Pap test

Before a Pap test:

• Try to schedule the test when you are not having your period, since blood can interfere with the results of the test. If your bleeding is light, you may still be able to have a Pap test. 
• Do not use douches, tampons, vaginal medicines, sprays or powders for at least 24 hours before having a Pap test. 

At the beginning of your visit, tell your doctor:

• If you are or might be pregnant 
• If you have any reproductive or urinary tract symptoms such as itching, redness, sores, swelling or an unusual odor or increased vaginal discharge. Be sure to discuss any changes you have noticed with your doctor.
• If you are using birth control 
• If this is your first Pap test 
• The first day of your last menstrual period and how long your period lasted 
• If you have had surgery or other procedures such as radiation therapy to the vagina, cervix, uterus or vulva

No other special preparations are needed before having a Pap test. For your own comfort, you may want to empty your bladder before the exam.

Talk to your doctor about any concerns you have about the need for the test, its risks, how it will be done or what the results will mean.

When you arrive for your Pap test, you will need to undress and drape a paper or cloth, covering you from the waist down. You will then lie on your back on an examination table with your feet raised and supported by footrests. This allows the doctor to examine your external genital area, vagina and cervix.

The doctor will insert a speculum into your vagina. The speculum gently spreads apart the vaginal walls, allowing the inside of the vagina and the cervix to be examined.

Your doctor may collect several samples of cells from your cervix using a cotton swab, brush or small spatula. Cells are collected from the visible part of the cervix as well as from its opening. In women who do not have a cervix, cells from the vagina are collected when indicated. The cells are smeared on a slide or mixed in a liquid fixative and sent to the lab for examination under a microscope.

A normal result means that the test did not find any abnormal cells in the sample. An abnormal result can mean many things. Most of these are not cancer.

The results of your test may be abnormal because:

• You have an infection of the vagina or cervix, such as a yeast infection. 
• You have an IUD (intrauterine device for birth control). 
• You have low estrogen levels after menopause that are causing the cells to change. 
• You have cell changes that may be a sign of precancer or cancer. 

You may need more tests to find out if you have an infection or to find out how severe the cell changes are. For example, you may need:

• Colposcopy, a procedure to look at the vagina and cervix through a lighted magnifying tool. 
• An HPV test. Like a Pap test, an HPV test is done on a sample of cells taken from the cervix. 
• Another Pap test in 12 months.

A colposcopy is usually done before any treatment is given. During a colposcopy, the doctor also takes a small sample of tissue from the cervix so that it can be looked at under a microscope. This is called a biopsy.

Treatment, if any, will depend on whether your abnormal cell changes are mild, moderate or severe.