Can You Get a Pap Smear on Your Period?
A Pap test, also known as a Pap smear, is a screening procedure for cervical cancer. It involves collecting cells from the cervix to check for precancerous or cancerous changes.
Some women wonder if its possible or advisable to get a Pap smear during their menstrual period. Lets discuss whether you can safely get a Pap test done while on your period.
What Is a Pap Smear?
During a Pap smear, a doctor gently scrapes a small amount of cells from the cervix using a brush or spatula. The cells are examined under a microscope to look for abnormalities that could indicate cervical cancer or precancerous changes.
Its recommended that women ages 2165 get regular Pap tests. Guidelines recommend the following (1, 2):
- Age 2129: Pap test every 3 years
- Age 3065: Pap test every 3 years, or HPV test with Pap test (cotesting) every 5 years
- Over age 65: No screening needed after adequate negative prior screening results
Screening is important, as finding and treating precancerous changes early prevents progression to cervical cancer. About 13,000 new cases of invasive cervical cancer are diagnosed yearly (3).
Can You Get a Pap Smear While on Your Period?
Having a Pap test while menstruating is generally fine. However, there are some things for both providers and patients to consider.
For Healthcare Providers
Performing Pap smears on menstruating patients is common in clinical practice. Guidelines do not specify restricting Pap tests to any particular time of the menstrual cycle.
However, some important factors for providers to keep in mind include:
- Use a speculum to visualize the cervix and collect an adequate sample.
- Take care cleaning away any blood so it does not obscure the cervix.
- Change gloves whenever needed to maintain clean technique.
- Repeat the Pap if results are obscured by excess blood or discharge.
One study found false negatives were slightly more common for Pap tests done during bleeding, although the difference was small. Still, providers should consider repeating any very bloody screenings (4).
For Patients
While getting a Pap smear during your period is not hazardous, there are some factors that may make it preferable to reschedule if possible:
- You may feel more comfortable rescheduling if you have heavy flow days.
- Inserting the speculum may be more uncomfortable with menstrual cramps.
- More pressure may be needed to collect an adequate sample if bleeding heavily.
- The accuracy could be reduced if the sample contains a lot of blood.
Discuss any concerns with your provider. If you wish to reschedule for after your period, a delay of a week or two will not make a significant difference in detecting abnormalities.
Does Menstrual Cycle Affect Pap Results?
Hormone fluctuations during the menstrual cycle cause changes in the cervix. But research on whether this affects Pap results is inconclusive.
One major study found no association between the timing during the cycle and the accuracy of Pap smears (5).
However, other studies suggest Pap tests may be slightly more accurate when performed in the follicular phase after menstrual bleeding ends. This phase may yield the clearest results (6, 7).
Overall, Pap smears done at different menstrual cycle stages appear to have very small variances in specimen adequacy and accuracy. So providers generally perform them at routine visits regardless of cycle timing.
Tips for Minimizing Discomfort
You can take steps to make getting a Pap smear more comfortable:
- Communicate with your provider about any concerns and request they use care and proper technique.
- Take ibuprofen shortly before your appointment to minimize cramping.
- Insert the speculum yourself slowly and gently if it causes pain.
- Do Kegel exercises to relax pelvic floor muscles.
- Breathe deeply and try to relax muscles during the procedure.
- Ask for a smaller speculum if the standard size is uncomfortable.
Let your provider know if you experience significant pain so they can help adjust the procedure and provide support.
Does Period Blood Affect Pap Results?
There are mixed findings on whether menstrual blood impacts Pap smear results. Heres what some studies have found:
- One study found no significant difference in specimen adequacy, but a slightly higher rate of unsatisfactory results (8).
- Another found no difference in accuracy between Pap tests from different cycle phases (9).
- One study reported blood led to 9% of tests being false negatives compared to 5% in the proliferative phase (10).
- However, a large meta-analysis concluded blood likely does not affect results (11).
Overall, research indicates menstrual blood is unlikely to significantly impact Pap smear results. However, providers may recommend repeating the test if a large amount of blood interferes with collecting a clear sample.
Does it Affect HPV Testing?
HPV stands for human papillomavirus, a common sexually transmitted infection. Many strains cause no symptoms and resolve on their own. But some high-risk types can eventually lead to cancer.
HPV testing may be used along with Pap tests to screen for cervical cancer in some age groups. This involves testing cells collected from the cervix for DNA from high-risk strains of HPV.
Studies show menstrual blood does not appear to affect the accuracy of HPV testing. One study found no difference in HPV results whether women were swabbed during bleeding or not (12).
So its likely fine to do HPV testing at the same time as a Pap smear, regardless of menstrual cycle timing. However, repeating the test is reasonable if excess blood reduces the adequacy of cell collection.
Other Screening Tests During Periods
Some other common screening exams overlap with Pap smears. Here are guidelines on whether these tests can be performed during menstrual bleeding:
Pelvic Exams
A pelvic exam involves manually examining the uterus, ovaries, and other pelvic organs. Providers can perform pelvic exams during periods by using extra care and new gloves to minimize mess.
STI Testing
Tests for sexually transmitted infections like chlamydia, gonorrhea or trichomoniasis can be done by swabbing the vagina and cervix. Menstrual blood doesnt affect most STI tests. However, blood could inhibit cell collection for wet mount testing for infections like yeast and bacterial vaginosis (BV).
Mammograms
Screening mammograms to detect breast cancer are safe at any point of the menstrual cycle. Be sure to mention your last period date, as hormones may affect breast density.
Let your provider know if you are menstruating. They can provide pads, clean technique, and minimize discomfort during any screening exams.
Abnormal Pap Smear Results
Most Pap results are normal, but some women may get an abnormal Pap smear finding. Common abnormal results include:
- ASC-US: Atypical squamous cells of undetermined significance. This means changes were found but may be due to an infection.
- LSIL: Low-grade squamous intraepithelial lesion indicating mild cell changes that may become cancer.
- HSIL: High-grade SIL with more precancerous changes.
- Atypical Glandular Cells: Precancerous changes in the glandular cells.
Abnormal results require follow-up. Depending on your results, your provider may recommend:
- Repeat Pap test in 6-12 months
- HPV testing
- Colposcopy procedure to examine the cervix
- Cervical biopsy to sample abnormal tissue
- Treatment like cryotherapy or LEEP to remove precancerous areas
Follow your providers advice for any follow-up testing or treatment. Early intervention is important for preventing progression to cancer.
Why Pap Smears Are Important
Pap tests screen for changes and abnormal cells that could become cervical cancer if left untreated. Routine screening is critical for prevention.
Its estimated that Pap testing cuts the cervical cancer death rate by over 60% (13). Survival rates are very high when cervical cancer is caught at an early stage before spreading.
Many medical groups endorse HPV vaccination to prevent infection with cancer-causing strains. But Pap tests continue to be recommended to screen for any abnormalities that may develop.
Follow your providers advice on age to begin screening, frequency of Pap tests, and managing any abnormal results. Staying up to date can save your life.
The Bottom Line
Its generally fine to get a Pap smear while you are menstruating. While research varies slightly, menstrual blood does not appear to significantly affect the accuracy of Pap or HPV test results.
However, you may prefer to reschedule if you have heavy flow or cramping. Let your provider know if you have any concerns. They can help minimize discomfort and repeat the test if blood inhibits a clear sample.
Staying on top of regular Pap and HPV testing is crucial for detecting any signs of cervical cancer early, when its most treatable.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
Add Comment