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Don’t Rely on Your Pap Smear Schedule for Chlamydia Screening

STD Chlamydia

If you’re sexually active, you’ve probably heard about the dangers of sexually transmitted diseases (STDs). That’s why you faithfully follow your physician’s recommendations for regular checkups, Pap smears, and STD testing. But a change in Pap testing frequency has decreased the amount of diagnoses of the most common bacterial STD—chlamydia. And physicians are worried.

Reduction in Pap Smear Frequency

In the recent past, women were advised to have an annual Pap test, pelvic exam and breast exam. But now, annual Pap smears are history. This is because we now better understand the way cervical cancer develops over time. Regardless of whether or not you are due for a Pap test, Women’s Health Arizona highly recommends annual well woman exams.

The U.S. Preventive Services Task Force (USPSTF) and ACOG recommend a Pap test to screen for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29. For women aged 30 to 65, screening is recommended every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting). 

The problem with the reduction in Pap smear frequency is that STD testing it typically done during or after your Pap smear. A Pap smear only tests for signs of HPV, and not for other STDs. STD testing is not automatically included as part of your well woman exam so be sure to request it if you have had unprotected sex with a new partner, if you or your partner have not been tested for STDs recently, or if you notice any unusual symptoms.

How Screening Frequency Impacts Diagnosis Rate

Chlamydia infection was the most common notifiable sexually transmitted infection in the United States in 2020. During 2019–2020, rates of reported chlamydia decreased among males and females in the United States across most racial and ethnic groups. However, decreases in rates of reported chlamydia were unlikely due to a reduction in new infections. As chlamydial infections are usually asymptomatic, case rates are heavily influenced by how many preventive and screening services are performed. Also, the COVID-19 pandemic played a role as annual well woman visits decreased. In sum, it’s not that the actual incidence of chlamydia infection has decreased, we are just not identifying as many new cases. The risk is that we will have more chlamydia cases in the future.

The Dangers of Chlamydia

Why is chlamydia so dangerous? For one thing, it often doesn’t cause symptoms, so you might not even know that you have it. Plus, if left untreated, it can spread to your uterus and fallopian tubes, causing lasting damage to your reproductive system.

Untreated chlamydia can lead to:

  • Difficulties getting pregnant
  • Pelvic inflammatory disease, which can cause ectopic pregnancy and chronic pelvic pain
  • Pregnancy-related complications
  • An increased risk of developing HIV

Recommendations for Screening

Besides practicing safe sex, one of the best ways to protect yourself from chlamydia is to increase your screening frequency. All sexually active women younger than 25 years old should be tested for chlamydia annually. Additionally, women 25 years and older with risk factors such as new or multiple sex partners or a sex partner who has an STD should also be tested annually.

Testing during or after your Pap smear with a swab of cervix discharge isn’t the only way to screen for chlamydia. You can also take a simple urine test.

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If you would like to meet with a knowledgeable doctor, consider contacting Women’s Health Arizona. As Arizona’s largest ObGyn group, we’re trained and solely dedicated to delivering the best ObGyn experience in convenient and comfortable settings around Phoenix.