The thought of getting a Pap smear can be intimidating, especially if you’ve never had one before. Knowing what to expect ahead of time can help ease anxiety and make the experience much less stressful.
What is a Pap smear?
A Pap smear is a screening test that checks the cervix (the area where the vagina connects to the uterus) for abnormal cells.
“These abnormal cells usually don’t cause symptoms, but over time they can turn into cervical cancer if they aren’t treated,” explains Isabel Tumminello, CNM, Carilion Clinic Midwifery Services.
Paps can also test for HPV, a very common virus that can increase the risk of cervical cancer.
Why Paps matter
Early detection of abnormal cells means treatment, if needed, is usually simpler and more effective. Even if you feel healthy and have no symptoms, regular screenings are still important.
Tip: Pap smear guidelines have changed in recent years, and most women no longer need an annual screening.
How to prepare for your appointment
You don’t have to do much to prepare, but to make sure you get the most accurate test results you should:
- Avoid sex for a day or 2 before the test
- Avoid vaginal creams or douching beforehand unless your clinician tells you otherwise
- Try not to schedule the test during your period, if possible
What happens during a Pap smear?
1. Change into a gown
You’ll undress and cover up with a provided sheet or gown. Your clinician will step out of the room while you change.
2. Lie back on the exam table
You’ll lay down and place your feet in footrests called stirrups. This position helps your clinician examine the cervix safely and comfortably.
Some patients feel vulnerable or embarrassed in this position, but remember: this is a routine medical exam that your care team performs every day.
3. Speculum is inserted
Your clinician will gently insert a speculum into the vagina. This tool helps hold the vaginal walls open so they can see your cervix.
It shouldn’t be painful. Taking slow, deep breaths and relaxing your pelvic muscles can help.
If it hurts, speak up. Your clinician may be able to adjust the speculum size or position to make you more comfortable.
4. Cells are collected
Using a small swab, your clinician will collect a sample of cells from the cervix.
This part usually lasts just a few seconds. Some people feel light cramping or a gentle scratching sensation, while others barely notice it. The speculum is then removed, and the test is over.
The entire exam usually takes only a few minutes.
Does a Pap smear hurt?
For most people, a Pap is more uncomfortable than painful. Every patient’s experience is different, but common sensations include:
- Slight pressure
- Stretching
- Brief cramping
“If pelvic exams have been painful for you in the past, or if you have anxiety, trauma, or a medical condition that could make the exam difficult for you, tell your care team beforehand,” says Isabel. “We can make adjustments to help you feel safer and more comfortable. You can also tell us to stop at any time.”
After the test
You can go about the rest of your day like usual. Some patients notice:
- Mild spotting
- Light cramping
This is usually normal and should go away quickly. If bleeding is heavy or lasts for more than 2 days, reach out to your care team.
Tips to make Paps easier
If you’re anxious about your appointment, these things may help:
- Schedule your appointment for a less stressful time of day
- Wear comfortable clothes
- Don’t be afraid to ask questions
- Let your nurse or clinician know if you’re nervous
- Focus on slow, deep breathing during the exam
- Ask for a smaller speculum if you’ve had discomfort before
- Bring a support person
You can always ask the clinician to pause or explain what they’re doing at any time during the exam.
If you have questions or it’s time to schedule your screening, reach out to your family doctor, OB/GYN, or certified nurse midwife.
