What to Expect with a Pap Smear and Abnormal Results

What Is a Pap Smear?

A Pap smear, also called a Pap test, is a routine screening tool to check for abnormal changes in cells on the cervix—the lower part of the uterus that opens into the vagina. These changes can be early signs of cervical cancer or conditions that might lead to cancer over time. It’s a preventive step, typically performed every few years.

A healthcare provider gently collects a small sample of cervical cells using a soft brush or spatula. It may feel slightly uncomfortable or produce a quick pinch, but the procedure is generally brief. Afterward, the cell sample is examined under a microscope to look for irregularities. Alongside the Pap smear, a test for high-risk strains of certain viruses (when recommended) may also be included. This careful approach allows early identification of cellular changes well before severe conditions develop.

Who Should Get a Pap Smear and When?

Pap smears are usually recommended for individuals with a cervix starting in their early 20s. The frequency varies based on health history and age:

• Ages 21 to 29: A simple Pap smear every three years is typical.
• Ages 30 to 65: Either a Pap smear every three years, a combination of Pap plus virus testing every five years, or virus testing alone every five years.
• Over 65: Screening may be paused if previous results were normal—though this depends on individual health history and provider advice.

Individuals with certain risk factors—such as a history of immune suppression, previous abnormal results, or specific health conditions—may be advised to screen more often. Comfort, informed conversation, and shared decision-making with a trusted provider make the process more personalized and empowering.

What Happens During the Pap Smear?

When you go for your test:

• You’ll lie down comfortably with knees bent and legs placed on a raised support.
• A gentle instrument called a speculum is used to open the vaginal walls briefly—this step may feel cool or mildly uncomfortable.
• The provider collects cells from the cervix using a soft tool—this may cause a brief sensation similar to a quick cramp.
• The sample is preserved and sent to a lab for review—results typically arrive in a few days or weeks, depending on the facility.

It’s a quick procedure—often under five minutes—and most people feel relief afterward. Normal results are reassuring, while unclear results might prompt a retest to ensure clarity.

What Does It Mean to Have Abnormal Pap Results?

Receiving the word “abnormal” can feel unsettling—even though it doesn’t automatically mean cancer. Abnormal results generally fall into categories such as:

• Atypical cells: Slightly different from normal, but not necessarily a cause for alarm.
• Low-grade changes: Mild alterations often linked to temporary infections or early virus-related influence—these may resolve on their own.
• High-grade changes: More significant cell differences that require prompt follow-up to prevent progression.
• Unclear or unsatisfactory samples: Sometimes, the sample isn’t sufficient and needs a repeat test.

Your provider is your best resource—reviewing the report, explaining what type of abnormality is present, and recommending the most appropriate next step.

What’s Next After an Abnormal Result?

Follow-up depends on the type and severity of abnormality:

1. Repeat Testing

For mild or uncertain changes—particularly in younger individuals—a repeat Pap smear or combined screening in a few months helps confirm stability or change.

2. Colposcopy (Detailed Exam)

In cases of more concerning findings, a special camera and magnification tool (colposcope) lets your provider closely examine the cervix. A gentle solution may highlight affected areas, and small samples—called biopsies—may be taken for microscopic evaluation.

3. Endocervical Sampling

If cells deeper inside the cervical canal are suspicious, a separate sample may be collected to ensure nothing is overlooked.

4. Treatment of Abnormal Tissue

Depending on biopsy results, minor in-office procedures—like removing or burning away abnormal tissue—can address high-grade changes before they progress. If deeper or broader removal is needed, more detailed evaluation followed by precise intervention may be recommended.

Throughout, emotional reassurance matters—understanding each step, its purpose, and the pace at which care moves can make all the difference.

Could Abnormal Results Become Cancer?

Abnormal results don’t typically mean cancer—especially when changes are mild or caught early:

• Many low-grade changes resolve naturally, particularly in younger individuals.
• High-grade changes signal that care should move more quickly, often with biopsy and treatment to prevent progression before it becomes a long-term issue.

Thorough follow-up and open communication ensure that any concerning changes are addressed promptly and thoughtfully. Early detection and monitoring mean interventions happen well in advance and support long-term health.

How Can I Prepare for a Pap Smear?

To make your appointment smoother:

• Schedule it when not menstruating, if possible (though light bleeding doesn’t always require rescheduling).
• Avoid using vaginal products, such as lubricants or douches, 1–2 days beforehand to ensure accuracy.
• Wear comfortable clothing and allow time afterward to relax—especially if you feel nervous.
• Ask questions ahead of time—knowing what to expect helps make the experience more grounded and stress-free.

What Should I Do While Waiting for Results?

Waiting can feel anxious, but there are gentle practices to center yourself:

• Take care of your mental well-being—engage in calming activities or reach out to someone supportive.
• Keep appointments scheduled—if a repeat test or follow-up call is suggested, mark it in your calendar.
• Trust that abnormal results often lead to simple monitoring or mild in-office care—not emergencies.

Can Normal Results Be Wrong?

Errors are rare, but they can happen. If new symptoms emerge—like abnormal bleeding or unusual discomfort—you can chat with your provider about repeating a test or checking again a little sooner.

How Often Should Abnormal Findings Be Screened After Treatment?

If abnormal tissue was treated:

• Your provider may recommend a repeat Pap smear in 6 months, or a combined test within a year.
• Once two consecutive normal screenings are complete, you may return to the standard screening timeline—though this varies based on personal history.

What Emotional Concerns Might Come Up?

It’s natural to feel anxious, scared, or uncertain. You may experience:

• Fear of hearing the word “cancer”
• Concern about invasive follow-up steps
• Frustration with repeat testing
• A sense of shame or embarrassment

If these feelings arise, consider talking to a trusted provider, partner, friend, or counselor. Sharing helps restore perspective—and others can help hold space while you navigate each step.

What Is the Long-Term Outlook?

Most people with abnormal results—especially when caught early—go on to have entirely normal screenings and healthy outcomes:

• Mild changes often resolve on their own or stay stable.
• High-grade changes are usually treatable before becoming unsafe.
• Women continue regular screening, and pregnancies, cycles, and health remain well managed.

Each step—though momentarily stressful—is part of a careful process that supports wellness and trust in your body’s capacity for resilience.

Can I Still Have an Abnormal Pap Smear if I Feel Fine?

Yes—many individuals with abnormal Pap smear results have no symptoms at all. That’s precisely why routine cervical screening is so important. Pap smears are designed to detect cellular changes on the cervix before any symptoms develop or escalate into more serious concerns.

Why Is This the Case?

Abnormal cells—especially early-stage changes—don’t usually cause discomfort, bleeding, or visible changes. In fact, even some higher-grade abnormalities may remain symptomless for a long time. Without screening, these changes could go unnoticed and continue silently.

That’s also why:

• Having regular screenings, even when feeling well, is essential.
• A normal physical exam or lack of symptoms doesn’t guarantee normal cervical cells.
• Waiting for symptoms to appear can delay early intervention.

Think of Pap smears as proactive rather than reactive. They’re a way to catch potential problems at their earliest stages, often years before they would ever become dangerous or noticeable. In short, feeling fine doesn’t mean skipping care. Pap tests are about prevention and peace of mind—not just problem-solving.

What’s the Difference Between a Pap Smear and a Virus Test?

Although they’re often performed together, a Pap smear and a virus (HPV) test look for different things. Understanding the distinction can help you better interpret results and next steps.

Pap Smear

• Checks for abnormal cervical cells
• Identifies pre-cancerous changes, not the cause
• Recommended every 3 years if results are normal (age dependent)

HPV (Virus) Test

• Looks specifically for high-risk virus strains known to be associated with cervical changes
• Helps determine your risk level for developing cervical disease
• Often performed alongside the Pap in those over 30 (co-testing), or sometimes as a standalone screen

Combined Testing

• Offers a more comprehensive picture
• Helps clarify when it’s safe to wait longer between screenings (up to 5 years)
• Adds precision to the decision-making process after borderline results

Why both tests matter:

• A normal Pap smear but a positive virus test—meaning the virus is present, but hasn’t caused visible changes yet.
• An abnormal Pap smear and a positive virus test—typically triggers closer follow-up.
• An abnormal Pap but no virus detected—may indicate non-viral-related inflammation or irritation.

Each result combination helps inform whether observation, repeat testing, or closer inspection (like a colposcopy) is best. By running both tests together when appropriate, healthcare providers gain clearer insight into current cellular health and future risk—allowing for personalized, thoughtful care.

How Do I Manage Anxiety Around Abnormal Pap Results?

It’s normal to feel anxious when you hear the word “abnormal.” Even though most Pap smear changes don’t lead to cancer, that initial phone call or lab result can trigger worry, confusion, or fear. Fortunately, there are ways to process that anxiety and feel more supported through each step.

1. Know that “abnormal” doesn’t mean cancer. The vast majority of abnormal results fall into low-grade or moderate changes. Many resolve on their own, especially in younger individuals. Even higher-grade changes are often caught early enough to be completely treatable. Reframing “abnormal” as “needs a second look” rather than a threat can be a powerful mindset shift.
2. Get clear, direct information. Ask your provider: What type of abnormality was found? What’s the next step, and when should it happen? Is this common for my age or health history? How likely is it that this will resolve?
3. Avoid “doom scrolling” online. Searching medical forums or vague search results can increase panic without offering clarity. Stick to trusted conversations with your provider or medically reviewed resources.
4. Consider a support person. For follow-up procedures (like colposcopy or biopsy), having a friend or loved one nearby for emotional support can help.
5. Practice calming routines. While you wait for next steps or results, stress-reducing practices—like walking, deep breathing, sleep routines, or creative hobbies—can help keep your nervous system in balance.
6. Normalize your experience. Many people—of all ages—have received abnormal Pap results. It’s a common, manageable part of cervical health. Sharing your experience (if comfortable) may open up support or solidarity.

Ultimately, you’re not alone, and you’re not powerless. With a clear plan, support, and perspective, anxiety becomes easier to manage—and confidence in your health decisions grows stronger.

Can I Have an Abnormal Pap Result During Pregnancy?

Yes—it’s possible to have an abnormal Pap smear while pregnant, and it’s not uncommon. Routine cervical screening may be performed during early prenatal visits if you’re due for testing. Pregnancy itself does not increase the risk of abnormal cervical cells, but your provider may discover changes simply because testing happened during this time.

Does Pregnancy Affect the Accuracy of the Test?

Pregnancy can cause hormonal changes in cervical cells, which may lead to reactive or atypical results. These do not necessarily indicate disease but may prompt a closer look. Your provider will interpret results in the context of your pregnancy, considering:

• Cervical inflammation due to increased blood flow
• Vaginal discharge that may alter sample clarity
• The presence of mild, temporary cellular changes

What Happens If Abnormal Results Are Found During Pregnancy?

• Mild abnormalities: Observation is often best. Your provider may recommend repeating the Pap smear or performing a colposcopy during the second trimester.
• Moderate to high-grade changes: Colposcopy may still be recommended. If a biopsy is needed, it’s typically safe, with special care to avoid disrupting the pregnancy.
• Severe or concerning results: In rare cases, if pre-cancerous or suspicious changes are confirmed, treatment is usually postponed until after delivery, unless immediate intervention is necessary.

Will abnormal cells affect the baby? No—cervical abnormalities do not affect the fetus directly. They are localized to the cervix and do not interfere with fetal growth or development. In nearly all cases, a safe pregnancy and delivery remain entirely possible.

In summary, abnormal Pap results during pregnancy are manageable and rarely require immediate action. Monitoring and follow-up, guided by your obstetrician, ensure safety for both parent and baby.

How Do I Resume Normal Screening After an Abnormal Result?

After an abnormal Pap smear, your future screening schedule may change slightly, depending on how the result was managed and whether treatment was needed. Your provider will create a customized plan based on your personal risk, age, and test history.

If My Abnormal Result Was Resolved Without Treatment

• A repeat Pap smear in 12 months to confirm stability
• Return to routine screening if two consecutive normal tests are achieved

This stepwise return ensures that even minor abnormalities are fully resolved before extending screening intervals again.

If I Had Treatment for Abnormal Cells

• Testing at 6 and 12 months post-procedure
• Combined Pap and virus testing to ensure clear margins and no recurrence
• Transition back to regular screening after 2–3 consecutive normal tests

Why not immediately return to 3– or 5–year intervals? Following an abnormal result, even if treatment was successful, the risk of recurrence is slightly higher. More frequent monitoring allows for early detection in the rare case that abnormal cells return. These precautions are temporary and designed for reassurance.

Will I need lifelong frequent screening? Not necessarily. Once follow-up testing shows consistent normal results, you’ll likely return to the routine interval recommended for your age group. Continued communication with your provider helps determine the right pace for your care.