Are you wondering whether you need to get a Papanicolau (Pap) test or colposcopy? Are you wondering whether it’s going to be painful or cause other harmful effects in your body? 

Well, if so, then you’re in the right place. I’m Dr. Doni Wilson, a naturopathic doctor as well as a professional midwife and a women’s health expert. I’ve been helping women with abnormal Pap smears and high-risk HPV virus for over 25 years, and I’m really glad that you’re looking for more information. That tells me you are on the path of taking care of yourself, and that is an essential first step.

When it comes to deciding whether to get a Pap smear and/or HPV test, keep in mind that these decisions have to do with your age as well as your exposure risk and your past medical history. We’re going to talk that through so that you understand exactly, based on your particular situation, whether screening for cervical cancer makes sense at this moment in your life. 

That’s what we’re really talking about here—risk of cervical cancer as well as other HPV-related cancers. That includes vaginal cancer, vulvar cancer, anal cancer, and others. The main one that we’re thinking about is cervical cancer because that’s what we’re looking for with the Pap smear and colposcopy (biopsy of the cervix).

In terms of medical history, it’s important to know that if you had a hysterectomy, you do still need to be screening for HPV and vaginal cancer. It’s also important to have gynecological exams including a Pap and HPV test even if you’re not sexually active at this time in your life, or if you’ve only had one sexual partner, or if you’ve only experienced genital contact without full intercourse. 

I want to emphasize that high-risk HPV virus can cause cancer risk even with one partner, even with minimal genital contact, and even if it’s been years since your last sexual activity. Let’s start by making sure you know what the testing options are, and the latest guidelines. 

What Does a Pap Smear Do? 

I want to help make sure you understand all of the information because what I find is the more information you have about what’s available and how to make these decisions, the less stress and anxiety you’re going to have and the more you’re going to feel in control of your health. That is so important when it comes to preventing cervical cancer and other HPV-related cancers.

A Pap smear is when the practitioner uses a vaginal speculum to take a superficial sample of the cells of the cervix. 

The speculum, which might be metal or plastic, is used to go in vaginally and hold the vaginal tissue out of the way so that the cervix can be visualized. The cervix is about two inches into the vaginal area. It looks like a pink doughnut with a hole in the middle. The opening is the endocervical canal that leads to the inside of the uterus. The cervix is the tip of the uterus that’s inside the vagina.

With a Pap smear, we’re using a plastic spatula and/or a little brush to gently slough superficial cells from the face of the cervix and right inside the endocervical canal. We’re not going all the way into the uterus—it’s just right inside the opening of the cervix. That’s where the high-risk HPV virus tends to cause abnormal cells. 

A pathologist looks at the cells under a microscope to look at the size and shape of the cells, and the color and shape of the nucleus of the cells. By looking at the cells, the pathologist is able to determine whether a high-risk HPV virus is causing abnormalities in those cells.

Those abnormalities are then graded on a spectrum from mild changes – even inflammation could be seen – to more moderate or severe abnormalities. With a Pap smear we are able to check the cells of the cervix and (hopefully) identify precancer before it turns into cervical cancer. 

If we see that there are abnormal cells, we can address them. If they are severely abnormal, we can remove them. What I do in my work is help women to prevent the high-risk HPV virus from causing abnormal cells.

Of all the Pap smears that are done, about 3.8 to 5% of them will show abnormal cells. That works out to be, in the United States, about 13,000 to 14,000 women who are diagnosed with cervical cancer based on the Pap smear. The numbers are much higher when you look at it worldwide.

How Do You Test for HPV? 

At this point in time, testing for high-risk HPV virus is being used to assess for cervical cancer risk. In fact, between ages 30 and 65, you can do an HPV test first in order to determine whether you need to get a Pap smear or biopsy (if HPV is positive, then a Pap is recommended).

HPV testing methods have advanced, making it so much more accurate to test for high risk HPV and to know whether it is present (detected) or not. The method used is called genotyping and it is able to identify high-risk HPV virus based on its DNA. 

We talk about HPV as if it’s a single virus, but in actuality, there are over 150 strains of the HPV virus. Not all of them are associated with cancer risk. There are 14 types that have been associated with cancer risk, that we know of at this time. 

The HPV test checks for those 14 high risk types. They’re called high-risk types because they’re associated with cancer risk. The low-risk types are associated with warts, such as plantar and genital warts. Your lab report may list exactly which type is positive, or it may simply say “other high risk type.” 

Current HPV Testing Guidelines and HPV Incidence

When you go into a practitioner’s office to get a Pap smear, it’s quite likely that they will also test for high-risk HPV at the time of the Pap smear. 

That’s called a co-test because they’re doing both a Pap smear to check the cells and a test for high-risk HPV at the same time. A co-test is considered to be the most accurate way to assess for risk of cervical cancer because we know that 95 to 99% of cervical cancer is caused by high risk HPV.

It can be quite shocking for women to find out they are testing positive for HPV. From my perspective, I would rather find out you have high-risk HPV so then I can help you address it.

It is also surprising to test positive because there are no symptoms associated with high-risk HPV. There are no warts, there’s no pain, and there’s no discharge. Most women have no idea that they have high-risk HPV virus. 

The statistics show that about 12% of women worldwide are testing positive for high-risk HPV virus at any point in time. 80% of us will test positive at some point in our lives.

Testing positive for high-risk HPV is quite common, even if you only have one or few sexual partners. There’s a bit higher prevalence in women who are under 30 years old—that’s almost half of the cases. At the same time though, there is risk of cervical cancer in women over 65. 20% of women who have cervical cancer are over age 65, so don’t be fooled that cervical cancer only occurs in younger women.

No matter your age, if you’ve been sexually active at any point in your life, then we need to be monitoring you for high-risk HPV. If you test positive, that’s when I recommend that you take action to protect yourself from it before it has a chance to cause abnormal cells or cervical cancer. Don’t wait for it to get worse! 

In 2018 there was an estimated 37 million women who tested positive for high-risk HPV virus, and over 666,000 were diagnosed with cervical cancer worldwide in 2022. 

It can be quite scary to find out that you are testing positive for a virus that could cause cancer. I want you to know that there’s a lot I can do to help you. I’ve been helping women for over 25 years to successfully clear HPV to negative and prevent abnormal cells and prevent cervical cancer. 

If you’re in this situation, testing positive and scrambling to figure out what to do, please contact me in my office and the practitioners who’ve been trained by me with my HPV protocol. You can find out more at doctordoni.com or clearhpvnow.com.

What Is a Colposcopy? 

A colposcopy is a biopsy of the cervix. A biopsy allows us to get a much closer look at the cells. To perform a colposcopy, a practitioner will use a vaginal speculum, they will use specific visualization techniques to be able to see more clearly where there may be abnormal cells on the cervix, and then take a biopsy in exactly those areas. 

A Pap smear is a general sample of the cells of the cervix. A biopsy, on the other hand, is much more specific. Specific areas are tested and then a pathologist looks at the tissue samples under a microscope to more accurately identify cell abnormalities. Sometimes the doctor might take multiple samples with a colposcopy.

A biopsy is usually only done if the Pap smear showed some abnormality. You wouldn’t go straight to a colposcopy without having a Pap first and HPV test. If there are abnormal cells showing on the Pap results, and high-risk HPV is present, that’s when your practitioner is likely to recommend a biopsy so they can take a closer look and confirm whether there are abnormal cells and the severity of those abnormal cells.

The colposcopy results provide specific information about the severity of the abnormal cells. The reason that is so important is that severity determines the appropriate treatment.

What Do the Results Mean? 

Abnormal cells are identified on a spectrum from low-grade to high-grade. The more modern terminology is ASCUS (atypical cells of undetermined significance) and CIN1 (low grade), and CIN2 and CIN3 (high grade). CIN stands for cervical intraepithelial lesion. This is before it turns into carcinoma in situ or carcinoma, which is precancer and cancer cells. 

In the case of ASCUS or CIN1, the cells may resolve on their own and so a procedure is not indicated. If the cells are CIN2 or CIN3, that indicates a need for a procedure to remove the abnormal cells. Your doctor may recommend a LEEP procedure (referred to as a LETTZ procedure in some countries) – to remove abnormal cells – or a cold knife or conization procedure – to remove part of your cervix.

There is a natural alternative approach to address CIN2 and 3 called escharotic treatments. There are not many practitioners trained in how to do escharotic treatments. I was trained to do escharotic treatments over 25 years ago. They are very effective at removing abnormal cells without causing scaring or damage to the cervix. If you would like to learn more whether escharotics are an option for you, please reach out to my office. 

If the abnormal cells have progressed into carcinoma in situ or carcinoma, you’re going to need to meet with an oncologist to talk about cancer treatment. 

At the same time, what I always recommend is to address both the abnormal cells and the virus. That’s what is often missing in the standard medical offices. 

There is a lot of research and clinical cases demonstrating that it is possible to support your body to clear HPV to negative. The human immune system has the capacity to clear HPV virus. In fact, most women will clear high-risk HPV virus without any help. We can use this information to help the women whose bodies are not clearing it on their own.

Is a Pap Painful? Risks of Screening Procedures

You might have been wondering, are there any risks of doing a Pap smear or are there any risks of doing a colposcopy? Is it going to be painful? I always say it’s important to understand both sides of anything we do or put into our bodies.

There is a study from 2017 that gives us some guidance. I find that it’s consistent with what I hear women reporting back to me – I talk to thousands of women every year.

With the Pap smear, there is a smaller chance that you might experience pain. The most common symptom from a Pap smear is discomfort from the pressure of a vaginal speculum. A speculum has smooth edges—it’s not sharp. There’s no injection needed with a Pap smear, and no needles are involved. Because a little brush is used to slough cells from inside the opening of the cervix, it can potentially cause a little tiny bit of spotting within a few days to a week afterwards.

With a biopsy, because a sample of tissue is taken from your cervix, there’s more likelihood of some pain and some cramping at the time of the biopsy. There can also be some vaginal bleeding. It could change your menstrual cycle a little bit. The research shows that between 50 to 80% of women will have some pain, bleeding, or discharge after a biopsy.

If you have a treatment like a LEEP procedure or conization, there is a higher likelihood that you’re going to experience some pain, bleeding, and/or discharge. Between 67 and 77% of women will have pain and bleeding. Usually practitioners will recommend four to six weeks of nothing vaginally after a LEEP procedure.

That’s why I would rather catch HPV early. I would rather find out that you’re testing positive for high-risk HPV and help you to clear it out of there before it has a chance to cause abnormal cells so that you can avoid these procedures.

What can happen for a lot of women, is they test positive for high-risk HPV and then the doctor says come back in six months or 12 months. There are women who’ve been repeating biopsies every six months for years. That’s why we need to be intervening. Abnormal cells and cervical cancer are absolutely preventable in my clinical experience.

The research shows that 35% of women had anxiety for at least 12 weeks after getting abnormal test results. From my experience, it’s way higher than that. Please know that anxiety about going through this process is very common. 

In my opinion, we need to be supporting women through the diagnostic and treatment process so the anxiety is not paralyzing and so that you can stay focused on helping your body heal. 

You don’t have to deal with all this on your own, and you should not be made to feel ashamed. The vagina is a normal part of our bodies, and testing positive for HPV is a very common situation women go through. I’m here to help.

Current Screening Guidelines and New Home Testing Options

At this point in time, the cervical cancer screening guidelines are: 

• Age 21 to 29, it’s recommended to do a Pap test every three years
• Age 30 to 65, do a Pap test every three years, or if you add the HPV test and it’s negative, then you can repeat the co-test every five years

I want you to know about a new option. From age 30 to 65, there is now a home test for high-risk HPV virus. You can order the test online. There’s one company called My Lab Box, and there’s another company called Teal, which will, if you’re in the United States, potentially be able to bill insurance for the test.

If you want to learn more about the home tests I mentioned you can find more about them here: MyLabBox home test, Teal Health test.

You order the HPV home test online, they send you a swab, and you collect the vaginal swab yourself. You don’t use a vaginal speculum. You don’t have to go to the doctor’s office. You just do a vaginal swab and send it in. The cost of the test is under $400.

You’ll get the test results back within a couple of weeks, and find out if you’re testing positive for any of the 14 high-risk types of HPV. It’s considered accurate and is recognized in the standard medical system. If you test negative to high-risk HPV and you are between age 30 and 65, then you don’t need to get a Pap (unless it comes back positive).

The exceptions are if at any point you have had an irregular result, such as abnormal cells, or if you’re taking an immunosuppressive medication, or if you’ve had abnormal bleeding, or if you had a hysterectomy, then you have to go in to have the doctor do a Pap and HPV test in the office. 

The home HPV test is for women who have a healthy history. If an HPV test is positive, then you’re going to want to go in and get a Pap smear because now you know you have high-risk HPV virus. If there are any abnormal cells on the Pap, then you’ll talk to your doctor about doing a colposcopy.

If you’re over age 65, the screening becomes less required. However, I’m still very cautious because 20% of cervical cancer is diagnosed in women over 65. If you have a new sexual partner over age 65, if you’re taking an immunosuppressive medication, or if you’ve ever tested positive for high-risk HPV earlier in your life, then you’re going to want to keep on screening after age 65. 

If everything’s been fine and negative for over 10 years, your risk is very low. But still, I would be cautious. I’ve helped many women over age 65 to clear high-risk HPV to negative so it’s better to find out so you can take action. 

Finding Supportive Practitioners

If you have experienced trauma at the gynecology office, or from getting a Pap smear or colposcopy, I’m sorry that happened to you. It’s still important to be screened for HPV and cervical cancer, so I want to provide ideas to help you get tested without more trauma. 

One idea is to look for a different practitioner type who offers Pap smears, such as a naturopathic doctor or midwife. The type of services practitioners can provide is different in each state (and country). Depending on the state you live in, or where you’re located, you may be able to choose a naturopathic doctor who offers Pap smears and well woman exams. A naturopathic doctor is more likely to be able to guide you in a very gentle way and help you through the process.

Another option is a midwife. Midwives are also trained to do Pap smears and are licensed to do Pap smears in most states. Look for midwives in your local area and call to ask if they can do a Pap smear for you. Midwives tend to take more time with their patients. They’re more likely to be supportive and talk you through it. Both naturopathic doctors and midwives are more likely to have training to know that it’s possible to help prevent HPV from causing cervical cancer. 

I want to give you permission to choose a new provider. Another option is to look for a holistic or functional gynecologist. There are also community clinics that offer Pap smears and HPV tests at a very low cost in case you don’t have insurance.

Preparing for Your Gyn Exam

What I recommend when you’re going for a gynecology exam is to prepare yourself ahead of time. Try to set aside the day so that you’re not rushing. Plan to have a calm start to the day. Make sure you eat protein and drink water. 

I also recommend bringing a headset so that you can listen to a meditation or calming music while you’re in the office. You can also use deep breathing. You can also take something to calm your nervous system prior to your appointment, for example, magnesium, theanine, and/or GABA.

A mindset that helps is to keep in mind that this is something you’re doing for yourself. You’re choosing to go in and get this test done so that you know whether HPV is positive and if there are abnormal cells. If so, then you’re going to have a plan to address it.

You’re going to be able to contact me in my office, because I help women around the world. You can set up a call with my team to review your results or with me directly, and we can discuss how you can follow my protocol to clear HPV. 

Stress and anxiety comes from not knowing what the tests involve or how to address abnormal results. But now you know all about the tests, and you know that you’re going to be able to contact me if there is an issue, so you’re going to feel much more comfortable.

Be sure to ask your provider for a copy of your test results. I believe that all women deserve to receive their HPV and Pap results as soon as they come back. Say to your provider when you go in for your exam, “please send me my test results, the actual report.” Having your results is part of being your own best health advocate. 

Don’t Delay Getting Tested

During the pandemic, many women were not getting Pap smears nor HPV tests, and that was over a three to five-year period. 

When the pandemic was over, and women started going back to the gynecologist, many women found out they are now testing positive for HPV and/or that abnormal cells had progressed. 

When women get abnormal results, they wish they would have known earlier because it’s a lot easier to address abnormal cells when they are mild. So don’t delay. It’s better to find a way to go about being tested so you can catch it earlier, and start addressing abnormal cells sooner.

Please know that whether you have mild or severe abnormal cells, you can reach out to me for help. I’ve helped women with very severe cases.

What we know from the research is that the more we support women through the process of getting tests done, and the more we support women once they find out that they have HPV or abnormal cells, the more it lowers their risk of cervical cancer. 

As health practitioners, we must start supporting women through the whole process of identifying risk of cervical cancer. You are worth it. You deserve help. You are not alone. 

Following an HPV Protocol and Your Path Forward

I hope this has helped answer your questions about Pap smears. The screening that is right for you is based on your age, your past history, and factors in your health history. 

The thing I’m hoping you heard is that there is help. It doesn’t have to be traumatic if we can support you through it, and there are now alternatives to going into the doctor’s office for a Pap smear. If you’re between age 30 and 65, you can do a home high-risk HPV test with a swab if you’ve had a normal, negative history.

We also use the home HPV test for women who are following my protocol and want to find out whether HPV is negative. Women can follow my protocol in the Say Goodbye to HPV group program, or by working with me one-on-one. 

The Dr. Doni’s HPV Protocol™ includes diet changes, lifestyle changes, supplements – including nutrients and herbs at clinical doses, vaginal suppositories, microbiome balancing, gut healing, hormone balancing, and nutrient optimization. 

We dig in deep to identify the hidden underlying causes of why your body isn’t clearing HPV and then support your body to clear the virus once and for all. 

When HPV virus is persistent and causing abnormal cells, there’s a reason. Your body should be able to clear it. What I do is help you to be a detective and figure out why is it not clearing. I help you get access to tests that will identify what needs attention in your body. That includes specific blood tests, urine hormone levels, food sensitivity testing, and if needed, PCR testing for the gut and vaginal microbiome. 

Let’s figure out what it is that your body needs help with so then your body can clear high-risk HPV virus and protect you from it going forward.

Once you have implemented my protocol, we can also use a home HPV test to find out if HPV is now negative. Once we see that HPV is negative, then I recommend following up with in gynecology office within six months to make sure that it stays negative. Once we see two negatives, that is confirmation that HPV is gone. And it’s going to stay gone because now you know how to take care of yourself.

I’m often asked if it is necessary to avoid sex. I want you to know it is not required for you to stop having sex in order to clear HPV. Many women who follow my protocol are sexually active. It’s also not essential for your partner to be treated. 

The whole point is to address the reasons your body wasn’t protecting you from HPV, and once we do, your body will be able to protect you even if you are re-exposed to HPV. 

The human immune system has the ability to clear high-risk HPV virus. We just need to know what’s making you susceptible to the virus so we can support you to address those factors. Then you’ll be able to maintain your resilience to HPV by continuing to support your health. This is absolutely possible using the Dr. Doni’s HPV Protocol.

If you’d like to learn more, join me over at doctordoni.com. You can download my HPV Recovery Guide, which is a free PDF. You’ll see all the success cases of women who’ve been through this process and found freedom from high-risk HPV so that you can have hope that it’s possible for you too. I see women achieving it every day.

If you have any questions, please don’t hesitate to reach out to my office. My team would be happy to connect with you and help you know what your next best step is to free yourself from HPV. My team can also help coordinate shipping worldwide. You don’t have to figure it out on your own. Click here to set up a call with my team.

If you’d like to get a better sense of my approach, I welcome you to join my next free How to Get Rid of HPV online workshop where I help you to create a plan to get HPV out of your life for good.

Sign Up Now (Free!)

From there, you might choose to join the Heal HPV Kickstart Program, for the initial steps of my protocol, including diet changes and supplements, over the next 30 days.

Register Now

Or you can begin with the comprehensive Say Goodbye to HPV Program, which is 3 months and includes everything you need to implement my full protocol and address all the susceptibilities with live, group support, and access to testing and vaginal suppositories.

Thank you so much for joining me for this video. I’d love to hear from you – please like, comment, share, and subscribe, if you haven’t already. I look forward to having you join me for the next episode of How Humans Heal.

Best wishes on your healing journey! 

Disclaimer: This specific article and all other Content, Products, and Services of this Website are NOT intended as, and must not be understood or construed as, medical care or advice, naturopathic medical care or advice, the practice of medicine, or the practice of counseling care, nor can it be understood or construed as providing any form of medical diagnosis, treatment,  natural HPV cure, or prevention of any disease.