Things That Can Cause An Abnormal Pap Smear

Pap smears are potentially life-saving tests that can detect precancerous cells on your cervix. While most Pap smear results are normal, most women will have an abnormal or unclear Pap test at some point in their lives. Fortunately, only around 1% of abnormal Pap results are cancerous, but that doesn’t make it any less stressful when you hear that you have abnormal results.

Our team of expert gynecologists here at Maiden Lane Medical in Manhattan, New York offers annual gynecological exams, including Pap smears, as well as follow-up testing and treatment if needed. Contact us today to book an appointment!

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What Is an Abnormal Pap Smear?

Pap smear results are classified as either normal, unclear, or abnormal. An abnormal Pap smear result means that unusual cells were found when your Pap smear was analyzed.

What Does it Mean to Have Abnormal Cells in a Pap Smear?

Abnormal cells in a Pap smear can mean a lot of things, not all of them bad or dangerous. However, if you have abnormal or unclear results, you should consult with your gynecologist and schedule any additional testing needed to collect more information about your abnormal test results.

Common Causes of Abnormal Pap Smear Results

Many things can cause abnormal Pap smear results. Below is a detailed list of some of the possible causes.

HPV

HPV, or the human papillomavirus, is one of the most common causes of an abnormal Pap smear. HPV is the most common STD. In fact, according to the Centers for Disease Prevention and Control (CDC), almost every sexually active person will have HPV at some point during their lives.

HPV is a concern because some of the 200 different strains of the virus can lead to genital warts or cancer. To put it in perspective, two strains of HPV can cause warts, and a dozen have been linked to cancer.

In most cases, HPV will go away without you ever knowing or having treatment. Nonetheless, because of the potential risks, it’s essential to have routine health screenings like Pap smears and HPV tests to monitor your health.

Infection

Another relatively common and benign cause of an abnormal Pap smear is infection. Yeast infections and bacterial vaginosis are two of the common types of infections that can interfere with your Pap results. These infections often cause a vaginal odor, itching, and discharge. If you have any of these symptoms, you should talk to your doctor and have the necessary treatment needed to diagnose and treat your condition correctly.

Cervical Dysplasia

Cervical dysplasia is abnormal changes to cervical cells that aren’t cancerous but could become cancerous in the future. Cervical dysplasia has several stages. Your gynecologist will recommend treatment depending on the severity of the cervical dysplasia stage.

For example, if you are in the earliest stage, your doctor may suggest monitoring your condition. Or if you have a more severe stage of cell abnormality, your doctor could suggest removing the abnormal cells.

Cervical Cancer

Cervical cancer is a slow-growing cancer. So, in most cases, a Pap smear will uncover precancerous cells before they develop into cancer.

However, it is possible for a Pap smear test to find cancerous cervical cells. Around 13,900 cases of cervical cancer are diagnosed in the United States each year. With the increased prevalence of Pap smears and early diagnosis, the mortality rate of cervical cancer has decreased significantly to less than 5,000 people a year.

Trichomoniasis or Other STDs

While Pap smears aren’t used to diagnose STDs, they can find cellular changes caused by STDs, like trichomoniasis. You should make an appointment for STD screenings if you think you are at risk or have any symptoms. Talk to your doctor about your STD risk factors to find out how frequently you should be tested.

Harmless Abnormal Cells

It is also entirely possible to have an abnormal Pap smear for completely benign reasons, such as recent sexual intercourse, being near the beginning or end of your period, using tampons, or even having a bath. Abnormal test results can also be caused by lab errors or issues with your cell sample.

What Should I Do if I Have Abnormal Results?

First, don’t panic. Very few abnormal Pap smear results are due to something dangerous. Call your Maiden Lane Medical gynecologist to schedule a consultation and any necessary follow-up tests. Your doctor will be able to give you more information about your results and what your next steps are.

Depending on your specific needs, you may need to schedule another Pap smear, either right away or in six months. Your doctor may also recommend a colposcopy. Colposcopy is a noninvasive procedure that allows your gynecologist to examine your cervical cells and uterus in detail.

What Happens During a Colposcopy?

During a colposcopy, you recline on a treatment table with your legs in stirrups, much like when you have a Pap smear. Your gynecologist inserts a speculum into your vagina to allow an unobstructed view of your cervix.

Then they position the colposcope, a magnifying instrument, outside of your vagina. The device allows them to examine a magnified view of your cervix to get more information about the abnormal cells and your health.

Can an Abnormal Pap Smear be Nothing?

Yes, an abnormal Pap smear can be caused by problems with sample preparation, lab errors, or even having sex or using a tampon before your pap test. The only way to find out is to talk to your doctor about your results.

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Are Abnormal Pap Smears Common?

Yes, abnormal Pap test results are very common. Most women will have an abnormal Pap smear at some point during their lives. While most Pap results are normal, this routine test has significantly contributed to decreased deaths due to cervical cancer. It is the most effective way to diagnose cervical cancer in its early stages or while cells are in precancerous stages, allowing for quick and effective treatment.

What Does it Mean to Have Precancerous Cells in a Pap Smear?

Precancerous cells, also called cervical dysplasia, indicate that you have abnormal cervical cells that aren’t yet malignant but could turn into cervical cancer. You’ll need to talk to your doctor about what precancerous cervical cells mean in your situation. Generally, it means that you will need to have additional testing, including a colposcopy and possibly a biopsy, for your doctor to learn more about your specific condition.

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What Happens if I Have Precancerous or Cancerous Cells?

If your Pap smear finds precancerous cells or cervical cancer, your doctor will schedule additional testing and treatments, which may include:

Colposcopy

Colposcopy is a noninvasive diagnostic procedure. While you recline on a treatment table with your feet in stirrups, as you would during a pelvic exam, your gynecologist inserts a speculum into your vagina to hold it open and positions the magnifying colposcope outside of your vagina. Your doctor looks through the device for a magnified view of your cervix to collect more information about your abnormal cervical cells and health.

Biopsy

During a biopsy, your gynecologist takes a small sample of cells from your cervix or uterus, which are then tested to diagnose and stage cervical cancer.

Cryotherapy

Cervical cryotherapy is a procedure to freeze and remove abnormal cervical cells. Your gynecologist can perform the procedure in their office.

While you lie on the treatment table with your feet in stirrups, your doctor gently opens your vagina with a speculum and inserts a cryoprobe, holding it against your cervix for a few minutes. The cryoprobe quickly freezes the cells. You might feel some cramping during the procedure, but most patients tolerate it well.

LEEP

A loop electrosurgical excision procedure (LEEP) uses a small electrical loop to remove abnormal cervical cells. Your doctor can also perform this procedure in their office. They apply a numbing cream to your cervix and a solution to prevent bleeding before using the LEEP device to treat your cervix. Your doctor may send the excised cells to a lab for further testing.

If you are due for your annual gynecological exam or have concerns about abnormal Pap test results, schedule an appointment at Maiden Lane Medical today. Our team of experts in Manhattan, NY is ready to help. Call us today!

Pap Smear FAQs

What is the difference between a pelvic exam and a Pap test?

During a Pap test, your gynecologist uses a small swab that looks like a mascara brush to collect cells from your cervix to test for abnormalities. A pelvic exam is an internal exam that allows your gynecologist to feel for growths like cysts and other abnormalities.

How often do I need to have a Pap smear?

In general, women between the ages of 21 and 29 should have a Pap test every three years. For ages 30-65, you can choose either Paps q3 years, HPV testing alone q5 yrs, or co-testing q5 years. However, if you have a family history of cervical cancer, you should talk to your gynecologist and determine if you should have more frequent testing.

When should I have a Pap smear?

The ideal time to have a Pap smear is five days after the end of your menstrual period. However, you can have a Pap test at any time of the month.

How should I prepare for a Pap smear?

You should avoid sexual intercourse or using tampons, birth control foams, or any vaginal creams or medications for two to three days before your appointment to keep your test results as accurate as possible.

Does a Pap test screen for STDS?

No, a Pap test doesn’t screen for STDs. Your doctor can perform an HPV test at the same time as your Pap smear and order additional blood and urine tests to check for STDs.

Medically Reviewed By

Sarah Adamic, NP

Women’s Health Nurse Practitioner

Specialists