Doctor's Advice - What does a Pap smear show?

• What does a Pap smear show?

Q. I am a young woman, and I recently did a Pap smear. This was at the beginning of the year. I heard that the result was normal. But then a month after that, I saw some small warts at the opening of the vagina. They have now grown in size and number. So I am confused about why the Pap result would show normal, yet I have genital warts? I have now been partially treated for these but stopped the treatment because it was too expensive. Doctor, I was of the view that the Pap smear should have shown some form or trace of the HPV virus, but it didn't. Why was this?

A: Well, I think that like many people, you haven't appreciated the fact that the Pap smear is taken from the tip of the woman's cervix (the neck of the womb), and that this is a good four inches away from the opening of the vagina.

During the Pap test, the sample is obtained from a small cervical area, which is usually less than the size of a one cent coin. The smear detects what is going on in that tiny area, but it can't tell you what is happening in the rest of your sex organs.

The point of 'scraping' that small zone of the cervix is that it is there that cervical cancer usually starts. The Pap test detects the earliest changes of this cancer long before it can cause any symptoms.

So a Pap test cannot tell you what is happening on your vulva (the opening of the vagina), or indeed inside the womb. Also, many women think that it can detect chlamydia, but it can't.

Your email asks me many other questions about Pap smears, and I will try and deal with them as soon as possible, but from what you say, I note that you don't seem to have completed your treatment for the genital warts. You really should do so. And you should avoid sex until you are completely cured, otherwise, you may give the warts to somebody else.

• Who is a virgin?

Q. I would like to know what constitutes virginity in a male. I am a guy who has never had sex.

A: Then you are a male virgin. That's all there is to it. In guys, there are no physical changes which differentiate virgins from non-virgins.

• Can she take more?

Q. I am a female studying biology. I have read on the Internet that the vagina is only four inches long, and I think you have said the same thing in your column. So what I would like to know is this. How on earth can a woman be expected to get a six-inch penis inside it when she is only four inches long?

A: A good question. But the answer is simple. The vagina is quite an elastic organ, and when a female becomes sexually excited, her vagina gets pretty relaxed and kind of 'balloons' upwards and sideways.

This means that she is able to accommodate pretty well any size of male organ. However, it is essential to realise that the vagina does not 'balloon out' unless the woman has become aroused. That is one of the reasons why a man should always try to give his partner some preliminary foreplay before entering her.

• Anti-cervical cancer vaccine

Q. I have decided to take the anti-cervical cancer vaccine. But which one should I choose? Cervarix or Gardasil?

A: If you have a choice, my feeling is that you should pick the Gardasil jab. This is because it not only helps protect you against cancer of the cervix, but also gives you considerable protection against two strains of HPV which cause genital warts.

• Attracted to my father's ex

Q. Doc, I am a teenage guy, and an attractive woman of around 40 or so is making a play for me. My friends all think this is a great idea and are encouraging me to go to bed with her. But I am not so sure. You see, Doctor, I have discovered that many years ago, she was the girlfriend of my late father. They may even have been in love. What should I do?

A: It is highly likely that this lady sees you as a sort of recreation of your father, who has sadly passed on.

But, of course, you are no such thing. You are your own person, and not a reincarnation of your late father. I feel that if you went ahead with this proposed sex relationship, then all kinds of psychological problems could affect both her and you. So I think that you should avoid any sexual or romantic contact with this lady. Maybe you should look around for a girlfriend who is nearer your own age.

• Am I at risk of HIV?

Q. I am a guy of 21 who has formed a considerable attachment to another man of my own age. He feels the same way about me. Neither of us has ever had sex with anyone else. What I need to know, doctor, is whether either of us is at risk of HIV or AIDS?

A: If it is true that neither of you has ever been with anybody else, then you are at no risk of HIV. However, I am assuming that neither you nor your friend has tried injecting drugs because that is a common way of catching the virus.

• Home-made condom

Q. My boyfriend has suggested that we have sex and use a home-made condom which we could make out of kitchen film. Would this be reliable, Doc?

A: Certainly not! There is a high chance that it would leak inside your vagina and you would become pregnant. If you want to use condoms, please get yourselves some real ones.

Email questions to Doc at saturdaylife@gleanerjm.com and read more in the Outlook Magazine tomorrow.