During a QPP exam:

1. 1. Your provider examines your front parts and checks for abnormalities, such as redness, discharge, and/or pain.
   2. Your provider inserts a lubricated speculum in your front hole. A speculum is a device used to open your front part and observe your cervix. It may feel weird or uncomfortable, but it shouldn’t hurt.
   3. If you’re getting a Pap smear, your provider uses a tiny spatula to wipe a small sample of cells from your cervix. This sample is sent to a lab for analysis to check for pre-cancer or cancer in your cervix. Your provider may also test you for STIs like chlamydia or gonorrhea as needed.
   4. Your provider puts a lubricated finger in your front hole to check for tenderness and pain in your uterus and ovaries.

This whole process only takes a few minutes.

If you’re sexually active and have a cervix, you’re at risk of getting cervical cancer, even if you don’t have penetrative sex. A major cause of cervical cancer is human papillomavirus, or HPV, a common sexually transmitted infection. HPV is usually harmless, but some types can lead to cancer. HPV spreads through sexual skin-to-skin contact with someone who has the virus. This includes oral sex, fingering, genital rubbing, and sex with toys. HPV is widespread and very contagious.

Consider these tips to prepare for your QPP:

• Ask questions! Our providers are happy to answer them.
• If you bleed monthly, wait until you’re not bleeding to do your exam.
• If you’re on testosterone and/or penetrative sex is painful, you can ask for a topical estrogen prescription to apply to your front parts for 1-2 weeks before your exam to make it easier. And don’t worry, this doesn’t mess up your hormone levels.
• If you rarely or never use your front hole and/or do not insert anything into it, consider bringing topical lidocaine for your provider to apply before your exam.
• If the thought of the exam makes you feel anxious, you can ask your provider about prescribing an anti-anxiety medication to take beforehand.
• You can say “stop” at any point during your exam if you’re uncomfortable or in pain. You’re in full control of your body, exam, and experience.

Your provider will ask you questions like:

Your provider checks for abnormalities on your cervix and tests for STIs as needed. They may do additional testing if you have front part concerns like itching, pain, and/or discharge. If you have a Pap smear done, the sample of cells collected from your cervix is sent out to a lab for analysis to check for pre-cancer or cancer in your cervix.

You may get some minor bleeding after your exam. This is totally normal. We can provide absorbent products if needed. If you experience distress or discomfort during your exam, we suggest having a post-exam self-care plan ready.

Your provider sends your Pap specimen for analysis and follows up with you if it has abnormal results. We do everything possible to collect a high-quality specimen during your exam. However, sometimes the lab determines the cells are not adequate for testing. We may ask you to return to the office in 2-4 months for retesting if this occurs.

It depends on the results. Most people with a cervix need a pelvic exam and Pap smear every 3-5 years if the results are normal. Some people are screened more frequently depending on findings, family history, and history of STIs.

You can reduce your risk of getting cervical cancer by:

• Getting the HPV vaccine. We can vaccinate you at our clinic. Ask your provider for more information.
• Beginning at age 21, getting Pap tests every 3 years (or more frequently if recommended by your provider) and sexual health screenings every year.
• Getting HPV testing when recommended.
• Using condoms and other barriers during sex to significantly reduce—but not eliminate—your risk of transmitting HPV and other infections.