I was today years old when I learned the 'why' behind getting a pap smear. I always used to look at it as one of my annuals that I booked an appointment for, propped up my legs, braced for the discomfort of the speculum, and just did. I knew it was for my health but for some reason, it never clicked for me that a pap smear had everything to do with being preventative and was mostly about your cervix. Even as a 31-year-old who had a LEEP procedure done to remove precancerous cells nearly a decade ago, the dots never totally connected for me that ‘pap smear’ is to the cervix and cervical cancer as ‘mammogram’ is to breasts and breast cancer. Don’t come for me, but I was simply doing what I was ‘supposed’ to do without thinking of the bigger picture as it relates to my health and preventative measures like annual pap smears.
Coming to terms with that realization is actually what led me to write this piece. I realized that there was probably someone like me who was simply rolling with the punches of booking yearly doctor exams, or even someone who might not even go because they may believe going to a gynecologist is only for people who have “an issue” down there. I’m here to demystify some of the myths around pap smears. In honor of it being Cervical Cancer Awareness Month, I am here to also do my part in empowering women to advocate for their health needs, especially when it comes to a form of cancer with a 92% survival rate when diagnosed in its earliest stages. And do you know the easiest way to detect cervical cancer before it becomes cancerous? If you said ‘pap smear,’ you are right on the money.
I spoke with Dr. Janelle Howell, DPT, WCS, also known as the Vagina Rehab Doctor to help spill the deets on what you need to know about pap smears and cervical health.
What is a pap smear?
Perhaps it's elementary, my dear Watson, but I wanted to cover all of my bases when breaking down pap smears for this piece. A pap smear, or a pap test, is short for the Papanicolaou test. It is a diagnostic procedure that tests for cervical cancer in women. A doctor takes a small instrument to brush sample cells on the cervix and then sends those samples to a lab for the results. Once the samples have been tested, a patient can either get a normal test result (which literally means everything is all good under the hood) or an abnormal result (which could signify abnormal changes found on the cervix).
Depending on your doctor, they might suggest doing a colposcopy or a biopsy to ensure that the abnormal test result is not due to the presence of precancerous cells. If it is due to precancerous cells, the next step might be scheduling a procedure like a LEEP to remove those cells from the cervix. Your gynecologist will know best in regards to formulating a treatment plan that works best for you.
Anchiy/Getty Images
How often should you be getting a pap smear?
The answer to this question may differ depending on your medical history, but Dr. Howell shares that "generally speaking, about every three years is a good frequency to get one." She also adds that every five years, it is recommended to get an HPV test for the human papillomavirus, which is what leads to cervical cancer.
While Dr. Howell suggests people visit their gynos yearly, pap smear or no pap smear, she says that ultimately your specific gynecologist will be able to tell you how often you should visit and what the plan should be if you do have an abnormal pap test result.
When should we visit the gynecologist and what should we expect?
Although there are some people who prioritize regular checkups, there are others who do not have the privilege of accessible healthcare. There are also folks who might not resort to visits with healthcare professionals unless there is a problem or an issue. Such is the case sometimes with gynecologists. As previously mentioned, Dr. Howell advises women to visit their gynecologist yearly even if they don't have a pap smear or a symptomatic health issue or concern. During those routine wellness checks with your gynos, you are able to get things done like a pelvic exam where they exam the vulva as well as the internal reproductive organs, which includes the cervix. Dr. Howell adds that during these exams, gynecologists usually "do an internal exam, apply manual pressure along the abdomen to see if you have tenderness along the uterine border, and order any other needed tests or measures, like a pelvic ultrasound."
She also shares that even if they don't go through the uncomfortable steps of giving you a pap smear, they will look at the cervix and the vaginal canal. "Think about it like getting an oil change. You gotta pop in there every now and then, especially if you are sexually active. You want to make sure you are staying on top of your pelvic health, your reproductive health, and all of that because we are getting our periods monthly, we are in our reproductive ages, and we still have our uterus that needs to be checked on."
"If we are having a lot of clotting, if we are having a lot of pain with our periods, or having missing periods or irregular periods -- those are things that we want to be updating our gynecologist on, so they can make sure nothing more serious is going on causing those symptoms," Dr. Howell concludes.
At what age should you start getting pap smears?
The most common age to start getting pap smears is 21, but typically when a patient is sexually active, they are advised to start getting pap smears then. Of note, just because you aren't sexually active doesn't mean you shouldn't be getting regular pap smears, especially if you are over the age of 21.
This brings us to our next question and answer...
Should you get a pap smear even if you're not sexually active?
Sometimes, we look at doctor's visits from a lens of reactivity versus proactivity. Such is the case with gyno appointments. Sexual activity and/or vaginal health issues are not a prerequisite for gynecologist visits. But Dr. Howell encourages everyone to see the importance of getting pap smears, and even HPV tests, even if you aren't sexually active. "HPV can be transferred, not just from internal sources [like the penis and vagina] but you can get HPV just from skin-to-skin contact."
She states this to emphasize the point that sex is not the only way to get HPV, which is ultimately what leads to cervical cancer. "You can literally just have someone’s skin who has HPV contact your skin, then you are at risk of getting it. There are HPV cells that live on the vulva, that live on the penis, that live on the groin. There’s also oral HPV," she continues, "You don’t have to have sex to get it. So be aware of that."
HPV can even be transferred from mother to child through the vaginal tract, so children can get it from their mothers if their mothers have it. The bottom line is, just because you aren't sexually active doesn't mean you shouldn't be getting pap smears and regularly testing for HPV.
PeopleImages/Getty Images
How can you advocate for your cervical health in relationships and gyno visits?
If you are sexually active, the number one thing you can do to better support your cervical health is to use protection. Dr. Howell notes that using condoms during sex is "one of the most basic, affordable, and safe ways" to guard the cervix. By practicing safe sex "we are limiting the amount of exposure to bodily fluids and bacteria on someone’s genital skin that can impact our cervix. Exposure to someone’s bodily fluid or [the] skin of someone who has HPV is a common way to become infected. We generally get it from another person."
In instances where women want to feel empowered to go beyond the routine pap smear, Dr. Howell wants you to advocate for your cervical health by doing your research and talking to your doctor openly in order to feel confident and comfortable with your cervical health status.
What are some holistic ways to support your cervical health?
Supporting your cervical health can go beyond regular doctor visits, getting pap smears, and using protection during sex. It also looks like having strong sexual health boundaries overall, as well as making better lifestyle choices. "If our diet is filled with more inflammatory foods than anti-inflammatory foods, then that is not going to necessarily help the cervix. So like processed foods, those things are more inflammatory than fresh foods."
For that reason, Dr. Howell suggests doing things like adding "color to your diet." She goes on to say, "You want to make sure that you are getting more color in your diet from plants, which help us to fight inflammation and fight disease. That’s the whole purpose of food, to nourish our bodies." Speaking of diet, another key to nourishing your cervical health is by decreasing your sugar intake. "When I am saying sugar, I am talking about artificial sugar like the sugar that we are putting in our coffee, or the sugar that is in juice; it’s concentrated into one small cup. Artificial sugar and high amounts of it, have been associated with just more inflammation in the body, which includes the cervix."
In addition to watching the amount of sugar you consume, she suggests observing your vitamin A and vitamin D levels as they are "protective for the cervix." "We are eating every day anyway, so you might as well eat foods that help your body to thrive." And for a beta-carotene-rich food that is accessible as it is nutritious, Dr. Howell looks to carrots and says one carrot a day is enough to assist with vitamin A levels which are necessary for cervical health.
As a Pelvic Floor Physical Therapist, Dr. Howell knows the importance of considering the pelvic floor as a way to support the cervix. "Your pelvic floor includes all the muscles that support your cervix and supports your uterus to prevent prolapse. So, checking in on your pelvic floor for pelvic floor symptoms, like urinary leakage, a bulge in the vagina, a 'heaviness' in your vagina, or constipation -- these are things you want to consider in terms of your pelvic floor. Seeing a pelvic floor physical therapist is crucial to helping you overcome those symptoms and take care of your pelvic floor muscles, which are by far the most important muscle group for supporting the position of your cervix and uterus."
For more of Dr. Howell, follow her on Instagram @vaginarehabdoctor.
Let’s make things inbox official! Sign up for the xoNecole newsletter for daily love, wellness, career, and exclusive content delivered straight to your inbox.
Featured image by Natalia Gdovskaia/Getty Images
RELATED
While speaking to xoNecole, Eva shares that she’s a lot like the beloved 1994 character in many ways. “Lyric is so me. She's the odd flower. A flower nonetheless, but definitely not a peony,” she tells us.
“She's not the average flower you see presented, and so she reminds me of myself. I'm a sunflower, beautiful, but different. And what I loved about her character then, and even more so now, is that she was very sure of herself.
"Sure of what she wanted in life and okay to sacrifice her moments right now, to get what she knew she deserved later. And that is me. I'm not an instant gratification kind of a person. I am a long game. I'm not a sprinter, I'm a marathon.
America first fell in love with Eva when she graced our screens on cycle 3 of America’s Next Top Model in 2004, which she emerged as the winner. Since then, she's ventured into different avenues, from acting on various TV series like House of Payne to starring on Real Housewives of Atlanta.
Je-Caryous Johnson Entertainment
Eva praises her castmates and the play’s producer, Je’Caryous for her positive experience. “You know what? Je’Caryous fuels my audacity car daily, ‘cause I consider myself an extremely audacious woman, and I believe in what I know, even if no one else knows it, because God gave it to me. So I know what I know. That is who Je’Caryous is.”
But the mom of three isn’t the only one in the family who enjoys acting. Eva reveals her daughter Marley has also caught the acting bug.
“It is the most adorable thing you can ever see. She’s got a part in her school play. She's in her chorus, and she loves it,” she says. “I don't know if she loves it, because it's like, mommy does it, so maybe I should do it, but there is something about her.”
Overall, Eva hopes that her contribution to the role and the play as a whole serves as motivation for others to reach for the stars.
“I want them to walk out with hope. I want them to re-vision their dreams. Whatever they were. Whatever they are. To re-see them and then have that thing inside of them say, ‘You know what? I'm going to do that. Whatever dream you put on the back burner, go pick it up.
"Whatever dream you've accomplished, make a new dream, but continue to reach for the stars. Continue to reach for what is beyond what people say we can do, especially as [a] Black collective but especially as Black women. When it comes to us and who we are and what we accept and what we're worth, it's not about having seen it before. It's about knowing that I deserve it.”
This interview has been edited for length and clarity.
Let’s make things inbox official! Sign up for the xoNecole newsletter for love, wellness, career, and exclusive content delivered straight to your inbox.
Feature image by Leon Bennett/WireImage
Fortunately, five simple words have simplified my dating process and ushered in clarity faster: “Would my husband do this?”
A couple of years ago, I met an entertainment lawyer who was tonguing down a twenty-something-year-old woman for breakfast while I slurped my green smoothie and chomped on a flatbread sandwich. Okay, Black love, I grinned and thought as I sauntered out of the Joe & The Juice. As soon as I stepped down from the front door, a torrential downpour of Miami summer rain cascaded and throttled me back inside to wait out the storm.
I grabbed a hot green tea and vacillated between peering out the wet door and anxiously checking my watch. My lengthy agenda started with attending the Tabitha Brown and Chance Brown’s “Black Love” panel, and I was already late. That’s when the lawyer introduced himself to me, after he made a joke about neither one of us wanting to get soaked by the rain. His female companion had braved the storm, leaving us to find our commonalities.
We both lived in L.A. and had traveled to the American Black Film Festival to expand our network. He represented various artists, including entertainment writers, while I was working as a writer/creative producer in Hollywood.
While there is no shortage of internet advice on how to strategically meet a prominent man at conferences, if I spend my hard-earned funds on career growth, I have tunnel vision, and that doesn’t include finding Mr. Right. So, I stowed his contact details away as strictly professional.
Keep It Cute Love And Hip Hop GIFGiphyAs the humidity and mosquitoes were rising around L.A., two months later, another suitor-turned-terrible match cooled off after three unimpressive dates and a bevy of red flags. I posted what some of my friends called a thirst trap, but it was really me wearing a black freakum jumpsuit with a plunging neckline to my friend’s 35th birthday soiree despite feeling oh, so unsexy and bloated on my cycle.
I’d been waiting to post a sassy caption and finally had the perfect picture to match: “You not asking for too much, you just asking the wrong MF.”
That’s when the entertainment lawyer swooped into my DMs and asked me to dinner. I was quite confused. Is he asking me on a date? Or is this professional? Common sense would’ve picked the former. Once it clicked that this would in fact be a date, I told my mentor, who’s been happily married for over twenty years and has often been a guiding light and has steered me away from the wrong men.
Upon telling him about how we met, he emphatically stated, “He ain’t it.” He followed up with a simple question, "You have to ask yourself: Would my husband do this? Would you tell others that you met your husband, tonguing down another woman, and later married him?"
Aint It No Way GIF by UFCGiphyOuch. The thought-provoking question cleared any haze. Prior to going out with the lawyer, the first thing I inquired about was the woman.
“You saw that?” He said, taken aback that I’d witnessed his steamy PDA. Surely, anyone with two open eyes peeped him caressing her backside as he kissed her in the middle of the coffee shop.
He brushed her off as a casual someone he’d gone on a couple of dates with but had since stopped talking to. He said he hadn’t been in a serious relationship in over three years. Though I was still doubtful, dating in L.A. is treacherous and ephemeral. Making it past three months is considered a rarity.
With my antennae alert, I dined with him at a cozy beachside steakhouse restaurant where we were serenaded by a live jazz band. I’d emphasized forming a platonic friendship first.
Break Up Friendship GIF by TLCGiphy“I’ll come to you,” he obliged. I liked that he had made me a priority by driving over 50 miles to see me. I also liked the effort he made to check in with me daily. But I still couldn’t wrap my head around the fact that he initiated on a professional pretense and then alley hooped through the back door on a romantic venture, which bombarded me with confusion.
If there’s one thing I’ve learned in my dating life, God is not the author of confusion; any man who brings confusion, rather than clarity, is simply not The One. It doesn’t matter how many boxes he checks–eventually, that confusion will manifest itself into bigger problems, in time.
After diving into deeper conversations on the phone, post our first dinner date, I quickly realized this man was indeed not The One for me. But I’m grateful for the valuable lesson I learned.
I don’t expect some unattainable fairytale of a husband; we all have our own flaws and conflict is inevitable, but after dating for two decades, through failure and success, I’ve realized that the person I ultimately marry must mirror the values I exert into the world. He must reciprocate kindness, patience, and respect. He must be quick to listen and slow to respond. He needs to be forgiving and trustworthy, practice healthy communication, and be a man of his word at the bare minimum.
If I’d had “Would my husband do this?” in my toolbox when I was dating and floundering in stagnant relationships, in my twenties, it would’ve saved me a lot of precious time. But now that I’m equipped with the reminder, it’s allowed me to ground myself in my non-negotiables and set/maintain the standard for the special person, I’ll one day say, “I do,” to.
Let’s make things inbox official! Sign up for the xoNecole newsletter for love, wellness, career, and exclusive content delivered straight to your inbox.
Featured image by stockbusters/Getty Images