A Pap smear is a test used to evaluate a woman's cervical cells. The cervix is the canal that serves as the passageway between the vagina and the body of the uterus. A Pap smear is a cervical cancer screening test, which involves taking a small sample of cervical cells using a tiny brush. The cells are then examined in a laboratory for abnormalities indicating precancerous or cancerous changes. While Pap smears typically do not cause complications, some temporary side effects are possible, including pelvic discomfort and minor bleeding. Infection is a possible but uncommon complication after a Pap smear.
Most women do not experience significant pain during or after a Pap smear. However, some women experience minor discomfort associated with the placement of the speculum -- the instrument that holds the vagina open so the cervix can be seen. Some women also experience slight pelvic discomfort, pressure or minor pain when the cervical cells are sampled. Pelvic discomfort associated with a Pap test typically resolves as soon as the sampling process is completed.
Mild uterine cramps, similar to those associated with a menstrual period, might occur during or after a Pap smear. These cramps are relatively common and usually subside shortly after the procedure. Some women, however, report for cramps lasting as long as a day or two after the test. Over-the-counter ibuprofen (Advil, Motrin) might be helpful for cramps after a Pap test, if cleared by your doctor. Contact your doctor right away if you are pregnant and experience cramps after a Pap test.
The cervical tissue is rather delicate and sampling the cells with a brush during a Pap test might cause some spotting or vaginal bleeding. Any bleeding is typically mild and subsides within a day or two after a Pap smear. You may notice that your normal vaginal secretions appear pink or contain a small amount of blood. If you experience persistent or heavy vaginal bleeding after a Pap test, contact your doctor -- especially if you are pregnant.
A Pap test can temporarily increase the risk for a urinary tract or vaginal infection, although these complications are uncommon. A study published in the May-June issue of the "Journal of the American Board of Family Medicine" evaluated the association between these infections and a recent pelvic examination with a Pap test. The researchers found a small but significant increase in the risk for a urinary tract infection (UTI) in the 7 weeks following a Pap test. They also noted a slightly increased risk for vaginal infections in this time period. A subsequent research study published in June 2015 in "MSMR" -- a monthly journal from the Armed Forces Surveillance Center -- also noted a slightly increased risk for UTI after a Pap test. These researchers, however, did not analyze whether there was an increased risk for vaginal infections associated with a recent Pap smear.
Next Steps and Precautions
Talk with your doctor about what cervical cancer screening tests are best for you and how often you need them, as yearly Pap smears are no longer the standard recommendation for most women. Additionally, both a Pap smear and HPV testing are recommended for some women.
Contact your doctor right away if you experience persistent, severe or worsening pelvic pain, cramps or vaginal bleeding after a Pap test -- especially if you are pregnant. Also contact your doctor if you experience signs or symptoms of a urinary or vaginal infection following a Pap smear, including:
-- pain or burning with urination
-- increased urinary frequency
-- vaginal itchiness
-- malodorous, increased or altered vaginal discharge
Reviewed and revised by: Tina M. St. John, M.D.