Pap smears shouldn’t hurt.
If you’re getting your first Pap, it may feel a little uncomfortable because it’s a new sensation that your body isn’t yet used to.
People often say it feels like a small pinch, but everyone has a different threshold for pain.
There are also other underlying factors that may make one person’s experience more uncomfortable than another’s.
Read on to learn more about why Paps are done, what can cause discomfort, ways to minimize potential pain, and more.
The answer is usually yes.
Pap smears can detect precancerous cells on your cervix and, in turn, help you prevent cervical cancer.
Although cervical cancer is often caused by the human papillomavirus (HPV) — which is spread through genital or anal contact — you should get routine Pap smears even if you aren’t sexually active.
Most experts recommend that folks who have a vagina start getting routine Pap smears at age 21 and continue until age 65. If you’re sexually active, your healthcare provider may advise you to start sooner.
If you’ve had a hysterectomy, you may still need regular Pap smears. It depends on whether your cervix was removed and whether you’re considered to be at risk for cancer.
You may also need regular Pap smears after menopause.
If you aren’t sure about whether you need a Pap smear, talk to your doctor or other healthcare provider.
Pap smears are used to determine whether you have abnormal cervical cells.
If you do have abnormal cells, your provider may conduct further tests to determine whether the cells are cancerous.
If needed, your provider will recommend a procedure to destroy the abnormal cells and reduce your risk of cervical cancer.
A Pap smear is different than a pelvic exam, although doctors often perform Pap smears during pelvic exams.
A pelvic exam involves viewing and examining the reproductive organs — including the vagina, vulva, cervix, ovaries, and uterus.
Your doctor will visually inspect your vulva and vaginal opening for unusual discharge, redness, and other irritation.
Next, your doctor will insert an instrument known as a speculum into your vagina.
This will allow them to inspect the inside of your vagina and check for cysts, swelling, and other abnormalities.
They may also insert two gloved fingers into your vagina and press on your abdomen. This portion is known as the manual exam. It’s used to check for abnormalities of the ovaries or uterus.
The American College of Obstetricians and Gynecologists recommends the following:
- People age 21 to 29 should have a Pap smear every three years.
- People age 30 to 65 should have a Pap smear and an HPV test every five years. Performing both tests at once is called “co-testing.”
- People who have HIV or those with weakened immune systems should have Pap smears more often. Your doctor will provide an individual testing recommendation.
If you prefer, you can have Pap smears done more often.
Although it may be tempting, you shouldn’t skip a Pap smear if you’re in a monogamous relationship or aren’t sexually active.
HPV can lay dormant for years and appear seemingly out of nowhere.
Cervical cancer can also be caused by something other than HPV, though this is rare.
There aren’t specific guidelines on how often you should have a pelvic exam.
It’s generally recommended that you have yearly pelvic exams starting at age 21, unless you have a medical reason to start sooner. For example, your provider may perform a pelvic exam before prescribing birth control.
You may be able to move forward with your Pap if you’re experiencing spotting or otherwise light bleeding.
But, in most cases, your provider will ask you to reschedule your appointment for a time when you aren’t menstruating.
Getting a Pap smear during your period can affect the accuracy of your results.
The presence of blood can make it difficult for your provider to collect a clear sample of cervical cells. This may lead to an inaccurate abnormal result or otherwise obscure any underlying concerns.
A Pap smear can be performed by a doctor or nurse.
Your provider may start by asking you a few questions about your medical history.
If it’s your first Pap smear, they may also explain the procedure. This is a great opportunity to ask any questions you may have.
Afterward, they’ll leave the room so that you can remove all clothing from waist down and change into a gown.
You’ll lie down on an examination table and rest your feet in stirrups on either side of the table.
Your provider will likely ask you to scoot until your bottom is at the end of the table and your knees are bent. This helps them access your cervix.
Next, your provider will slowly insert an instrument called a speculum into your vagina.
A speculum is a plastic or metal tool with a hinge on one end. The hinge allows the speculum to open, subsequently opening your vaginal canal for easier inspection.
You may feel some discomfort when your provider inserts and opens the speculum.
They may shine a light into your vagina so that they can take a closer look at your vaginal walls and cervix.
Then, they’ll use a small brush to gently wipe the surface of your cervix and gather cells.
This is the part that people often compare to a small pinch.
After your provider obtains a cell sample, they’ll remove the speculum and leave the room so you can get dressed.
It usually takes less than a minute to insert the speculum and take a cell sample from your cervix.
Pap smear appointments typically last about the same amount of time as regular doctors’ appointments.
If you’re nervous or have a lower pain threshold, there are a few things you can do to help reduce any potential discomfort.
- When you schedule your appointment, ask if you can take ibuprofen an hour before your appointment. Over-the-counter pain medication can reduce the feeling of discomfort.
- Ask someone to come to your appointment with you. You may feel more comfortable if you bring someone you trust with you. This could be a parent, partner, or friend. If you’d like, they can stand next to you during the Pap smear, or they can simply wait in the waiting room — whatever makes you feel more comfortable.
- Pee before the exam. When Pap smears are uncomfortable, it’s often because there’s a sensation of pressure in the pelvic region. Urinating beforehand can relieve some of this pressure. In some cases, your doctor might request a urine sample, so be sure to ask if it’s OK to use the restroom beforehand.
- Ask your doctor to use the smallest speculum size. Often, there are a range of different speculum sizes. Let your doctor know you’re worried about the pain, and that you’d prefer a smaller size.
- If you’re worried it will be cold, ask for a plastic speculum. Plastic speculums are warmer than metal ones. If they only have metal speculums, ask them to warm it up.
- Ask your doctor to describe what’s happening so that you aren’t caught off guard. If you’d prefer to know exactly what’s happening as it’s happening, ask them to describe what they’re doing. Some people also find it helpful to chat with their doctor during the exam.
- If you’d rather not hear about it, ask if you can wear headphones during the exam. You could play relaxing music through your headphones to help soothe any anxiety and take your mind off of what’s happening.
- Practice deep breathing during the exam. Breathing deeply can soothe your nerves, so try to focus on your breath.
- Try to relax your pelvic muscles. It may feel instinctual to squeeze your pelvic muscles when you feel pain or discomfort, but squeezing could add pressure to your pelvic region. Deep breathing may help you relax your muscles.
- Speak up if it hurts! If it’s painful, let your provider know.
What about using a numbing agent?
If you’ve had an IUD inserted, your provider probably used a numbing agent to help reduce pain in your vagina and cervix. Unfortunately, it isn’t possible to do the same before a Pap smear. The presence of a numbing agent can obscure your results.
- Use a pantyliner or pad. Mild bleeding after a Pap smear isn’t uncommon. It’s usually caused by a small scratch on the cervix or on the vaginal wall. Bring a pad or pantyliner along just to be safe.
- Use ibuprofen or a hot water bottle. Some people experience mild cramps after a Pap smear. You can use ibuprofen, a hot water bottle, or other home remedy for relieving cramps.
- Contact your provider if you’re experiencing heavy bleeding or severe cramping. While some bleeding or cramping is normal, severe pain and heavy bleeding could be a sign that something is wrong. Consult your provider if you’re concerned.
Some factors may make Pap smears more uncomfortable.
A number of underlying health conditions can make your Pap smear more uncomfortable.
- vaginal dryness
- vaginismus, the involuntary tightening of your vaginal muscles
- vulvodynia, persistent vulvar pain
- endometriosis, which occurs when uterine tissue begins to grow outside of your uterus
Let your provider know if you’re experiencing symptoms of — or have received a previous diagnosis for — any of the above conditions.
This will help them accommodate you better.
The exam might be more painful if you haven’t experienced vaginal penetration before.
This could include penetration through masturbation or sex with a partner.
If you have experienced sexual trauma, you might find the Pap smear process difficult.
If you can, look for a trauma-informed healthcare provider, or a provider that has experience helping people who have experienced trauma.
Your local rape crisis center may be able to recommend a trauma-informed healthcare provider.
If you feel comfortable doing so, you may choose to inform your provider of your sexual trauma. This can help shape their approach and provide you with more comfortable care.
You can also bring a supportive friend or family member to your Pap smear to help you feel more comfortable.
Yes! While it doesn’t happen to everyone, bleeding after a Pap smear isn’t uncommon.
Often, it’s caused by a small scratch or scrape on your cervix or in your vagina.
The bleeding is usually light and should go away within a day.
If the bleeding gets heavier or lasts longer than three days, contact your provider.
Pap smear results often take about a week to get back to you — but this depends entirely on the lab’s workload and on your provider.
It’s best to ask your provider when you should expect your results.
The results of your test will either read “normal,” “abnormal,” or “inconclusive.”
You may get an inconclusive result if the sample was poor.
To get an accurate Pap smear result, you should avoid the following for at least two days before your appointment:
- vaginal suppositories, creams, medicines, or douches
- sexual activity, including penetrative masturbation and vaginal sex
If your results were inconclusive, you provider will likely advise you to schedule another Pap smear as soon as you can.
If you have “abnormal” lab results, try not to be alarmed, but do discuss the results with your doctor.
Although it’s possible that you have precancerous or cancerous cells, this isn’t always the case.
Abnormal cells can also be caused by:
Your doctor will discuss the specifics of your results with you. They may recommend that you get tested for HPV or other infections.
Cervical cancer can’t be diagnosed from a Pap smear alone. If needed, your provider use a microscope to examine your cervix. This is called a colposcopy.
They may also remove some tissue for a lab test. This will help them determine whether the abnormal cells are cancerous.
Regular Pap smears are essential for screening for cervical cancer and other reproductive health concerns.
While a Pap smear can be uncomfortable for some, it’s a quick process and there are a number of ways to make the experience more comfortable.
If your current provider doesn’t listen to your concerns or makes you uncomfortable, remember that you can absolutely seek out a different practitioner.