A vaginal smear is a swab of the vaginal wall performed by a gynecologist when needed. It is used to determine the current stage of the menstrual cycle and diagnose diseases affecting the vagina, and is not the same as a cervical smear.
What is a vaginal smear test?
A vaginal smear is a swab of the vaginal wall performed by a gynecologist as needed. The biannual exam with the gynecologist includes, among other things, the vaginal smear. It is often equated with the portio smear, the smear taken directly from the cervix. However, a vaginal smear is a sample taken from the posterior third of the vaginal mucosa, which is not the same as the cervix. A vaginal smear test can first determine which phase of the cycle the woman is in. This is where hormones are deposited that can be used for diagnostic purposes – for example, as an indication of hormonal imbalance or general hormonal activity. Regular vaginal smears are very important for the detection of cancer. It is considered to be a simple and yet very safe method of detecting tumor cells and precancerous lesions at an early stage. For this purpose, portio and vaginal smears are often performed at the same time in order to obtain the best possible confirmation. Also, vaginal smears are performed for suspected fungal infections and similar diseases of the vagina for laboratory diagnosis of the smear.
Function, effect and goals
Vaginal smears are usually performed every six months as part of a regular gynecologic exam. Some gynecologists use the writing of a new prescription for birth control pills for this purpose and are reluctant to give the prescription without this examination. For the vaginal smear, the vagina is first dilated with the speculum or raven’s beak so that the gynecologist can comfortably take the smear and see where it is located in the vagina. Through the speculum, which is open at the upper end, he inserts a cotton swab and strokes it along the vaginal wall in the upper third of the vagina. A new cotton swab is used for the cervical smear, if needed. The sample obtained is usually first subjected to a Pap test to detect irregular cell growth. Various cancers, above all cervical cancer and its precursors, can thus be detected at an early stage. This greatly simplifies any necessary treatment. Hormonal and microbial function diagnostics are also possible. This could detect fungal diseases or unusual hormonal activity. A vaginal smear is also used to determine the pH of the vagina, especially during pregnancy, as this can fluctuate, making the woman more susceptible to infection. Vaginal smears are therefore one of the examinations that are regularly carried out during preventive check-ups, especially in the first and second trimesters of pregnancy. In this way, unusual hormonal activity and pathogens that could negatively affect the baby and the mother can be detected in time. When treating fungal infections, for example, which are not uncommon during pregnancy, the gynecologist can then intervene in time before the woman and child are noticeably affected. Forensic medicine also uses the vaginal swab to detect sexual abuse. Sperm traces in the vagina can be detected in this way, and from these in turn the DNA of the perpetrator can be determined. This works up to three days after sexual intercourse and serves as reliable evidence of sexual crimes against women for the jurisdiction.
Risks, side effects and dangers
Compared with other diagnostic procedures, the vaginal smear is considered minimally invasive and carries no particular risks. However, the first smear test is often unpleasant and emotionally stressful for young women, which is why the treating gynecologist should handle them very carefully. If the vaginal smear is performed on a woman who is not yet sexually active, special care may be needed because of the hymen. This could tear due to the insertion of a speculum – if this is important to the patient, the gynecologist will try not to injure the hymen or, if possible, refrain from performing a vaginal smear.However, a vaginal smear test should be performed at the latest when the first birth control pill is prescribed, as the first pathogens can enter the vagina with the first sexual activity. The main purpose is cancer screening. Vaginal smears are also difficult for women who suffer from vaginismus, as the introduction of a speculum is associated with great pain for them and the gynecologist is therefore often unable to introduce it at all. Vaginismus sometimes also occurs after sexual abuse, but when the vaginal smear is mandatory for legal medical reasons. Such situations must be handled sensitively by the gynecologist so as not to aggravate the trauma the woman has already suffered. As a rule, however, vaginal smears are neither dangerous nor particularly emotionally stressful for the woman. Over time, most women get used to it, which is helped by trust in the gynecologist and a generally good relationship. Regular vaginal smears during pregnancy are also not unusual, especially in the first and second trimesters. After that, they are performed less frequently anyway and only when necessary, but not at every examination. Especially towards the end, the gynecologist must be a little more careful and also make sure that it does not hurt the woman. The vaginal area has more blood flow than usual and can therefore be more sensitive. Care must also be taken during a cervical smear test, but with an experienced gynecologist, nothing will happen in the process.
