What is a Pap Smear? All You Need to Know

Keeping up with routine medical checks is important.

With many health conditions, the earlier risks are detected, the more options there are available.

This is the case with cervical cancer — the reason it’s important to go for a pap smear test when you’re due. [1]

For some people, this simple procedure can turn out to be life-saving.

But, yes.

Your first pap smear can be daunting.

The more you know about what to expect, the more confident you will be going into it.

We’ll take you through what a pap smear is, why it’s important, and what to expect during and after your appointment.

Read on.

In this article: 📝

What is a Pap smear?

A pap smear (also called a pap test or cervical screening) is a medical test to screen for cells that have the potential to turn into cervical cancer or have done so already. [2]

It’s been around since the mid 20th Century when George Papanicolaou (see where they get Pap from?) and his colleagues realized you could view cells from the cervix under a microscope to look for abnormalities. [3]

These differences help medical professionals detect signs of cancerous or precancerous cells.

Your cervix is the channel between your vagina and your uterus. [4]

(It means “neck” in Latin.)

The tissue that makes up the lining of your cervix is a really important part of your reproductive system.

It helps mucous pass up and down between the vagina and uterus, which facilitates everything from vaginal birth, the passage of sperm towards your fallopian tube, and the exit of your menstrual blood.

So yep, it has a pretty important job to play.

But sometimes, that tissue can change and abnormal cells in the lining of the cervix begin to grow uncontrollably.

If this happens, it can cause changes to your cells that can lead to cancer.

What does a pap smear test for?

A pap smear tests for:

• Cervical dysplasia, where abnormal cells grow on the surface of your cervix [5]
  
• Cervical cancer
  

It often includes screening for an STI called HPV (the human papillomavirus) because 13 types of the infection can lead to cervical cancer. [6,7]

HPV is very common, with more than 42 million Americans infected with types of HPV that are known to cause disease. [8]

HPV most commonly spreads through vaginal or anal sex but, it can also spread through skin-to-skin touching during sex.

An HPV test is usually done at the same time as the cervical screening — by collecting a tissue sample from your cervix.

This can be done through surgical removal (i.e. excision of the lesions or biopsies), freezing (also known as cryosurgery), or laser. [9,10]

This can be done through surgical removal, freezing, or laser.

(And top tip: there’s now also an HPV vaccine that can protect you from the infection.) [11]

Is a pap smear necessary?

In short — yes.

Approximately 14,000 people are diagnosed with cervical cancer every year in the United States. [12]

Pap smears and the HPV vaccine are two of the best defenses we have against cervical cancer.

If abnormal cells are detected early, they can be treated before they head deeper into the cervical lining.

Plus, you get full bragging rights for being on top of your reproductive health.

How often should you get a pap smear?

The recently updated guidelines from the American Cancer Society are that you should start getting screened for cervical cancer when you hit 21. [13]

According to the ACOG, women who are between the ages of 21 to 29 should have a pap test every three years. [14]

Between the ages of 30 and 65, you have the option of one of the following:

• An HPV test every five years
• An HPV/pap cotest every five years
• A pap test every three years

Talk to your healthcare provider about what is available in your area.

Side note: if you are outside of the US, you may be called to have a cervical screen earlier (at a younger age) and more frequently.

Each country has a different set of guidelines so make sure you are following the correct guidelines for where you live.

Do I need to have a pap smear if I have never had sex?

Yep, afraid so. [15]

Whatever your sexual history may be, it’s recommended that you have your routine cervical cancer screening.

You could still be at risk of cervical cancer so, for this reason, it is best to get checked. [16]

The truth is that if you are not sexually active, you are unlikely to have HPV, as this is spread through sexual intercourse.

But, it’s not impossible… so it’s better to get checked.

It may be worth mentioning to your doctor that you are not sexually active, though, when you make the appointment, just so they are aware.

What should I expect at my first pap smear?

A doctor or nurse will start by asking you about your medical and sexual history and ask you if you’re experiencing any uncomfortable symptoms.

During the exam, you will lie on your back with your feet up, either in stirrups or on footrests.

Using a cervical screening tool called a speculum, your doctor will open up your vagina so that they can get to your cervix.

They will gently brush the lining of your cervix to collect a sample.

This cell sample will then be sent to a lab for testing.

The whole appointment will likely be less than half an hour.

OK. We know.

This may not sound like the most fun, but luckily you don’t have to do it too often.

And it can be life-saving.

Experiencing anxiety before the procedure is common — and a reason people delay their routine screenings. [17]

Knowing what to expect before the procedure can help you feel more confident going in.

Addressing any underlying fears related to your physical and mental health is also important. Talk to your healthcare provider about how you’re feeling — and if that feels like too much, touch base with a friend or your Peanut community.

Using tools like aromatherapy and music to help relax can go a long way.

We promise you’re not the only one feeling out of sorts about going in.

Does a pap smear hurt?

A pap smear can be uncomfortable — particularly if it’s your first one and you’re not used to it.

But it shouldn’t be very sore.

And luckily, the procedure doesn’t last long, not more than a few minutes.

How long do smear results take?

According to the CDC, you can wait up to about three weeks to get your pap smear results. [18]

They can be:

• Normal
• Unclear (could be abnormal, but the test is inconclusive)
• Abnormal
• Unsatisfactory (not enough cells or cells that are clumped together, meaning you’ll have to go for another test)

An HPV test will be either positive or negative.

What is a normal pap smear result?

A normal or negative result means that there have been no changes to the cells on your cervix.

That means there are currently no cells at risk of becoming cancerous.

So you have normal results and wondering when to go back to see your doctor?

Always make sure you talk to your doctor about which testing option is right for you, but in the US, it usually follows this pattern:

• If you had an HPV test only (and all is normal): Your doctor may tell you to wait five years until your next screen.
  
• If you had an HPV and Pap test together (and all in normal): Your doctor may tell you to wait five years until your next screen
  
• If you had a pap test only (and all is normal): Your doctor may tell you to wait three years until your next screen.

What is an abnormal pap smear?

If you get an abnormal pap smear result, try not to panic.

Although this can feel scary, it usually doesn’t mean you have cervical cancer.

Rather, it means that there have been changes to the cells in your cervical lining.

In many cases, these changes are caused by HPV.

And thank goodness you went for a screening, because now you can get the treatment you need.

In some rare cases, an abnormal pap smear means cervical cancer.

But even if this is the case, if cervical cancer is detected early, there is a 91% chance of survival. [19]

(This means that people diagnosed with cervical cancer are 92% as likely to be alive five years after diagnosis than people without.)

Dos and don’ts before a pap smear (and what to expect after)

If you’re new to this whole pap smear thing (hey, we’ve all been there), it can be handy to know what to do to prepare, what to expect, and what not to do.

So consider this your guide.

Before your pap smear

To make sure that your pap smear results are as accurate as possible, the American Society of Clinical Oncology recommends avoiding the following two to three days before your appointment:

• Sex
• Douches
• Birth control foams
• Vaginal medicines, creams, and powders
• Tampons

After your pap smear

Is it normal to bleed after a pap smear?

Yes, you may experience some light bleeding after a cervical screening.

This can be alarming — particularly if you’ve already hit menopause.

In most cases, a bit of bleeding is normal and is just a result of the cervix lining being disturbed.

But if you experience pain or bleeding that lasts for a few days or is heavy, it’s a good idea to check in with your healthcare provider as this could mean that something else is wrong.

Can you get a pap smear on your period?

You’ve booked your pap smear appointment.

You’ve organized your day around it.

And then bam, your period arrives.

So what’s the deal?

Can you get a pap smear on your period, or is it best to reschedule?

Yes, you can get a pap smear on your period.

But, the general rule is that you should avoid getting a smear test on a day that your have your period if you can — especially if you have a heavy flow.

Although its not impossible to have a smear on your period, it isn’t recommended because the blood from your period can make the sample harder to analyse.

This means that you might not get clear results, and then could end up having to come back in.

Its always best to give your healthcare provider a call to discuss this, especially if it is a few days before your smear or even on the day of the appointment.

In an ideal world, it’s best to wait about five days after your period before getting a pap smear.

But sometimes, life doesn’t work out that way.

And if you’re wondering if you can get a pap smear while pregnant, we’ll take you through the details here:

🔍 Read more: Getting A Pap Smear While Pregnant.

Should I cancel my gynecologist appointment if I have my period?

So here’s the thing — pap smears are necessary but not much fun.

An instrument shaped like a duck’s bill (called a speculum) is inserted into your vagina to open up the passage.

Then a brush is used to collect cells from your cervix.

These cells are then placed under a microscope to check for any abnormalities that could indicate a risk of cancer.

How many days after my period can I get a pap smear?

There are no hard and fast rules here.

But, the American Society of Clinical Oncology (ASCO) suggests that it’s best to schedule your appointment for at least five days after your period ends. [20]

Can you wear a tampon to a gynecologist appointment?

ASCO also says it’s best to avoid using tampons, birth control foams, vaginal medicines and creams, and douches for two to three days before your pap smear.

That’s because they might interfere with your test results.

They also say it’s best not to have sex in the two to three days before your appointment.

The best thing to do is talk to your healthcare provider before your appointment and get exact instructions from them.

Congrats on keeping up with your reproductive screenings.

You have full permission to treat yourself after your test in whatever manner you see fit: 🍫💅🏽🛏️