A Pap smear is a screening procedure that can detect cervical cancer. This practice, also called a Pap test, can also detect unusual cells, such as those caused by sexually transmitted infections (STIs) or precancerous conditions.

To perform a Pap smear, your doctor will need to collect a sample of cells from the surface of your cervix. The cervix is the opening of your uterus.

During a pelvic exam, you’ll lie on your back on a table. Your doctor will place your feet in stirrups and use a speculum to widen the opening of your vagina. The speculum helps your doctor see your upper vagina and cervix. They’ll use a scraper or brush to collect a sample of cells from your cervix. That sample is then sent to a lab for analysis.

A Pap smear can be uncomfortable. It’s not uncommon to experience cramping or mild bleeding as a result of the screening. However, heavy bleeding or severe cramping isn’t normal. Read more to learn what’s normal and abnormal following a Pap smear.

Some bleeding or spotting after a Pap smear is normal. Heavier bleeding may be a sign of another condition or issue.

Cervical scratch

In order to get a sample of cells, your doctor must scrape or scratch the delicate lining of your cervix. This can cause bleeding and sensitivity. However, bleeding from a cervical scratch is typically very light and ends on its own in a matter of hours or a few days.

Cervical sensitivity

Blood will surge to your cervix and other reproductive organs following a Pap smear and pelvic exam. This can increase bleeding from a scratch or irritated spot on your cervix.

Increased cervical blood vessels

If you’re pregnant during a Pap smear, you may see more bleeding following the test. Your cervix develops additional blood vessels during pregnancy. These can bleed following a test, but the bleeding should end within a few hours or no more than two days.

Cervical polyps

Cervical polyps are small, bulblike growths that develop on the opening of your cervix. During a Pap smear, a cervical polyp may bleed, which increases the amount of surface tissue that’s bleeding.

Birth control pills

Birth control pills and other forms of hormonal contraception increase your hormone levels. This can make your cervix more sensitive and may cause more cramping or pain. This may make bleeding more likely after a Pap smear.

Infections

Yeast infections, as well as STIs, can cause cervical bleeding after a Pap smear. These infections may make your cervix more tender, and blood vessels may bleed more following the procedure.

Friable cervix

This condition causes the tissues in your cervix to be overly sensitive and easily irritated. If you have a friable cervix, you may experience heavier spotting and bleeding following a Pap smear. Spotting also isn’t uncommon after other activities, such as sex, with this condition.

Cervical cancer

One of the primary symptoms of cervical cancer is irregular vaginal bleeding. This bleeding is likely coming from your cervix. Anything that irritates the cervical tissues, such as a Pap smear, can cause additional bleeding.

Light bleeding or spotting following a Pap smear is common. More serious bleeding is less common and may be a sign of a bigger issue. Concerning symptoms include:

  • bleeding larger amounts than typical spotting
  • severe cramping
  • bleeding that lasts longer than three days
  • bleeding that gets heavier, not lighter, following the exam
  • heavy bleeding that requires more than one pad in an hour
  • dark blood with clots or very bright red blood

Irregular bleeding is a common sign of cervical cancer. However, bleeding following a Pap smear can be a sign of many other issues, including an infection, an STI, or pregnancy. Don’t immediately assume unusual bleeding after a Pap test is a sign of cancer. But, you should talk with your doctor right away about your symptoms.

If bleeding after a Pap smear is from normal causes, such as a cervical scratch, the bleeding should stop within a few hours. Spotting may last up to two days, but the bleeding will become lighter.

Avoid sex and don’t use a tampon in the two to three days following a Pap smear if you’re experiencing bleeding. The additional pressure may cause bleeding to start again or become heavier.

Bleeding or spotting after a Pap smear isn’t unusual, even for people without infections, cancer, or other conditions. The delicate tissues of your cervix can bleed after a brush or swab scratches the surface. If you’ve had issues with bleeding in the past, ask your doctor if you should take any special precautions this time.

Likewise, take the time during your exam to ask your doctor when you can expect your results. Some offices require that you call for results. Others will email or mail your results to you. If the results show a potential issue, ask your doctor when and how follow-up tests will be ordered.

Don’t exert yourself if you’re experiencing cramping or soreness after the test. Give your body a bit of time to heal so you don’t accidentally worsen the bleeding.

Call your doctor if your bleeding is heavy, becomes worse, or doesn’t end after three days. Let them know about your bleeding and any other symptoms, such as soreness or cramps. This may help them with a diagnosis. They may also want you to make a return visit for another examination.