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Abnormal Pap Smear? Don’t Panic

Getting a pap smear is a necessary -- but not exactly fun -- part of your well-woman exam, and it’s normal to fret before you get the test result.

Try not to worry. There are steps you can take to help ensure a normal pap smear. And chances are, if you get an abnormal result, it’s because of a treatable condition.

Avoid a Bad Sample Collection

Many test results cannot be analyzed if the collection was contaminated or insufficient in some way. These test results are called unsatisfactory. Here’s how to avoid an unsatisfactory test result:

  • Do not have a pap smear test when you are menstruating, even if it is the end of your cycle.
  • Do not use a tampon within 24 hours of the test. A tampon makes contact with the cervix, absorbing and removing too many surface cells for an adequate sample to be taken at your exam.
  • Do not douche within 24 hours of the sample collection.
  • Do not have intercourse within 24 hours of the sample collection.
  • If you are in menopause or suspect you might be, let your gynecologist know, if he or she doesn’t already. Menopause reduces the amount of cells produced by the cervix, which limits the ability for an adequate test sample.

If your test produces an unsatisfactory result, you likely will be asked to have the pap smear repeated.

7 Reasons for an Abnormal Pap Smear

The primary reason you get a pap smear test is to detect the presence of cervical cancer. However, an abnormal pap smear can signal inflammation in the cervix, caused by a host of conditions, including:

Vaginal Candidiasis

Vaginal Candidiasis, also known as a yeast infection, is caused by a buildup of Candida yeast. This yeast is normally present in the vagina but can become a problem when hormone changes, new medicines or increased immune-system stressors result in too much Candida, causing a fungal infection signaled by discharge and itchiness.

Bacterial Vaginosis (BV)

This is caused by overgrowth of bacteria in the vagina producing increased foul discharge with itching. Douching or having new or multiple sex partners can increase your risk of BV.

Cervical Dysplasia

Cervical dysplasia is when an abnormal group of cells forms on the cervix, usually as a result of an HPV infection. A biopsy would be needed to confirm dysplasia, which is diagnosed as mild, moderate or severe. Treatment options include cyrosurgery to freeze these cells and surgery to remove them. In some cases, no treatment is needed.


Human papillomavirus, or HPV, is one of the most common culprits for an abnormal pap smear. This virus can cause genital warts and has been linked to cervical cancer. In nine out of 10 cases, HPV clears on its own within two years. However, if the HPV stays in the body, pap smears will need to be conducted more regularly to test for cervical cancer.


HSV-2 is transmitted through sexual contact of the genital or anal areas. It can be spread by contact with the skin, sores or fluids of someone who has the virus. Even if someone’s skin appears normal, if the person is infected, they can still transmit HSV-2. There is no cure for HSV-2. Once someone has become infected, the virus stays present in their body. However, antiviral medicines can shorten outbreaks and decrease the likelihood of spread.


Chlamydia is one of the most common STDs, easily spread in large part because it’s often asymptomatic. One telltale symptom of chlamydia is a burning sensation when you urinate. It is transmitted through oral, vaginal or anal sex. If untreated, chlamydia can cause fertility problems.


Gonorrhea can be spread through any kind of sex – oral, vaginal or anal. If you have gonorrhea, you may feel pain when peeing, and experience increased vaginal discharge and bleeding in between periods. Gonorrhea can cause infections in the genitals, rectum and throat. This STD can be cured by medication. If untreated, gonorrhea can cause pelvic inflammatory disease, ongoing pelvic pain as well as fertility issues.

All these conditions can cause abnormal pap smear test results. If an STD is the cause, additional testing will be done for conclusive results.

The pap smear is just one piece of the well-woman exam. It does not test for ovarian, vulvar or endometrial cancer. During the visual part of the exam when the speculum is inserted, your OB-GYN will look for the presence of vaginal and vulvar abnormalities. The manual part of the exam checks for internal pelvic abnormalities such us ovarian tumors.

How Often Do You Need a Pap Smear?

The frequency changes depending on your age.  The first pap smear is recommended at age 21.  Follow-up is determined by your gynecologist based on your results.

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