How to Prepare for a Pap Smear

Before a Pap Test

Blood can interfere with the test results, so try not to schedule the pap smear during your period. However, it should be okay if you are only bleeding lightly. Avoid using tampons, and any type of vaginal medicine, spray, powder, or douche at least 24 hours prior to the smear. Some doctors also advise abstaining from sex the day before as well.

During the Test

Start by telling your doctor if:

• You are using contraceptive pills.

• You have never had a pap smear before.

• You are or may be pregnant.

• You have previously had an abnormal pap smear result.

• You have any sores, itching, redness, swelling, changes in discharge, or strange smells around your genitals. You can also talk about any changes you have seen if you regularly examine your vagina.

• You have ever had an operation or any other procedure, such as radiation, in the vulva, vagina, cervix, or uterus.

You’ll also need to tell your doctor the first day of your last period and how long the bleeding lasted. In addition, if you have any fears about the procedure, particularly if you’ve had any bad experiences, it’s important to share these with your doctor. Ask if you are unsure about anything, such as the reasons for the test, any risk factors, the specific procedure, and what the results signify.

There aren’t any other specific preparations you need to make before the test. However, for comfort, you may wish to go to the bathroom beforehand.

To learn more about how to prepare for a pap smear, see the following video:

• You will usually be given a privacy screen to allow you to change into a paper gown. You may receive a breast exam before the pap smear, which involves the doctor feeling your breasts and nipples for lumps.

• Next, you’ll be told to lie on your back on the examining bed, with paper or cloth covering your waist area. Your feet will be raised up on foot-rests, and you may wish to wear socks to keep them warm.

• The doctor will then examine your vagina, external genitals, and cervix. To take the smear, he or she will use a speculum to gently widen the vagina to allow examinations of your vagina and cervix. A brush (cervix brush/cytobrush), small spatula, or cotton swab will then be used to gather a few cervical cell samples. These will be taken both from the visible part of the cervix and the cervical opening (endocervical canal). In women who do not have a cervix undergoing a pap text, the cells are collected from the vagina.

• Once finished, you’ll be left to get dressed again. The doctor either mixes the cells in liquid fixative or smears them onto a slide. They can then be sent for microscopic examination at the laboratory.

This procedure is usually painless, but there may be some slight pain and it is common to be a bit sore afterwards.

Normal

There were no abnormalities detected in your cervical cells, so it’s good news. However, novel cell changes can still occur in the future, so you’ll need to keep regularly getting pap tests to check if you’re still healthy.

Unclear

An unclear result, which may also be described as inconclusive, equivocal, or ACS-US, is quite common. This signifies that your cells could be abnormal, but it’s not certain that this is due to HPV infection. The changes may simply be due to menopause, pregnancy, or another type of infection. For confirmation of HPV infection, you’ll need a HPV test.

Abnormal

An abnormal cervical smear means cervical cell changes have been detected, which is probably due to HPV infection, but this will usually not indicate cancer. The changes can be minor (low-grade), in which case the cells will usually return to normal by themselves. However, if more serious (high-grade) changes are found, the cells are thought to be pre-cancerous and need to be removed.

Rarely, an abnormal pap smear is due to cervical cancer. To confirm this, further tests are required. However, even if you do have cancer, it’s usually treatable if detected early.

The time between pap tests will be determined according to your age and medical history. Ask your doctor what she/he recommends. Generally speaking, they’ll follow these guidelines:

• Women aged 21-29 should have a pap smear every 3 years.

• Women aged 30-64 should have either a pap smear alone every 3 years, or a pap smear together with a human papillomavirus (HPV) test every 5 years.

• Women 65 or over should speak to their doctor about whether they still need pap smear testing.

However, more frequent pap tests may be required in some cases. In particular, you should speak to your doctor if:

• You have previously had cervical cancer or abnormal pap smear results.

• Your mother had diethylstilbestrol (DES) exposure whilst she was pregnant with you.

• Your immune system has been weakened due to chemotherapy, steroid use, or organ transplant.

• You are positive for HIV. HIV predisposes women to cervical disease, including cancer. According to the U.S. Centers for Disease Control and Prevention (CDC), women who test HIV-positive should get an immediate pap test, and then another six months later. This should be followed by annual smears, provided the initial two tests are normal.