As with any study, there are certain rules and principles of preparation when taking gynecological smears. It is important to understand that the final result and the informativeness of the smear largely depend not only on the technique of taking material and preparing smears, but also on the preparation of the patient. Preparing for smears in gynecology is actually not difficult. Here are the basic rules:
- Smears are not taken during menstruation or other bleeding from the genital tract.
- On the day of taking smears and the day before, you should not douche or use any aggressive antibacterial agents for hygiene.
- Sexual activity within the specified period is undesirable - that is, 2 days.
The most interesting thing is that sexual activity with a condom can affect the result of a smear due to the spermicidal lubricant of the condom, and open sexual intercourse can present another unpleasant surprise. Spermatozoa, especially live ones, are very often mistaken by laboratory technicians for Trichomonas, which forces laboratory diagnostic specialists to give the patient the unpleasant diagnosis of trichomoniasis or trichomonas colpitis.
- Any courses of treatment with vaginal products - creams, suppositories, tablets must be completed no earlier than 3-5 days before taking smears. Of course, smears while taking vaginal suppositories are completely uninformative.
- On the day of taking a smear, it is recommended to abandon hygiene procedures or carry them out only externally and without using any detergent - just clean water.
- It is recommended to refrain from urinating 2-3 hours before taking a smear, since urine can wash away the material and a smear from the urethra will not be informative.
Gynecologists and venereologists of the “old school” adhered to an interesting rule. At that time, the arsenal for diagnosing sexually transmitted diseases was extremely limited and was, in principle, limited only to gynecological smears. Then the woman was asked to carry out a so-called provocation on the eve of the smear.
The provocation included eating salty, spicy food, a small amount of alcohol the night before, and going to the bathhouse or sauna. By the way, menstruation also belonged to such a provocation, so the 4-7th day of the menstrual cycle was and is considered the ideal time for taking smears. Nowadays this method of increasing the information content of strokes has been forgotten, but in reality the method is quite working.
How is a smear taken in women?
A smear is one of the research methods in gynecology, which makes it possible to identify female genital diseases (thrush, STDs, uterine tumors, vaginosis). What is a smear test for women?
This is a procedure for obtaining material for laboratory microscopic examination. The gynecologist takes a scraping from the genital mucosa.
There are two types of smears:
- Flora smear (checks for the presence of microbes)
- Cytological scraping (cervical tissue is examined)
A smear on the flora reveals the characteristics of the microflora of the female genital organs. Disruption of the natural microflora of the vagina or cervix can lead to serious gynecological diseases.
A normal smear includes several elements:
- Rod flora
- Epithelial cells
- Leukocytes
By the number of epithelial cells, you can determine the day of the menstrual cycle, as well as the content of certain hormones. The leukocyte level will indicate the presence or absence of infectious diseases.
The norm is different in each phase of the cycle. In the first phase, the norm of leukocytes should be from 10 units, in the second from 10 to 15. Rod flora provides acidity in the vagina. The presence of other microorganisms in the flora indicates a disease that requires treatment.
There are likely cases that the smear was taken incorrectly by the gynecologist, or the infection is hidden. In such cases, the flora smear is repeated. It is best to take a smear for PCR (polymerase chain reaction) or culture.
A smear is taken to prevent female genital diseases. And also for diagnostic purposes, if there is a feeling of discomfort, itching and uncharacteristic discharge.
It is recommended that women undergo a flora test after long-term use of antibiotics and before conceiving a child.
A smear is taken using a special gynecological instrument on a doctor’s chair. The procedure is considered painless. Only some people feel slight discomfort when taking a smear. The material is applied to special glass and subsequently sent to the laboratory for research. The resulting material is stained with special reagents and studied microscopically, identifying deviations.
You should have a pap smear every 6 months to prevent various diseases.
Learn about taking a smear from the video provided.
Reasons for the appearance of discharge after a gynecological examination
Visits to specialists of this kind involve certain manipulations in the vaginal area. The appearance of bloody discharge after examination by a doctor can be the result of:
- careless use of instruments: they are used to examine the inside of the vagina, and its mucous membrane, like the surface of the cervix, is very sensitive and easily damaged;
- patient behavior: vaginal tension or fidgeting during manipulations contribute to injury to mucosal tissue;
- Taking a smear is a necessary procedure to determine the health of the genital organs; it involves collecting cells from the mucous membrane with a special instrument resembling a brush or a small brush. During its implementation, the tissues may be slightly damaged and cause spotting and bloody discharge after visiting the gynecologist;
- the beginning of menstruation: manipulations performed inside the vagina can provoke its onset ahead of schedule, as a result of which a brownish secretion may initially appear.
The above factors are usually not harmful to health. Normally, after an examination by a gynecologist, the discharge will bother you for a maximum of one or two days. If after this time the symptom does not go away, you need to seek help. It also happens that after a gynecologist, or more precisely, after his actions, there is pain in the lower abdomen, burning and itching in an intimate place without discharge.
If the discomfort does not go away after a couple of days, then you need to visit the hospital. It is possible that an infection was introduced during the doctor's examination.
We cannot exclude the possibility that the time of the appearance of the pathological secretion only coincided with the date of the examination and the reason for its appearance was not a visit to the doctor. We recommend that you study information about what discharge can be during pregnancy and what they mean in our article at the link.
Preparation for flora analysis
It is necessary to prepare correctly for taking the analysis. There are some preparation rules, it is important to follow them so that the results are correct.
If you are menstruating, you should postpone your visit to the doctor. During menstruation, smears are not taken, since no pathological abnormalities will be visible among the red blood cells; blood has an antimicrobial effect. It is best to take a smear between periods or three to four days after the end.
Before taking the test, you do not need to thoroughly wash your genitals; it is important that the flora remains natural. You are only allowed to wash with soap; you cannot use gels, shampoos or special products. The acidity of the vaginal environment is disturbed by the use of various detergents.
It is worth refraining from urinating for several hours before going to the gynecologist. Before taking a smear on the eve of the test, you should not use suppositories, ointments or tablets. You should not take a bath or douche before the test.
One or two days before the test you should not be sexually active; you should abstain from sexual contact.
By following all the recommendations for preparing for the test, you will be able to see the correct results and will not have to take the smear again.
Decoding flora indicators
The result from the cervical canal is designated in the analysis by the letter C.
Table 1 deciphers the analysis designations and normal indicators.
| Designation | Decoding | Norm |
| (L) | Leukocytes | From 0 to 15 |
| Slime | Slime | Normal volume |
| (trich) | Trichomonas | Absent (there may be a dash) |
| (Gn) | Gonorrhea, gonococci | None |
| Candida | Candida | None |
Anything above or below normal indicates an inflammatory process and requires treatment. You don’t need to do the decoding yourself; a qualified doctor is responsible for this!
Making the correct diagnosis
For a correct diagnosis, a complete history of all symptoms is needed. Light bleeding that ends quickly should not be a cause for concern. More voluminous ones require close attention and additional examination.
Excessive bleeding interferes with gynecological examination. In such cases, an ultrasound is performed, which is completely harmless even for pregnant women. With its help, you can diagnose the disease, determine the duration of pregnancy, and existing pathologies.
Leukocytes in the cervical canal
A flora study reveals the number of leukocytes. If there are few of them, then this is normal. Leukocytes are designed to protect the female genital organs from infections.
The norm of leukocytes in a healthy woman is approximately up to 15 units per field of view, but no more. Also, the amount depends on the day of the menstrual cycle, so when taking the test, the specialist taking the test asks the woman when her last menstruation was.
If the level of leukocytes is significantly increased, then most likely an inflammatory process is occurring in the genitals (vaginitis, colpitis and other infections). The greater the deviation from the norm, the more acute the disease. To clarify the diagnosis, additional examinations are carried out.
Let's consider how many leukocytes should be normal in a particular female genital organ:
- The norm of leukocytes in the cervical canal should be no more than 15
- In the vagina, the norm is no more than 10 units
- The indicator in the cervix should correspond to no more than 15
- In the urethra there should be a norm of less than 5
The level of leukocytes in the cervical canal of a healthy woman should be normal. After taking a flora test, you need to ask your gynecologist about the results and leukocyte levels.
Discharge after examination by a gynecologist during pregnancy
During pregnancy, the frequency of any activities in the vaginal area decreases significantly. You should be especially careful with them in the early stages, when there is the highest risk of miscarriage. Because of this, the doctor tries to carry out any manipulations no earlier than 8 weeks. In this case, there is a possibility of blood particles or brown stains appearing in the mucus.
Discharge after examination by a gynecologist during pregnancy can be caused by:
- trauma to mucosal tissues: during pregnancy, a large amount of blood flows to the genitals, which makes the vagina and cervix especially sensitive to the touch of medical instruments;
- the passage of a mucus plug, which coincided with an appointment with a gynecologist: usually at 38 weeks, the doctor suggests undergoing an examination on a chair to look at the readiness of the cervix for labor;
- injury to the internal genital organs - this is a dangerous phenomenon and requires prompt medical attention;
- abruption or placenta previa - this is typical for pregnant women who have problems with the course of pregnancy. In this case, the inspection becomes a catalyst for such negative processes.
Brown discharge during pregnancy after examination, especially in the later stages (38-40 weeks), should not cause alarm unless it is accompanied by other unpleasant signs (inflammation, itching, etc.). Often, spotting after examination at 40 weeks of pregnancy becomes a harbinger of labor. Brown discharge may also appear in women before childbirth; these are signs of the same phenomenon.
Care should be taken when a similar symptom appears in the second trimester. If in the early stages of pregnancy it may be the result of any hormonal changes or implantation of the fertilized egg, then later it will indicate a possible pathological condition.
In any case, all unusual signs during pregnancy should be promptly reported to the gynecologist who is observing you. He will also tell you if the body is ready to give birth.
Elevated white blood cell count
An increased level of leukocytes in the cervical canal indicates inflammation. And the higher the indicator, the more acute the disease. With inflammation, the numbers can reach 100. Or even the test results may say: “leukocytes cover the entire field of view,” in which case urgent measures must be taken and treatment must begin immediately.
Indicators also increase during pregnancy, as hormones act on the level of leukocytes. Dormant infections appear.
Inflammations can occur from STDs (sexually transmitted diseases). In addition, thrush causes an increase in white blood cells.
What are the types of STDs?
- Mycoplasmosis
- Syphilis
- Herpes
- Gonorrhea
- Ureaplasmosis
Diseases that are detected with elevated levels of leukocytes:
- Endometritis - inflammation of the uterine walls
- Cancers of the reproductive system
- Cervicitis – inflammation of the cervix
- Colpitis - inflammation of the vaginal walls
- Intestinal dysbiosis
- Vaginal dysbiosis
- Adnexitis - inflammatory processes in the ovaries
- Urethritis is a disease of the genitourinary system
If high levels are detected, the doctor usually prescribes additional tests. To identify the cause, a PCR test is performed. Having identified the disease, the gynecologist prescribes a course of treatment. If local drugs are not effective, then antibiotic therapy is used.
There are cases in practice that after treatment the level of leukocytes does not decrease. This is often caused by vaginal dysbiosis. In this case, a repeated antibacterial course of treatment is prescribed.
An increased level of white blood cells should not be ignored, even if there are no other unpleasant symptoms. Consultation with a gynecologist will help solve any gynecological problems.
Reasons for the appearance of discharge after a gynecological examination
By examining a smear to identify suspicious cellular elements, a specialist can damage the vulnerable surface of the vagina, which is why brown discharge occurs after examination by a gynecologist. As a rule, they pass quickly.
Brownish discharge after taking a smear can also signal pathological changes in the pelvic organs, or be a consequence of stress, an unhealthy lifestyle, taking contraceptives, or wearing an intrauterine device.
By the way, after installing the spiral, the discharge may also be different, so we advise you to read separate information on this topic.
The pink color of the discharge indicates the presence of hormonal problems, the occurrence of erosion, and endometriosis. When scraping, the doctor scratches the erosive surface or touches excess growth, which begins to bleed.
Normally, representatives of the fairer sex should have discharge of short duration if emergency methods of contraception (Postinor) are used, laparoscopic surgery has been performed, erosion has been cauterized, or low functionality of the thyroid gland has been detected.
After Postinor, the discharge may be unusual in nature, so special attention to this issue is required.
Leukocytes are low
A reduced number of white blood cells is observed in a certain group of women who rarely have sexual relations with men. There may be no leukocytes at all in older women, with tissue atrophy in the vagina. Such cases are quite rare and are a deviation from the norm.
The absence of leukocytes or a small number of them negatively affects a woman’s health, since there is no protection for the genital organs, they are more vulnerable to infections. To strengthen the immune system, it is necessary to maintain the optimal number of leukocytes in the cervical canal.
How to increase the number of leukocytes to normal:
- Maintaining intimate hygiene
- Regularly washing the genitals, especially in the evening, also before and after sex
- When washing, use a special product or soap with a low acidity level, since the vagina needs to maintain its pH level
- Avoid gels for intimate hygiene, they wash away protective bacteria from the genitals
If the external genitalia experience dryness, then after washing you need to use a special moisturizing cream that contains the hormone estrogen. The cream will help get rid of dryness and provide a positive effect on the vaginal microflora.
The most important thing is sexual intimacy with a man. A sufficient amount of sex in a woman’s life allows her to regulate the level of leukocytes, and, therefore, the body will be protected.
If the level of leukocytes in the cervical canal is low, some recommendations should be followed, then the level may increase. If, with independent efforts, the level of leukocytes does not increase, you should consult a specialist for additional advice.
Bloody discharge after examination in pregnant women
If, with caution, discharge is still observed after examination by a gynecologist during pregnancy, this can be caused by:
- injury to tissues to which blood flows;
- separation of the mucus plug;
- damage to internal organs, which is dangerous and requires medical intervention;
- abruption or placenta previa.
When checked in the fortieth week of pregnancy, bloody or brown discharge often indicates imminent labor. This is usually preceded by the rejection of the mucus plug, which clogs the uterus, protecting the fetus from infection.
Normally, small discharge is not accompanied by annoying symptoms such as itching and inflammation. If they occur, this indicates possible pathologies.
In the early stages of pregnancy, hemorrhages can threaten the development of inflammatory or infectious diseases, deformation of the cervix, and miscarriage.
Spotting can occur after examining the expectant mother's cervix, cytology, since this organ is very traumatic, any external invasion can cause damage to the epithelium and, as a result, discharge from the genital tract.
Existing neoplasms inside the reproductive organs (polyps, tumors) are very often traumatized during examination, causing hemorrhage. This should worry you and be a reason to contact a specialist.
