it is because birth control can increase the risk of things (blod clots, strokes, heart attacks and cervical cancers) but only if you have a family history of those things, and if you already have certain conditions then being on birth control can make it worse. I also think some clinics automatically assume that if you are using birth control that you are sexually active and I think they want a "normal" pap on file to compare to future things. Ok, to be fair I am not sure if either of those reasons are correct at all, it's just my best guess.


When I first got birth control I was 16 and 17 years old, and that clinic did not require a pap to prescribe birth control - I was told to come in 1 year for that because I was sexually active.

Then I moved to a new city - same province though.

When I was 18-22 I went to a clinic that did require a pap to prescribe birth control. However, I had 2-3 partners that summer and had recently started sleeping with the 4th guy, so I wasn't about to complain, I thought it was a good opportunity to get checked out just in case. Additionally, I had an irregular pap during the time period mentioned, which turned out to be nothing - but I am glad that I knew that was going on and that it was going to be ok because if it had been something and I was not getting annual paps I would't have known.

Then I moved to yet another new city - still the same province

So this is now 23+ and my new clinic did not require me to give a pap. I explained my history, including partners, paps, how long I used birth control for, that no one in my family has a history of clots, stokes, heart conditions, etc etc except my deceased grandmother who died in her 60's from a heart attack., I informed my doctor that I wanted her to run a panel for STI's and that I had a new boyfriend. It was not a big deal for her to comply and for her to provide me with the birth control - I think even if she would have insisted on a pap I would have said no, that I had just had a pap earlier this year, and to call the clinic where I used to live in order to retrieve those records (I would have had to sign a medical release consent form but still)


In the 1 clinic that required a pap, they only asked for it once and probably would have prescribed birth control indefinitely after that.

I think you can refuse to get a pap - just don't tell the nurses or people who book the appointments that, save it for the doctor because in my experience they get really grouchy and/or condescending when you say things like that, whereas the doctors are more likely to hear you out. This is especially true if you are under the age of 21, because it is stupid to make you get a pap just to have birth control if, for every other reason, you are not a high risk person.

I don't think it is a big deal if they want one though - I know that paps are awkward and uncomfortable, but I look at it as an opportunity to make sure that my lady business is healthy. So what if I have to spend a few minutes feeling horribly uncomfortable? At the end of the day I know that my lady business isn't secretly withering away inside of me

Research the provincial/state/federal laws where you live, and, if nothing else, make sure your doctor thoroughly explain the reasons before you allow any medical procedures to happen which you do not feel comfortable with or that you do not wish to have.

[Lelola]

The guidelines changed. Before it was when sexually active or 21 and it was yearly. They changed it to 21 regardless of sexual activity due to the risk of having a positive pap smear. When women are younger, they may have abnormal cells but the body is likely to correct it. More women were going through unnecessary tests and procedures. Hence why they upped the age and lengthened the time between them.

http://www.cdc.gov/cancer/cervical/pdf/guidelines.pdf


Now, you are still recommended to get tested for STDs which is a pelvic exam and possibly a blood draw yearly. Keep in mind that pap smears are not STD tests. STD tests are cultures whereas pap smears takes tissue to exam for abnormal cells.


For getting on birth control, it depends on the practitioner and what practice they currently follow. If they haven't updated their guidelines, then they may still want you to get a pap smear.


For the cancer risks, it hasn't been proven that the risk is greater due to the pills themselves. It appears to be greater but there are other factors that need to be addressed such as genetic, lifestyle (such as whether people use condoms), health history, and others. The oral contraceptive does not give women HPV which is what almost all of the cervical cancer was caused by. Further research is needed.



When I was sixteen, I didn't need a pap smear.

[Coffee.]

Originally Posted by Lelola

The guidelines changed. Before it was when sexually active or 21 and it was yearly. They changed it to 21 regardless of sexual activity due to the risk of having a positive pap smear. When women are younger, they may have abnormal cells but the body is likely to correct it. More women were going through unnecessary tests and procedures. Hence why they upped the age and lengthened the time between them.

http://www.cdc.gov/cancer/cervical/pdf/guidelines.pdf


Now, you are still recommended to get tested for STDs which is a pelvic exam and possibly a blood draw yearly. Keep in mind that pap smears are not STD tests. STD tests are cultures whereas pap smears takes tissue to exam for abnormal cells.


For getting on birth control, it depends on the practitioner and what practice they currently follow. If they haven't updated their guidelines, then they may still want you to get a pap smear.


For the cancer risks, it hasn't been proven that the risk is greater due to the pills themselves. It appears to be greater but there are other factors that need to be addressed such as genetic, lifestyle (such as whether people use condoms), health history, and others. The oral contraceptive does not give women HPV which is what almost all of the cervical cancer was caused by. Further research is needed.



When I was sixteen, I didn't need a pap smear.

I'm not sure this is accurate, at least not across all doctors. My gynecologist has still not requested I do a pap; I have no family history, my STI tests are negative, and my pelvic exams are coming up healthy. Therefore, he told me it'd be a waste of lab resources and my (lack of insurance) money to send it all in because the risk is so low.

[Lelola]

Originally Posted by Ignite

I'm not sure this is accurate, at least not across all doctors. My gynecologist has still not requested I do a pap; I have no family history, my STI tests are negative, and my pelvic exams are coming up healthy. Therefore, he told me it'd be a waste of lab resources and my (lack of insurance) money to send it all in because the risk is so low.

What part? You mean the part where I said before it was 21 and yearly? The before part implies that the guidelines have changed.

Are you questioning the guidelines posted to the CDC website? Those are accurate and up to date. They changed the rules I think in 2011? I forget when. However, your situation is different. You do not have insurance. The cost for lab work is very expensive for the uninsured. Ideally he should be following the guidelines posted by the different professional bodies but chances are he is factoring in the affordability of the test. Your doctor is being nice by remembering you are paying for tests out of pocket. Not every doctor remembers that.

Officially, most providers should up date their standards to follow the professional bodies recommendations as is posted on the CDC website. However, the providers do have discretion.

Are you questioning about how they test STDs vs what a pap smear is? A pelvic exam is not the same thing as a pap smear. A pap smear is not culturing for STDs. A pap smear and a STD cultures are done during the same time during a pelvic exam. Also, they are not testing for HPV unless they are doing a pap smear and that's only if they have an abnormal result with the pap smear. The blood tests are for syphilis, hepatitis, and HIV which they don't usually test for although HIV can be tested through saliva now.

Many women do not realize what is included with all of the tests. When they hear STD test, they think it is all inclusive but it's not. People will also think they are being tested for HIV or hepatitis when we draw blood in the ER. I have to explain no, it's a different test that the doctor would have to order.

Doctors do pelvic exams all the time in the ER. They occasionally do cultures which involve two specific cultures, one for bacteria and one for viruses. They do not do the pap smear.

Are you questioning about my correcting about how the studies do not prove that it was the oral pill that caused the increase in the risk of cervical cancer? Look up the research and read the end where it discusses the limitations of the studies. It's an issue of causation vs correlation.

[Jack Lowden]

I believe it's required if you've had sex. If you have not, likely no. A pregnancy test is required though.

[Coffee.]

Originally Posted by Lelola

What part? You mean the part where I said before it was 21 and yearly? The before part implies that the guidelines have changed.

Are you questioning the guidelines posted to the CDC website? Those are accurate and up to date. They changed the rules I think in 2011? I forget when. However, your situation is different. You do not have insurance. The cost for lab work is very expensive for the uninsured. Ideally he should be following the guidelines posted by the different professional bodies but chances are he is factoring in the affordability of the test. Your doctor is being nice by remembering you are paying for tests out of pocket. Not every doctor remembers that.

Officially, most providers should up date their standards to follow the professional bodies recommendations as is posted on the CDC website. However, the providers do have discretion.

Are you questioning about how they test STDs vs what a pap smear is? A pelvic exam is not the same thing as a pap smear. A pap smear is not culturing for STDs. A pap smear and a STD cultures are done during the same time during a pelvic exam. Also, they are not testing for HPV unless they are doing a pap smear and that's only if they have an abnormal result with the pap smear. The blood tests are for syphilis, hepatitis, and HIV which they don't usually test for although HIV can be tested through saliva now.

Many women do not realize what is included with all of the tests. When they hear STD test, they think it is all inclusive but it's not. People will also think they are being tested for HIV or hepatitis when we draw blood in the ER. I have to explain no, it's a different test that the doctor would have to order.

Doctors do pelvic exams all the time in the ER. They occasionally do cultures which involve two specific cultures, one for bacteria and one for viruses. They do not do the pap smear.

Are you questioning about my correcting about how the studies do not prove that it was the oral pill that caused the increase in the risk of cervical cancer? Look up the research and read the end where it discusses the limitations of the studies. It's an issue of causation vs correlation.

I apologize, I was not clear. I'm not questioning whether or not these are the guidelines, nor if they are effective/ineffective/based on research. What I meant by accurate was actually put into application. While these may be the guidelines, that doesn't mean that's what doctors actually do. I'm a 22 year old sexually active female in the US, and I have not had a pap, and my gynecologist didn't assume urgency in having me get one anytime soon with my background, pelvic exam, and STI test results. I'm uninsured, I have one sexual partner that I use condoms with, I have no family history of cancer of any kind, and it'd be expensive and likely unnecessary, so my doctor concluded that until some of this changes, it was unnecessary for a while. Pap smears are typically not required for birth control, but they are recommended at a certain age and sexual activity status.

I felt it was important to point out to the OP that it's going to be up to the doctor's discretion, and while these are guidelines, these are not rules for the prescription of birth control. I didn't feel your post was clear in saying that, so I apologize if I came off as questioning the data. I was simply clarifying that this may not always be the case in practice.