Women's Health

How It Is Done

You will need to take off your clothes below the waist and drape a paper or cloth covering around your waist. 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. You may want to wear socks to keep your feet warm while they are in the footrests.

The doctor will insert a lubricated 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 will collect several samples of cells from your cervix using a cotton swab, brush (cytobrush or cervix brush), or a small spatula. Cells are collected from the visible part of the cervix as well as from its opening (endocervical canal). In women who do not have a cervix, cells from the vagina are collected if a Pap test is needed. The cells are smeared on a slide or mixed in a liquid fixative and sent to a lab for examination under a microscope.

How It Feels

You will feel more comfortable during your Pap test if you and the doctor are relaxed. Breathing deeply and having a light conversation with your doctor may help you relax. Holding your breath or tensing your muscles will increase your discomfort.

You may feel some discomfort when the speculum is inserted, especially if your vagina is irritated, tender, or narrow. You may also feel pulling or pressure when the sample of cervical cells is being collected.

Risks

There is very little chance of a problem from having a Pap test. You may have a small amount of vaginal bleeding after this test, and you may want to use a pad or panty liner to protect your clothes from any spotting.

Results

A Pap test is done to look for changes in the cells of the cervix . Results are usually available in 1 to 2 weeks. Ask your doctor when you can expect the results.

Classification systems

In the United States, the Bethesda system (TBS) is the most widely used system for reporting Pap test results. It provides information about the quality of the cell sample and the types of cell changes found.

Normal

The sample contained enough cells and no abnormal cells were found.

Abnormal

The sample did not contain enough cells, or abnormal cells were found. For more information about abnormal Pap test results, see the topic Abnormal Pap Test.

What Affects the Test

Pap test results may be affected by:

• Menstrual blood on the slide. This can make it harder to examine the cervical cells.
• A vaginal infection.
• The use of douches or vaginal creams or preparations within 24 hours of the exam.
• Not enough cells in the sample.