I recently went to the gynecologist to renew my birth control prescription. I was told by two nurses that women on birth control pills need a pap smear every six months and that I was due for a pap smear. I had never heard of this before. I told them (1) I wasn’t sexually active, (2) I used the pill for pain management, and (3) I had a pap smear in June and it showed nothing out of the ordinary. They insisted I needed a pap smear and had me take off my pants. When the gynecologist came in, I explained the situation and she was nice enough to apologize for the nurses. However, she did say they performed pap smears more frequently on women who “had a lot of sex.”

I was (and still am) very confused. Does anyone have any thoughts on this?

Edit: I just want to thank everyone who commented. There was a lot of information and insight I hadn’t considered. The more I reflected on the situation, the more I was bothered by what happened, so I’m definitely going to look into switching gynecologists and filing a complaint.

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26 Responses to Frequency of Pap Smears

  1. NywNo says:

    That’s strange. I was under the impression it was annual, so I went in for an annual one in 2011 and the doctor there (Planned Parenthood) told me that I only need to go in every other year — but I’m in a monogamous relationship and wasn’t having sex at the time.
    Then early this year I went to renew the Rx and this doctor (different one, at Patient First) said it’s every THIRD year.

    Perhaps the nurses are just being hypervigilant and maybe fresh out of school? Which is still weird, you think they would give them updated information. I don’t know. Once a year unless you’re inactive or in a long term monogamous relationship seems sensible to me…

  2. DniRu says:

    Yeah, I thought it was every 1-3 years unless your results were abnormal.
    I’m not sure it’s simply a case of hypervigilance =/

  3. XdxWoman says:

    Oh trust me, a lot of nursing textbooks have downright incorrect information in them or are taught outdated information.

  4. EadWo says:

    Amusingly, I just went to see a new doctor, and she informed me that the “new guidelines were stupid, and the NPH is stupid, and you absolutely have to get an ‘annual’ (she couldn’t say Pap smear I guess…?) exam done here for me to prescribe your birth control.” I explained that I wasn’t sexually active, and I wasn’t there for a prescription anyways, and …she scheduled me for an “annual.” I laughed, and promptly cancelled that appointment and won’t be going back to her. So yes, there are lots of doctors out there with very different information. I’ve always kind of gone with PP’s recommendation, they don’t seem to have much of an ax to grind beyond keeping me healthy and happy.

  5. Leroeva says:

    Um, wow. That’s kind of messed up of them to assume that just because you’re on birth control that you’re having lots of sex. And second of all, no one needs a pap smear that frequently unless something abnormal has come up. It’s recommended to get a pap every 2 years.

  6. Knious says:

    This. That “have a lot of sex” comment really took me aback. So presumptuous!

  7. Nwooeva says:

    they performed pap smears more frequently on women who “had a lot of sex.”

    Wow, that’s… I’m tired and can’t brain right now, but that’s a bad way of thinking. :/ Taking HBC =/= having sex. Also, having a lot of sex =/= having a lot of risky sex, which would be a good reason to have more frequent paps done.

  8. DniRu says:

    Also, having a lot of sex =/= having a lot of risky sex, which would be a good reason to have more frequent paps done.

    Exactly. Maybe it was horrible wording on her part, but even then… =/

  9. Eneora says:

    exactly. every 6 months certainly isn’t the accepted recommended frequency, but I can see choosing (between the person and their doctor) to have them more frequently if one had abnormal results on a previous PAP (to follow up on) or was engaging in frequent risky sex.

  10. Sseyle says:

    I’m actually not sure that having lots of risky sex is even a reason to have paps that often. Testing too often can lead to over-treating problems that would otherwise resolve themselves, and thus has risks of its own.

    I don’t actually know, and am not a doctor! But I wouldn’t assume that having unprotected sex with multiple partners is necessarily a reason to get more frequent paps.

  11. Ytiiut says:

    Agreed with previous comments.
    1) Most insurances I’ve encountered only pay for 1 pap a year.
    2) Most doctors I’ve had recommend paps every 3 years or so when you are younger, and more frequently when you are older, have had abnormal ones in the past, etc
    3) I suppose that if you are at high risk for HPV (high risk sex) you’d also fall into that category, but I know of people who were in long term monogamous relationships, very very few lifetime sex partners for both parties, and yet, still contracted HPV, so I do think that anyone who has sex at all is at some risk.

  12. DniRu says:

    You’re right. I was talking to my mother about this and our insurance wouldn’t have covered it. It bothers me that they would require sexually active women on birth control pills to have a pap smear every six months simply because they’re on birth control pills, or because they have “a lot of sex.”

  13. EifNet says:

    You’re absolutely right to be bothered, IMHO. They’re trying to shame and humiliate women they suspect of being, omg, sluts! You know, women who have more sex than the accuser thinks is appropriate? Slut shaming is *so* not okay.

  14. 689No says:

    Wow, that seems pretty odd to me. I’ve been on the pill for a while and have never heard that before. I had them done every 6 months for a while, but that was entirely because the one at my annual exam came back abnormal and showed what my gyn described as “precancerous changes.” After about two years or so of that schedule, none had come back abnormal again so now I’m back to the once-a-year schedule. It had absolutely nothing to do with the fact I use BCP.

  15. DniRu says:

    I started the pill when I was 15 and had never heard that either. In hindsight, I should have asked them about it a bit more.

  16. EifNet says:

    Current recommendations are no pap smears *at all* until age 21, then every three years after that unless something abnormal turns up. So if you had a pap smear done in June 2011 and it wasn’t abnormal, then you don’t need another one until June 2014.

    This office sounds like it’s into shaming and humiliating women for having the nerve to have sex. If you have the energy, I would suggest filing a complaint about the presumptive, misogynistic way that you were treated by the nurses and the doctor. I would also suggest finding a new gynecologist, since this one has some really screwy ideas that you don’t need to deal with.

  17. Kraous says:

    My insurance wouldn’t even cover me getting one every 6 months unless it was deemed medically necessary. I do not like what they said to you at all about having more sex though.

  18. EegTuT says:

    Ugh. Ugh ugh ugh. It sounds like the doctor was (in a very twisted way) trying to support you by making your sexual habits seem responsible… but what a horrible mentality for a health practitioner to have! “A lot of sex” isn’t quantifiable, and shouldn’t be a factor for testing schedules anyway. Giving the doctor serious benefit of the doubt, exposure to semen can increase the likelihood of precancerous changes from HPV, which I suppose might warrant more frequent testing in theory; but six months is definitely overkill unless you have a history of cervical abnormalities. From this story, I really have the impression that your doctor has a judgmental attitude towards women who have sex.

  19. Naceva says:

    Not only does it sound like slut shaming, I’d also question their ethics, as it would appear this is one way to get more money for more procedures performed, whether they’re required or not. Actually, I’d go so far as to call it coercive and blackmailish, because people who depend on their hbc prescriptions are considered to be vulnerable and will usually comply in order to get their Rx refilled.

    Also, it appears that this doctor’s practice is counting on patients not being informed enough to question or refuse to have the extra paps done.

    Both reasons would indicate this is not a good place to seek medical assistance and advice. And, as another commenter suggested above, you may wish to file a complaint with the appropriate medical body where you live.

  20. Sseyle says:

    This is basically what I was going to say. Not only is their recommendation incorrect, it’s taking advantage of clients. Over testing has costs, both financial and health-related, as it can have side effects, or lead to over-treating/unnecessary procedures that carry risks of their own. They are placing their clientele at risk by over-testing.

  21. AssFriut says:

    Only time I heard of one doing that frequently is when I worked with street sex workers, they were advised to pap smear like every 3-6 months. But it is pretty obvious why they should have frequent pap smears and checkups.

    But for the regular person? ehhhh no.

  22. SseNope says:

    Paps or comprehensive sti tests? What will a pap catch at six months that is worth doing it so often? I didn’t think cervical cancer progressed that quickly.

  23. 407Super says:

    Wow that comment would’ve pissed me off!! I had to have pap tests every 6 months but only because I’ve had cancerous cells on my cevix. But now only once a year because I’m still at risk.

  24. 642ova says:

    i am both baffled and annoyed by the misinformation you encountered. no, a person on birth control does not need paps every 6 months.

    people with cervixes need pap smears. the frequency recommendation varies based on whether a pap smear has ever been abnormal, whether the person has ever had sexual contact with others, and additional factors. the basic “person with cervix, is sexually active, no history abnormal paps” is to receive a pap smear every 2 or 3 years; the old outdated recommendation is to receive a pap every year. never has there been such a strange recommednation to have a pap every 6 months if one takes hormones or has “a lot of sex” (what is “a lot”? for that matter, what is “sex”, for their standards?).

    in brief, fuck all of that. you need a pap q 2-3 years. if your medical provider won’t base recommendations for your healthcare on science and clinical evidence, i’d strongly recommend finding someone more competent.

  25. DniRu says:

    people with cervixes need pap smears

    I realized my phrasing wasn’t inclusive and I want to apologize for that!

    if your medical provider won’t base recommendations for your healthcare on science and clinical evidence, i’d strongly recommend finding someone more competent.

    You’re right. I hope I can find someone who is both competent and respectful of their patients.

  26. Lydia says:

    I just found this post and it really struck a chord with me, too. I live 2 hours out from New York City and every gynecologist I have seen has insisted that I return to their office every 6 months for a pap smear and a refill on my birth control pills. The doctor insisted that, because I wasn’t married to my boyfriend, I can never be too sure that he isn’t cheating on me. No joke, he actually said that. Every time the 6 month mark would come up, I’d find that I was swamped at work and couldn’t make it into their office to get my prescription renewed. I’d beg and cry on the phone until the nurse on the other end would give me “one more month”. I moved back to Massachusetts with my boyfriend for a year after being laid-off from work and I was able to use COBRA to keep my health care coverage during that time. I switched to a new gynecologist and found out that my old doctor (surprise, surprise) was probably scamming my health insurance. My new doctor said that she likes to see her patients once a year when they’re on the pill, but has no problem letting them go 2 years before seeing them again if they’ve had no health issues linked to their pill usage. My blood still boils when I think that every pap smear I had with my old NY doctors came back healthy and they still insisted on taking a pap smear every 6 months or no pills for me. It’s like they were toying with me on a very personal and emotional level. They know that many young women in monogamous relationships are reliant on birth control to keep them from having children when they are not able to support them or when they are not ready for them. Unfortunately, we moved back into the same area in NY a few months ago and already my new gynecologist has insisted on seeing me every 6 months for prescription refills (no pap smear, I guess he just wants to have me sit on the table to get money from my insurance company). I am so glad that I had that experience with a good doctor in MA and I’m ready to do battle with this new doctor if he challenges me on the 6-month policy he shares with his other area doctors.

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