Pap smears are a series of tests conducted to detect cells that have the potential to grow into cervical cancer. This test is done by taking a part of the cell that is around the surface of the cervix. Generally, women are advised to do pap smears regularly starting at the age of 21 years. Pap smears are usually directed at married or sexually active women. This is because they are sexually active, especially for those who frequently change partners, are at high risk of getting cancer or infection.
You also need tests that are more frequent if you are HIV positive and have a weak immune system for various reasons. Usually you are encouraged to keep doing pap smears even if you have a relationship with one partner. This is because the HPV virus that is the cause of cervical cancer may be in your body, but is entering a latent or veiled period so that symptoms have not yet emerged.
However, not all diseases related to the reproductive and genital systems can be detected using pap smears. The following are diseases that cannot be detected by pap smear:
1. Ovarian Cancer
Ovarian cancer is a cancer that is rare compared to other types of cancer. However, this type of cancer you cannot underestimate because you might be at risk of developing ovarian cancer. For that, you can consult the obstetrician. The problem is that unlike cervical cancer that can be detected through precancerous cells, ovarian cancer cannot be detected in the same way.
Rarely can ovarian cancer cells be detected by pap smear tests. If ovarian cancer cells move away from your ovary through the fallopian tubes and uterus to the area around your cervix, ovarian cancer cells can be collected during a pap smear test. However, this rarely happens. So pap smears are not a reliable test for ovarian cancer.
Unfortunately, there are no tests to detect ovarian cancer. Researchers have not found a screening tool that is sensitive enough to detect ovarian cancer at an early stage and is specific enough to distinguish ovarian cancer from other non-cancerous conditions.
Chlamydia is one of the most common sexually transmitted diseases. In Indonesia alone around 150 thousand cases are detected each year. People who are infected with chlamydia generally do not show any initial symptoms until they see a doctor. However, in general women if they have been infected long enough will have an effect including smelling vaginal discharge, bleeding outside menstruation, very painful menstruation, pain during sex, to itching and heat around the vagina.
If you are sexually active and under the age of 25, the National Chlamydia Screening Program (NSCP) recommends that you be tested for chlamydia every year, or when you change sexual partners. There are two ways to test for chlamydia, using urine samples and taking membranes from the cervix. Although using membranes from the cervix, chlamydia cannot be detected by pap smears.
Elizabeth Etkin Kramer, MD., an obstetrician in Florida, United States, said that a series of antibiotics can clear this bacterial infection. Therefore samples taken from inside your vagina taken during a pelvic examination and urine tests are very important to detect this infection.
Gonorrhea is a sexually transmitted disease caused by a bacterial infection with Neisseria gonorrhoeae. It usually tends to infect warm moist areas such as the urethra, anus, vagina, fallopian tubes, cervix, uterus to the throat. Gonorrhea will show initial symptoms after 14 days of infection. However, like most other sexual diseases, gonorrhea does not show the visible symptoms. Therefore it is important to do gonorrhea testing.
Doctors do not use pap smears for gonorrhea examination. Cell samples collected during a urine test can help identify bacteria in your urethra. Doctors also use tests such as your throat, urethra, vagina, or rectum (rectal) swab, to detect these bacteria.
Trichomoniasis is a sexually transmitted disease caused by a protozoan parasite called Trichomonas vaginalis. This infection is not fatal but can lead to complications such as infertility and infection of the vaginal skin tissue (cellulitis) in women. Infection during pregnancy can lead to premature birth and mild birth weight.
Women can experience common symptoms, such as vaginal odor or green vaginal fluid, foaming fluid, itching, and swelling in the vagina. Other symptoms include pain during intercourse or during urination.
The doctor will examine the vagina to take samples. A diagnosis will be made when the parasite is found in the sample when examined under a microscope. Another diagnosis is by breeding parasites. Results can be seen after breeding ranging from 3 to 7 days. Blood tests are also possible to diagnose parasites.
5. Syphilis (lion king)
Syphilis is a venereal disease caused by bacteria that can infect the skin, mouth, genitals, and nervous system. Syphilis is also known as the king of lions. This disease is caused by the bacterium Treponema pallidum. Infection usually occurs because of sexual contact. In very rare cases, bacteria can pass through gaps or sores on the skin after touching a person infected with syphilis.
The doctor can strengthen the diagnosis based on the medical history and examination of the patient's body by observing the sex organs, mouth, and anus. If there is even the slightest sign of disease, a small piece of tissue slice or liquid disease will be examined immediately to find out the type of bacteria using a dark-field microscope.
A blood test, known as VDRL, is performed to determine whether there are antibodies (substances produced by the immune system to fight infection from the bacterium Treponema pallidum) in the blood. Not until that, the doctor will also test your sexual partner.
6. Genital herpes
Genital herpes is a venereal disease caused by the herpes simplex virus (HSV). Usually characterized by runny bumps on the genitals, anus, or mouth. Genital herpes can spread by touch, but more often spreads through sexual intercourse. People with genital herpes are diagnosed with several tests, namely:
- Examination of viral cultures. This examination uses samples from the ulcer on the skin or canker sores to confirm the presence of the herpes virus.
- Polymerase chain reaction (PCR) tests. This test checks your DNA from a blood sample to confirm the presence of HSV and determine its type.
- Blood tests. This test is to check for HSV antibodies, which detect previous herpes virus infections.
Therefore, the detection or diagnosis of herpes with pap smears is not justified.
7. Polycystic ovary syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is a hormonal disorder that is common in women of childbearing age. Women with PCOS may have irregular or prolonged menstruation or have excessive levels of male hormone (androgens).
The exact cause of PCOS is unknown. Early diagnosis and treatment together with weight loss can reduce the risk of long-term complications such as type 2 diabetes and heart disease.
Detection of PCOS is done by ultrasound (USG). From there, the doctor will check whether your ovulation is normal based on observation. Therefore, pap smears cannot detect PCOS disease.
One important thing to remember. Although not all diseases can be detected by pap smear, doing a pap smear is very important as an early detection of cervical cancer so as not to regret it later.
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