Does Ovulation Timing Affect Cervical Pap Smear Accuracy?

Cervical smears should be performed close to the ovulation period?

Hello Dr.
Lin, thank you for taking the time to answer my questions.
I would like to inquire about the accuracy of Pap smear results.
Last winter, my Pap smear result was "LGSIL, with a possibility of HGSIL." My family physician recommended that I see a gynecologist for a colposcopy.
After the procedure, the gynecologist stated that everything was normal and there were no abnormalities.
This year, during my health check-up, I had another Pap smear, and this time the results came back normal.
I felt relieved at that moment, but I also found it strange that there was an issue last year and none this year.
Could it be that I somehow cleared the virus on my own? Then I wondered if my normal result this year could be a false negative.
I have this suspicion because the day after my Pap smear, I noticed a small amount of clear, semi-fluid discharge; on the third day, I felt that my ovulation period was about to begin.
(Since my menstrual cycle is very irregular, I can only rely on observation or intuition to estimate it.) If the Pap smear was done the day before ovulation or even at the start of the ovulation period, could that have led to a false normal result? I certainly plan to continue monitoring next year, but I am very curious if ovulatory discharge could affect the results and cause a false normal.
What is your opinion on this, doctor? Thank you for your professional insight!

Danxin de ren, 20~29 year old female. Ask Date: 2014/10/13

Dr. Lin Wenbin reply Obstetrics and Gynecology

In a Pap smear examination, if there are issues, a biopsy is usually required for further investigation.
However, if the Pap smear result is negative, it is also possible that the cells we intended to sample were not collected.
This is referred to as a false negative in medical terminology.
Of course, it is also possible that low-grade squamous intraepithelial lesions (LGSIL) have transformed into more normal cells.
Currently, the cervical cells appear more normal.
It is still advisable to undergo regular follow-up examinations.
My recommendation is to continue with human papillomavirus (HPV) testing.
If high-risk HPV types persist, it indicates an increased likelihood of a false negative result.

Reply Date: 2014/10/13

More Info

The accuracy of a cervical Pap smear can indeed be influenced by the timing of the test in relation to a woman's menstrual cycle, particularly ovulation. The cervical mucus changes throughout the cycle, becoming more abundant and thinner around ovulation, which can affect the quality of the sample collected during the Pap smear.

During the menstrual cycle, the cervix produces different types of mucus, influenced by hormonal changes. Around ovulation, the mucus becomes more elastic and clear, resembling raw egg whites. This type of mucus is designed to facilitate sperm movement, but it can also impact the collection of cells during a Pap smear. If the smear is taken during this time, the presence of abundant cervical mucus might dilute or obscure the cellular material that is being sampled, potentially leading to an inaccurate result.

In your case, the previous Pap smear indicated "LGSIL, not excluding HGSIL," which suggests that there were some abnormal cells present. The recommendation for a colposcopy was appropriate, as it allows for a more detailed examination of the cervix and the collection of biopsies if necessary. The subsequent normal result you received could be attributed to several factors, including the possibility that the abnormal cells were transient or that they were related to a temporary infection or inflammation that resolved by the time of your next test.

It's also important to note that the human body can sometimes clear infections or abnormal cells on its own, especially if they were related to transient conditions like HPV (human papillomavirus) infections. HPV is common, and many women will clear the virus without any treatment. However, persistent infections can lead to more serious changes in cervical cells, which is why regular screening is crucial.

Regarding your concern about the clear, semi-fluid discharge you noticed after the Pap smear, this could very well be related to your ovulation cycle. It's not uncommon for women to experience changes in discharge around ovulation, and this is typically normal. However, if you notice any unusual symptoms, such as a strong odor, itching, or discomfort, it would be wise to consult with your healthcare provider.

In summary, while the timing of a Pap smear in relation to ovulation can affect the results, it is just one of many factors that can influence cervical health. The fact that you had a normal result after a previous abnormal one is not uncommon, and it is essential to continue with regular screenings as recommended by your healthcare provider. If you have further concerns about your cervical health or the timing of your Pap smears, discussing these with your gynecologist would provide you with tailored advice and reassurance. Regular follow-ups and open communication with your healthcare provider are key to maintaining cervical health and addressing any potential issues early on.

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