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This article was medically reviewed by Erik Kramer, DO, MPH. Dr. Erik Kramer is a Board-Certified Primary Care Physician at the University of Colorado. With over 15 years of experience, his clinical interests include obesity and weight management, diabetes care, and preventive care, as well as embracing a holistic approach to primary care. He received his Doctorate in Osteopathic Medicine (D.O.) from the Touro University Nevada College of Osteopathic Medicine and completed his residency at Central Maine Medical Center. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine.
There are 19 references cited in this article, which can be found at the bottom of the page.
This article has been viewed 44,447 times.
The human papillomavirus, or HPV, is an extremely common sexually transmitted infection. It often clears spontaneously without treatment, but it sometimes progresses to rectal or oral cancer, cervical cancer in women, and penile warts in men, which is why screening is important. Fortunately, tests can detect this virus very early on and prevent most cases of later complications.[1]
Steps
Method 1
Method 1 of 3:
Undergoing Initial Testing
Consider whether you're at risk for HPV. The main risk factor for HPV is being exposed to it from a partner, so you should be screened if your partner has shown symptoms. Depending on the type of HPV you've contracted, you may develop genital warts or warts on other parts of your body. These warts might appear as raised growths, flat bumps, or other types of lesions.[2]- People with HPV are often symptomless, and many types of HPV don't cause warts at all. Though you may not have symptoms, it's a good idea to get tested if you think you might have been exposed to the virus at any time.[3]
- If you have multiple sex partners, you should definitely consider being screened. Most sexually active people should be screened every 3-5 years.
Schedule a Pap test with your gynecologist. Your gynecologist performs this test regularly, so all you need to do is call and make an appointment. Let the office know that you think you may have HPV, and you'd like to be tested. You can also just say you want a Pap smear or a well-woman exam.[4]- HPV may not be checked with a pap smear if you’re under 25. If you’re 25 or younger, ask specifically for an HPV reflex test.
- If you don't have a gynecologist, ask your friends and family for a recommendation. If you can't afford an appointment, try a sliding scale clinic or a Planned Parenthood, which may offer their services for a low rate or for free.
- The Papanicolaou smear, or "pap smear," is a test used by a doctor to look for changes in the cells that line the cervix, which is the passage that connects the vagina to the uterus. It doesn't test for HPV directly, but any changes in its lining can suggest you have HPV.[5]
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Ask to have an HPV test done at the same time. The HPV test is performed in the same way as a Pap smear, so if you suspect you have HPV, ask if you can have a combination Pap smear-HPV test. That way, you don't have to go through the procedure twice.[6]- Keep in mind, though, that doing both tests will likely cost you more, so check with your insurance first.
Get undressed when the nurse asks you to. When getting this exam done, you'll likely be asked to undress and put on a gown. Then, you'll get up on the exam table and put your feet in stirrups so the doctor can examine you. This test is typically administered by family medicine physicians or gynecologists with the help of an assistant.[7]- Usually, the staff will leave the room while you get undressed.
Relax and expect discomfort, but not pain, during your examination. To begin the exam, the doctor inserts a thin, duck-bill shaped instrument called a speculum inside your vagina to hold it open. It shouldn't hurt, but it may be a little uncomfortable. Then, they will use a small brush (which looks similar to a mascara brush) or small spatula to brush the inside of your cervix and gather a few cells.[8]- The brush is then stirred into a preservative fluid or spread onto a slide and examined under a microscope to look for abnormal or pre-cancerous cells.
Wait for the results to come back from the lab. They should have your results within a week. If the results are abnormal, don't panic. The doctor will want to do some follow-up tests to figure out exactly what's going on. The HPV test will determine if you have HPV or not, and the Pap smear measures whether you have abnormal cell growth, which may indicate pre-cancerous growth.[9]
Schedule further testing if you have an abnormal pap smear, a positive HPV test, or both. If your Pap smear is abnormal and your HPV test comes back negative, you don't have HPV, but the doctor will likely want to do further tests to see what could be causing the abnormality– it could result from an infection, menopause, pregnancy, or pre-cancerous cell growth. If you do have a positive HPV test with a normal or abnormal Pap smear, that means you have HPV and you could be at risk for cervical cancer in the future. If you get these results, it's important to be screened frequently in the coming months to catch any early signs of cervical cancer. [10]- Even if you contracted HPV years before the test, but your body cleared out the infection, a negative HPV test combined with abnormal pap smear could still indicate the presence of pre-cancerous cells. In this case, make sure to schedule further testing even if you have not been sexually active for a while, or if you no longer test positive for HPV.
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Method 2
Method 2 of 3:
Scheduling Follow-Up Screenings
Get an HPV test every 3 years if you're under 30. When you're at this age, you should be screened for abnormal cells. However, because HPV is common and not curable, most doctors don't recommend automatically screening for HPV. While HPV can spontaneously clear up, there's no treatment for the virus once you have it.[11]
Have a Pap smear and HPV test every 5 years if you’re over 30. Until you're 65, you should still be screened regularly. Even having just a Pap smear every 3rd year may be sufficient, but if you're worried, you can add in the HPV test to help calm your fears.[12]- Most of the time, you can stop both Pap smears and HPV testing after age 65, unless you've had abnormal results in recent years.[13]
Discuss how often you should be screened based on your results. If you have abnormal results, talk to your doctor about whether you should be screened more often for changes in your cervical cells. Abnormal changes can take as long as 10 years to develop, but your doctor may want to screen once a year just to be safe.[14]- If you do have HPV, you can also be tested for HPV-16 and HPV-18 specifically, which are the most likely versions of the virus to cause cancer. If these tests are positive, your doctor will likely want to do more screening.[15]
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Method 3
Method 3 of 3:
Taking Further Steps to Protect Your Health
Understand that HPV may clear on its own. Often, your body will fight off this infection, and you won't have the condition any more within a year or two. Though it can clear spontaneously, there is no cure for the virus. However, you can take a vaccine to prevent it if you're sexually active.[16]- If you had warts with your HPV, they should clear once the infection has cleared. Otherwise, the only way to know if the HPV has cleared up is to get the test again in a year or so.
- You can get an HPV vaccine starting at age 9. Continue getting a vaccine until age 26 if you’re female or age 21 if you’re male.
Discuss if a colposcopy is necessary. With this procedure, the doctor will use magnification to take a close-up look at your cervix. That will help them decide if you need further testing, such as a biopsy.[17]- With this procedure, you'll need to be on the examining table with your feet in the stirrups. They will use a speculum to hold your cervix open during the examination. Then, they will rinse out your cervix to make it easier to see.
- The magnifying lens will not touch you. It's set slightly away from your body.
- You may feel some discomfort during the procedure, but ask if you can take an ibuprofen or naproxen beforehand to ease any pain.
Be ready for a biopsy during your colposcopy. If the doctor decides that something doesn't look quite right, they may want to gather a sample of tissue to be sent to the lab. This part may hurt a little. You might feel a cramp or a pinching sensation.[18]- You may experience a little spotting for a few days after the biopsy.
- Combined with the colposcopy, the procedure shouldn't last more than 10 minutes.
Ask whether you need pre-cancerous cells removed with a LEEP. This procedure, the Loop Electro-Surgical Excision Procedure, can be done by your gynecologist. They will give you local anesthesia and will then use a wire to remove some tissue from your cervix. The wire is hot so it may cause some pain after the procedure. However, you shouldn't feel it during the process.[19]- After this is done, you may have discharge for several weeks.
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Tips
- Make sure to get tested regardless of whether you're vaccinated or not. While getting the HPV vaccine does reduce your risk of acquiring infections from high-risk strains, it cannot completely prevent it.[20]Thanks
- Try to schedule the test when you're not having your period, as it can skew the results. However, if you have between-period bleeding, go to the appointment anyway, since they should be able to remove the blood and continue your screening.[21]Thanks
- In the 48 hours before a Pap smear, do not have sex, use tampons, or douche, as they can affect the test.[22]Thanks
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References
- ↑ https://www.cdc.gov/hpv/parents/whatishpv.html
- ↑ https://www.mayoclinic.org/diseases-conditions/hpv-infection/symptoms-causes/syc-20351596
- ↑ https://www.mayoclinic.org/diseases-conditions/hpv-infection/symptoms-causes/syc-20351596
- ↑ https://www.plannedparenthood.org/learn/cancer/cervical-cancer/whats-pap-test
- ↑ https://www.mayoclinic.org/tests-procedures/pap-smear/about/pac-20394841
- ↑ https://www.mayoclinic.org/tests-procedures/hpv-test/about/pac-20394355
- ↑ https://medlineplus.gov/ency/article/003911.htm
- ↑ https://www.mayoclinic.org/tests-procedures/pap-smear/about/pac-20394841
- ↑ https://medlineplus.gov/ency/article/003911.htm
- ↑ https://www.cdc.gov/cancer/cervical/basic_info/test-results.htm
- ↑ https://www.cancer.org/cancer/cancer-causes/infectious-agents/hpv/hpv-and-hpv-testing.html
- ↑ https://www.cancer.org/cancer/cancer-causes/infectious-agents/hpv/hpv-and-hpv-testing.html
- ↑ https://medlineplus.gov/lab-tests/human-papillomavirus-hpv-test/
- ↑ https://www.mayoclinic.org/tests-procedures/hpv-test/about/pac-20394355
- ↑ https://www.cancer.org/cancer/cancer-causes/infectious-agents/hpv/hpv-and-hpv-testing.html
- ↑ https://www.mayoclinic.org/tests-procedures/hpv-test/about/pac-20394355
- ↑ https://www.plannedparenthood.org/learn/cancer/cervical-cancer/what-colposcopy
- ↑ https://www.plannedparenthood.org/learn/cancer/cervical-cancer/what-colposcopy
- ↑ https://www.nccc-online.org/hpvcervical-cancer/cervical-cancer-screening/
- ↑ https://www.cdc.gov/std/hpv/stdfact-hpv-vaccine-young-women.htm
- ↑ https://medlineplus.gov/ency/article/003911.htm
- ↑ https://medlineplus.gov/ency/article/003911.htm
About this article
Erik Kramer, DO, MPH
Doctor of Osteopathic Medicine
This article was medically reviewed by Erik Kramer, DO, MPH. Dr. Erik Kramer is a Board-Certified Primary Care Physician at the University of Colorado. With over 15 years of experience, his clinical interests include obesity and weight management, diabetes care, and preventive care, as well as embracing a holistic approach to primary care. He received his Doctorate in Osteopathic Medicine (D.O.) from the Touro University Nevada College of Osteopathic Medicine and completed his residency at Central Maine Medical Center. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine. This article has been viewed 44,447 times.
Co-authors: 13
Updated: October 21, 2021
Views: 44,447
Article SummaryX
You’ll want to get tested for HPV, a common sexually transmitted disease, if you’ve had multiple sexual partners or if you or your partner experience any symptoms, like warts. However, many people with HPV are symptomless, so if you’re sexually active, get screened every 3 to 5 years. For those who are over 25 years old, schedule a combination Pap smear-HPV test with your gynecologist or at a sliding scale clinic, like Planned Parenthood. However, for those who are 25 or younger, a pap smear may not detect HPV, so you’ll need to request an HPV reflex test. If your tests come back positive for HPV, discuss follow-up screenings with your doctor. For more tips from our Medical co-author, including how to prevent HPV, keep reading!
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