The Papanicolaou test (Pap Test, Cervical Smear, Pap Smear or Smear Test)

What is Pap smear?

A Pap smear is a simple test to check your cervix to make sure it is healthy. Your cervix is the opening of the womb. The Pap test (or Pap smear) looks for precancerous cell changes on the cervix that might become cervical cancer if they are not treated appropriately.


Why are cervical screening tests advised?

Cervical cancer is a disease that can often be prevented. Early changes can be detected in the neck of the womb (cervix), which indicate that cancer may develop. It usually takes 3–7 years for high-grade changes in cervical cells to become cancer. Cervical cancer screening may detect these changes before they become cancer. Since screening started, the numbers of cases of cervical cancer have dramatically dropped. It is one of the few types of cancer which can be detected and stopped before it ever begins.


What causes cervical cancer?

An infection with a virus called HPV (human papillomavirus) is the cause of almost all cervical cancers. There are more than 100 different types of HPV. Two of these types are known to cause most of cervical cancer. HPV is very common. Most people (four out of five) will have HPV at some time in their lives. Anyone who has ever had sex can have HPV. In most cases, HPV clears up by itself in a few years. This means that most women who are infected with HPV do not develop cancer. Sometimes the virus can stay in your body longer and can lead to cervical cancer. This usually takes a long time.


How is Pap smear done?

During the Pap test, the doctor will use a plastic or metal instrument, called a speculum, to widen your vagina. This helps the doctor examine the vagina and the cervix, and collect a few cells and mucus from the cervix and the area around it. The cells are then placed on a slide or in a bottle of liquid and sent to a laboratory. The laboratory will check to be sure that the cells are normal. If the test shows any abnormality, you will have treatment to stop you ever getting cancer of the cervix. So, an abnormal test does not mean you have cancer. It means you should have some treatment to stop you getting cancer. Cervical screening tests are not painful, although some women find the speculum uncomfortable. It generally helps if you can relax – this makes the experience better for you and easier for the person taking the sample.


When does Pap smear need to be done?

The screening guidelines vary from country to country. In general, the Pap test is recommended for all the women about the age of 21 – 25 years and continuous until the age of 65 years. It can be done in a doctor’s clinic. Screening is typically recommended every 3 to 5 years as long as the results are normal.

Pap smear screening is also recommended for those who have been vaccinated against HPV. As the vaccines don’t cover all types of HPV and the vaccine does not protect against HPV exposure before vaccination.

Only cancer for which the Pap test screens is cervical cancer. It does not screen for ovarian, uterine, vaginal, or vulvar cancers. So even if you have a Pap test regularly, if you notice any signs or symptoms that are unusual for you, see a doctor find out why you’re having them. If your Pap test results are normal, your doctor may tell you that you can wait three years until your next Pap test.


What do the results of the cervical screening test mean?

In most women, the cells that are taken are found to be normal. Abnormal cells are found in some women. An abnormal result does not mean cancer in the vast majority of cases. Abnormal cells indicate that cancer may develop sometime in the future. About 6 women in 100 will have an abnormal result that requires further testing or treatment.The results are reported as one of the following:

  • Normal.
  • Inadequate.
  • Abnormal – of which there are several grades or degrees of abnormalities from low grade to high grade.
  • Possible cancer cells: invasive or glandular neoplasia.

Most of these changes will not lead to cervical cancer. Treatment can be given to prevent cancer from developing in women with abnormal cells. Depending on your test results, your health care provider may recommend:

Routine follow-up testing. Depending on your age and tests received, this may be every 3-5 years.

Follow-up testing with a Pap test and an HPV test.

Colposcopy and cervical biopsy

Like a lot of medical testing, it’s not very pleasant to do a pap smear but the brief discomfort isn’t a good reason to neglect your wellbeing. Getting regular pap smear is the best way to protect your health from cervical cancer.

Dr.Usha Sethi

Specialist Gynaecologist 

Aster Clinic, Tecom (Barsha Heights) 



Read More

Periods are not meant to be painful

It is human tendency to believe that certain conditions appear only among adults, failing to realize how ignorance leads to greater health issues in the future. Chicken pox for example, once a child gets chicken pox we believe that it is not going to occur again. Nobody takes the effort to know more in detail about an issue, the causes for it and if it has any future implications. Another major health issue that is considered to affect only adult women is Endometriosis. Endometriosis is a health condition that affects almost 100,000 women in the UAE.  It is a condition of equal opportunity, differentiates on no grounds. The youngest patient of Endometriosis as literature states was said to have been 101/2 years of age who had only two previous menstrual flows.

Endometriosis is a condition where the tissue that serves as the lining of the uterus starts growing outside in other places like the ovaries, fallopian tube, outside the uterus, the bladder, the intestines and others.  The most common symptom of Endometriosis is adolescents is pain during the menstrual flow. There are other symptoms including heavy bleeding during periods, or irregular periods and spotting, painful urination, pain during sexual activities. In some cases, women experience pain is areas where the tissue or uterus lining has developed.

It is common for women to experience discomfort during menstruation, but the intensity of pain and discomfort experienced is what determines whether or not medical attention is required. In order to understand why women experience pain during menstruation, we need to know what happens inside a female body during menstruation. During each menstrual flow, the lining of the uterus sheds because this is when the uterus is ready to receive the egg released from the ovaries. If the egg is not fertilized, the uterus sheds the uterus lining. One cause of pain during the menstrual cycle is a chemical called prostaglandins, which causes the uterus to contract when the lining is shed and these contractions, in turn, cause pain.

There are no fixed causes for the condition, even Doctors do not have an established reason for the causes of Endometriosis. Although hereditary factors do play a rather strong role in the same, women who have family members suffering from Endometriosis are more likely to develop the condition.

In most cases of adolescents, endometriosis as a health condition is not diagnosed because it is either considered a normal part of menstruating or the abdominal pain is considered to be caused because of some other cause. A lot of times, they themselves are unable to distinguish between what is normal pain and what isn’t, for they may have only experienced the cycle a few times and do not know.  Slight pain during the first few days of menstruation is normal but the continued pain that disrupts normal day to day activities isn’t normal. This is how we as individuals can understand that something about the functioning of the body is wrong. Constant pain during periods, worsening of the period pain, heavy flow during periods, back pain, diarrhea, feeling of nausea, constipation, painful urination, feeling of seeing blood when using the bathroom, inability to function normally and refraining from physical activities etc. are some of the most common visible symptoms of Endometriosis.

Yet again, on visible symptoms such as these, we need not conclude that the girl is suffering from Endometriosis, there is a possibility that these symptoms could have occurred because of any infection. Women generally tend to ignore such symptoms, period pain, in particular, is always disregarded as normal but do we know how much pain is normal, the intensity of the pain matters. On viewing any abnormal symptom or anything abnormal in the body, a Gynecologist must be consulted. The Doctor may require certain tests to rule out every other possibility. The only way to conclude that a woman is suffering from Endometriosis is by performing a minimally invasive surgery called Laparoscopy where the doctor views the organs in the pelvic cavity with the use of a thin telescope called as Laparoscope. This gives the doctor a clear picture of the internal cavity, hence making diagnosis easier.

Dealing with Endometriosis is definitely challenging for it has no definite cure but that is no reason to dread the issue, individual symptoms experienced can be controlled. There are certain medications available to control the condition. Surgery may also help if medications do not work at all, although results may vary from person to person. One woman may find it helpful while the other may develop pain again over time. Certain lifestyle changes and exercises like walking and swimming may also help a long way in curbing the condition.

Every girl needs to take their body seriously and never shy away from asking if anything seems different. Regular health checks are a must, moreover, if a condition such as Endometriosis is diagnosed in the very beginning it will help reduce the severity of the condition and a woman may never have to say ‘I wish I had been diagnosed earlier’.


Dr. Ann Mini Mathew 

Specialist Obstetrician/Gynaecologist 

Aster Hospital Mankhool 


News Source – Filipino Times 


Periods Painful


Read More

The Most Common Reproductive Disorders

Do I have Polycystic Ovarian Syndrome (PCOS)? 

PCOS is one of the most common hormonal disorder caused in women of reproductive age. It is caused by hormonal imbalance and metabolic issues in women, also affecting their physical appearance and overall health. Although most experts believe that there are a number of causes including genetic factors that cause PCOS, the exact cause of the condition still remains unknown. Androgen is a male hormone which is produced in the body of every women but in very small amounts, the excess presence of Androgen causes male pattern baldness and excess facial hair growth which are two symptoms of PCOS. High levels of male hormones can also cause the ovaries to not release an egg during the menstrual cycle. Another cause of PCOS, as believed by experts is Insulin resistance, insulin is a hormone that converts the food we consume into energy. When the body does not respond to insulin, the insulin levels in the blood becomes higher than normal which in the long run could cause Type 2 Diabetes.

Women with PCOS have similar symptoms but they may experience them differently. The severity and the type of symptoms visible in women vary. The most common symptom experienced is irregular periods, delay of normal menstruation, fewer than normal periods and painful menstrual flow. Excessive body or facial hair, male pattern balding from the scalp, acne, infertility, weight issues, skin discoloration, acne, difficulty in losing weight etc are the most commonly seen symptoms of PCOS. This may not all appear together in a woman, some may have one of the symptoms, and others may have more than one. For a lot of women, the process of being diagnosed with PCOS in itself could be a challenge, for instance in the case of balding or skin discoloration, a Gynecologist will not be our choice of Doctor. PCOS can go undiagnosed for a period of time because the symptoms may overlap with other medical conditions women face. On conducting blood tests, physical tests, pelvic test and an ultrasound, if a women has one of any the symptoms; namely multiple cysts on each of the ovaries, excess androgen levels, irregular periods, she will be diagnosed with PCOS.

What is the cure? 

There is no permanent cure or treatment for PCOS. Each symptom can be individually managed and treated. On experiencing any visible symptom or any bodily change, one should consult a Doctor, and on being diagnosed with PCOS, the Doctor would prescribe medication and treatment options depending on the symptoms. Fertility treatments are available to help women conceive. But the ideal way to treat PCOS is through nutrition and exercise, losing as little as 5% excess weight can help women reduce symptoms. Losing weight is an extremely important aspect of the condition and even though it may seem difficult to lose weight, one should continue the effort because it helps avoid the risk of certain conditions that may affect women with PCOS much earlier than women without PCOS. Health issues like heart diseases, stroke high cholesterol, diabetes, high BP are linked to long term consequences of PCOS. Surgery is the last resort for PCOS where laparoscopic drilling is done to trigger ovulation in women, the surgery can be an option for women who do not ovulate even after losing weight or trying fertility medicines.

Endometriosis, on the other hand, is a health condition that affects almost 100,000 women in the UAE. It is a condition that sees no differentiation and appears in women across all age groups. Endometriosis is when a condition when the tissue that lines the uterus begins to grow outside the uterus in areas like in pelvic organs and rarely beyond. With endometriosis, the tissue would act like it normally would, it will break down and bleed with each menstrual cycle, but since the tissue is displaced it has no way to exit the body.

Are the symptoms similar to PCOS? 

Endometriosis may appear with symptoms or also be asymptomatic. Similar to PCOS, Endometriosis has no designated cause but the menstrual blood containing the lining that has to flow out of the body may flow back into the pelvic cavity through the fallopian tubes in a condition called retrograde menstruation, the immune system may be unable to recognize the tissues growing outside the uterus, heredity factors, a surgical after effect where after a Hysterectomy or C-section the endometrial cells may stick to an incision.

The severity of the condition depends on the exact location, extent, and depth of the endometrial lining deposit. Symptoms of the condition differ in each woman. Some women may experience painful periods, pain during intercourse, painful urination, excessive bleeding, infertility, digestive issues like diarrhea, constipation etc. Sometimes this condition is asymptomatic. Some women wild mild endometriosis may experience severe pain and sometimes women with severe endometriosis may have mild pain.

Can it be treated?

Unlike PCOS, Endometriosis has the option of surgical treatment. Endometriosis is generally treated with medication or surgery depending on the severity of the symptoms and depending on whether or not the woman chooses to conceive.

Surgery is beneficial if the woman is experiencing severe pain. Hormone therapy is used to treat pain related to Endometriosis. Generally, on consultation, doctors would suggest surgery be the last resort and will begin with pain relief medications. Conservative surgery, assisted reproductive technology and hysterectomy are the surgical methods used. Conservative surgery is done in case the woman wishes to become pregnant, assisted reproductive technology like IVF will help in conceiving and is preferable if the conservative surgery does not produce effective or desired results. Hysterectomy is the choice of procedure is the condition is severe and if the woman does not desire to conceive because in this surgical procedure the reproductive organs are removed.

The key to successful fertility treatment 

Endometriosis is a progressive disease and can recur after stopping treatment. The key to successful fertility treatment is not delaying pregnancy. A woman diagnosed with Endometriosis desiring pregnancy should complete her family at the earliest. Endometriosis affecting the uterine wall can cause a condition called Adenomyosis can cause severe bleeding and pain during periods, the condition also causes infertility. Laparoscopic surgery is performed if the woman wishes to conceive where the surgeon removes any visible endometriosis implants and scar tissue that may be causing pain or infertility. The definitive or curative treatment for the condition is the removal of the uterus and ovaries.

These are all methods by which the quality of life for a woman living with the condition can be improved. For both PCOS and Endometriosis, the type and method of treatment should be decided by a healthcare professional depending on various factors like age, severity of the condition and the symptoms associated with it. These are both conditions that are widely present in women but generally goes unnoticed because a lot of times women tend to ignore a lot of the symptoms associated with these conditions.


Dr. Ann Mini Mathew

Specialist Obstetrician/Gynaecologist

Aster Hospital Mankhool


News Source – Mother Baby child Magazine 2016


Dr ann 1Dr ann 2



Read More

Major Gynecological Problems

Did you know the strangest menstrual bleeding is due to Hormonal Imbalance? Most women are not aware of the signs of gynecological problems and are particularly uninformed of symptoms irrelevant to the reproductive organs, such as back pain and increased urination.

Here are a couple of basic Gynecological issues that each woman needs to know:-


Essentially dysmenorrhea is by far the most well-known gynecologic issue in menstruating women. It is common to the point that many women neglect to report it in medical interviews, even when their daily exercises are limited. It is usually defined as cramping pain in the lower abdomen occurring at the onset of menstruation in the absence of any recognized pelvic disease. It is distinguished from secondary dysmenorrhea, which refers to difficult menses         because of pelvic pathology, for example, endometriosis.

Dysmenorrhea refers to the symptom of painful menstruation. It can be separated further into two general classifications: primary (occurring in the absence of pelvic pathology) and secondary (resulting from identifiable organic diseases)

Primary dysmenorrhea is another name for regular menstrual cramps. Cramps normally start after one or two years after a woman starts getting her period. Pain usually starts in the lower abdomen and back. It can be mild to severe. Basic menstrual cramps start shortly before or at the onset of the period and proceed one to three days. They generally turn out to be less difficult as a women ages and may stop entirely after the women have her first child.

Secondary dysmenorrhea is pain brought on by a disorder in the women’s reproductive organs. These cramps usually begin in the menstrual cycle and last longer than regular menstrual issues.

Ovarian cysts    

The ovary is one of a couple of conceptive organs in ladies that are situated in the pelvis, one on every side of the uterus. The ovaries produce eggs (ova) and female hormones estrogen and progesterone. The ovaries are the principle source of female hormones, which control the advancement of female body qualities, for example, the breasts, body shape, and body hair. They likewise control the menstrual cycle and pregnancy. Ovarian cysts are shut, sac-like structures inside an ovary that contain a fluid, or semisolid substance. “Cyst” is simply a general term for a liquid filled structure, which might speak to a tumor or neoplasm (new growth). On the off chance that it is a tumor, it might be favorable or dangerous. The ovary is likewise alluded to as the female gonad.


Endometriosis sometimes called “endo,” is a typical wellbeing issue in women. It gets its name from the word endometrium, the tissue that ordinarily lines the uterus or womb. Endometriosis happens when this tissue becomes outside of your uterus and on different regions in your body where it doesn’t have a place.

Most often, endometriosis is found on the:

  • Ovaries
  • Fallopian tubes
  • Tissues that hold the uterus in place
  • Outer surface of the uterus

PCOD (Poly Cyst Ovarian Disease)

Polycystic Ovary Syndrome (PCOS) is a common disorder, affecting 5-10% of women of reproductive age. Women with PCOS have a number of conditions that may include irregular menstrual cycles, an increase in facial and body hair, increased weight, hyperinsulinemia, and infertility. Diagnosis is made on the basis of a combination of clinical, laboratory and ultrasound findings. Women with PCOS are at a greater risk of complications during pregnancy, including Miscarriage, Diabetes (Gestational Diabetes), Preterm Birth, and increased Fetal and Neonatal Death.


Dr. Keya Rahul Shivadey

Gynaecology/obstetrics, Aster Clinics



Read More

Best gynecologist in Dubai

Pregnancy can be a daunting experience for a lot of women, and especially for those women who are getting pregnant for the first time. Under such novel and fragile circumstances, sometimes a woman’s gynecologist can serve as a point of support, both medically and otherwise. Hence, it becomes imperative that women find a gynecologist that they can put their trust and faith in during the term of their pregnancy.

In Dubai itself there are a large number of practicing gynecologists. But in order for you to choose the best gynecologist in Dubai for yourself, it is important that you keep certain factors in mind such as:

  • Get referrals: Asking your primary physician, family and friends for their recommendations in choosing a gynecologist, will only help you focus on the most meritorious candidates when choosing the best gynecologist in Dubai.
  • Research their credentials: In order to get treated by the best gynecologist in Dubai for your needs, you have to research their credentials. Including their academic background, past experience in the Middle East, and the number of live births that they have handled previously. Again, it always helps if the doctor in question has been referred by someone that you trust.
  • Consider the gynecologist’s experience: When choosing the best gynecologist in Dubai to treat you during your pregnancy term it becomes very important to have an experienced doctor who has dealt with high risk pregnancies successfully in the past. The more experience a doctor has with a condition or procedure, the better your results are likely to be.
  • Research the hospital quality: Ensuring that the gynecologist treating you works at a hospital that offers high quality services is extremely vital. The most important part of your pregnancy will take place in the hospital, and a top rated hospital would have a better rate of successful pregnancies. Your doctor can be the best gynecologist in Dubai only if they practice in a hospital that provides a high standard of healthcare services.

The aforementioned steps are just guidelines in your search for the best gynecologist in Dubai for your pre-pregnancy, pregnancy, and post pregnancy needs. The more thorough your research on your doctor and their practicing hospital, the better your chances will be to find a gynecologist that understand your needs and works with you every step of the way during your pregnancy.


Read More