2 Q's: no period on pill & pap smears!

[in-this-love.livejournal.com]

Hey all,
i read this community religiously so please don't think I haven't searched the memories! I'm just a bit confused...

1. i have been on the pill (yaz) since December 07. Recently, in the past 3 months, i have had only VERY little spotting as a period. I'm not pregnant and it comes around the right time... but its hardly even noticeable. i know people have talked about this happening, but i don't know if it was on a BC like Yaz where you still are supposed to have a period. so is this okay?

2. I want to know when I should get checked out down there. I starting having sex in july 07 when i was 18. went to the gyno in december 07 and she said, since i just started having sex, there is no need for a pap smear or anything. she said something about it taking 3 years to show up. I recently went back, in april 09 (i had gone in between these don't worry) and i am now 20. she still said, it hasn't been 3 years, you don't need one. I understand her explanation, i'm just wondering if it is accurate. (shes a university health center doctor, so i hope she's not cutting corners because she's so busy or they have different policies, etc) All my friends i tell that i have never had a pap say i need to get one ASAP. even my mom said sexually active or not, you should get one when your an adult. please tell me what the truth is!
[disclaimer: I have gotten std tests before through urine, and i have been with the same partner since dec. 07.]

Comments

[melodic-lyrics.livejournal.com]

1. It's totally normal to have super light periods on HBC. That's part of the reason some women take it, to lighten their periods.

2. Usually the idea is you should have a pap after you become sexually active, or if you're 21. I'd ask to get one since you're sexually active, and would like to make sure there aren't any atypical cells on your cervix. If she still doesn't want to give you one and you'd like one, I'd consider asking another doctor.

[queensugar.livejournal.com]

Just for reference, the current US guideline is to start having pap tests three years after becoming sexually active, or at age 21; the guideline is sometimes worded as "within three years," but other sources are more clear that it should be after three years (http://www.kaisernetwork.org/daily_reports/rep_index.cfm?hint=2&DR_ID=19140) have elapsed since first sexual intercourse.

For the OP -- your doctor's advice is absolutely accurate and in keeping with current US guidelines. The reason for these guidelines is because it is extremely common for transient abnormal cervical cells to occur within the first few years of sexual activity in young females. The vast majority of these mild abnormalities heal up within a couple of years, and pose virtually no risk of becoming cervical cancer in that time. (It takes 7-10 years on average for initial mild abnormalities to become cancerous.)

In 2003, experts (including the American Cancer Society and more) revised the age guidelines to "age 21 or within 3 years of becoming sexually active" in order to reduce the number of unnecessary follow-up procedures occuring in females in that age group due to the frequency of these mild, transient abnormal cells.

Revising the guideline to "three years after becoming sexually active" means that the likelihood of any abnormalities resolving by the time of first pap increases, while the risk of developing undetected cervical cancer does not increase. Basically, it saves everyone time and trouble without risking the client's health.

[anni-hilation.livejournal.com]

1. HBC definitely causes periods to almost disappear in some women. It's totally normal and probably just means that the Yaz has thinned out your uterine lining enough to cause spotting instead of a full blown flow. Totally normal effect of the pill, even Yaz.

2. WOW I've NEVER heard that from a gyno before. I started getting regular Pap's done as soon as I became sexually active, which from what I hear is the norm (or if not sexually active, regular paps starting at 18-21). Pap smears are not solely for women who are sexually active. I would highly suggest getting a second opinion on that. I don't think the incubation period on any sexual/reproductive related health issue (STD's, STI's, HPV included) is three years. You said you've been tested for STD's, which is great, but Paps are used to detect any kind of abnormal cells on the cervix which cannot be detected in urine. Pap smears are an important part of female health regardless of sexual orientation, number of partners, or number of years of sexual activity. I would definitely take your mom's and your friend's advice and try to get one done soon. Good luck with everything! Hope that answered some of your questions.

[queensugar.livejournal.com]

In the United States, the current pap test guidelines (as revised in 2002-03) are to begin having paps at age 21, or three years after becoming sexually active. You can read that here (http://www.acog.org/from_home/publications/press_releases/nr05-04-04-1.cfm) from the American College of Obstetricians and Gynecologists; the American Cancer Society and other national health groups also agree by and were fundamental in developing these guidelines.

In other countries, the age is higher or lower (in England it's 25; in other parts of the UK 20; Canada still technically adheres to the old "18 or when sexually active" guideline, though more practitioners up here are adopting the new US guidelines).

And yes, pap tests are indeed primarily for females who are sexually active, since females who are not sexually active are not at much of a risk for genital HPV.

[atalanta0jess.livejournal.com]

Its not an incubation period per se, but the three year guideline is based on the idea that any cervical changes that require treatment would take at least three years to develop, and additionally, on the idea that catching changes sooner than that leads only to increased stress/intervention, and not to improved outcomes.

[https://users.livejournal.com/----hissunshine/]

I get a pap smear every year since i have been sexually active. I have never heard anything different advised.

[paraxeni.livejournal.com]

The advice about smear tests differs wildly depending on where you live.

[tritest.livejournal.com]

1) Sounds normal!

2) If that thing about 3 years applies, maybe I would not be alive then :| (I have moderate dysplasia and have only been sexually active for around half a year when I first found out). I definitely think you should find a doctor who would do it for you. Good luck!

[queensugar.livejournal.com]

The three year guideline does indeed apply, but it was established because it reduces the risk of unnecessary medical intervention without raising the risk of cervical cancer in young females who are newly sexually active.

You can read a good explanation as to why on this page (http://www.obgmanagement.com/article_pages.asp?AID=3450&UID=) from OBG Management:

Why wait 3 years after onset of intercourse for first Pap test?

Care is not compromised

Delaying screening until at least 3 years after coitarche does not compromise the diagnosis of high-grade lesions, yet does allow discovery and eradication long before they become malignant. On the other hand, screening young women sooner than 3 years after first sexual intercourse risks diagnosing numerous self-limited HPV infections and transient low-grade dysplastic lesions, which have very low premalignant potential.

[applefaerie.livejournal.com]

You have a right to get a PAP done. Please schedule it regardless of what the doctor says. If you'd feel more comfortable seeing a different doctor as a result of her dismissing your curiosity about it, definitely do. I got my first PAP done at 21, and I got badgered a bit about not having had one in 3 years this past time. I've moved around a lot in the past 3 years, and hadn't been sexually active in that time, and I hate getting them, and and and. But there's no real reason for me to not have gotten one done, they can generally be scheduled quickly when you call to get one, I got one done the same day I called to set up an appointment, this past time.
Frankly, with how sexually mature teens are getting these days, regardless of whether they're sexually active, it wouldn't surprise me if the guideline ages got lowered.

[atalanta0jess.livejournal.com]

"they can generally be scheduled quickly"

that varies widely from place to place. I've gotten paps the next day, but I've also waited months. :)