Pap Smears - Do They Hurt and What Is Involved?

A pap smear (known in some countries as a cervical smear test), is a simple health screening procedure for women, to check for pre-cancerous cells on the cervix.

Pre-cancerous changes in these cells are a sign that cervical cancer may develop, so it is important to detect them as early as possible so that they can be treated before this happens.

The major causes of these pre-cancerous changes (and cervical cancer itself) are Human Papillomaviruses (HPVs), a group of infections which are sexually transmitted.

The existence of this test makes cervical cancer "one of the most preventable and curable of all cancers"(1). And having regular pap smear tests gives you the best chance of detecting pre-cancerous cells.

So what is a pap anyway?

The name "pap smear" can perhaps be a bit off-putting to some. For me anyway, the whole thing used to seem rather mysterious because I didn't know what it meant; and to be papped also sounded like it would be a bit of a messy and nasty experience!

Well, don't let the name alarm you, the pap smear is simply named after George Papanicolaou, the man who developed it. And the reason that it's also known as a "smear test" is because the sample of cells taken during the test is spread on a glass slide when they examine them in the lab.

What does the test involve?

The test may be carried out by a doctor or nurse at your doctor's or gynaecologist's surgery, or at a well woman or sexual health clinic. It is an extremely quick test, lasting just a few minutes at the most.

You may also be offered other tests at the same time, such as an internal examination or a breast examination.

For the pap, you will be asked to lie down on the examination couch, remove the clothing from the lower half of your body, and cover yourself with a sheet. The doctor or nurse will then ask you to get in the position that will best allow them to carry out the test. This will usually be lying on your back with your knees bent outwards and your ankles together, or with your feet in stirrups.

The doctor or nurse will then place a metal or plastic instrument called a speculum into your vagina; this helps to open it, and allows them to examine your cervix; then they will collect some cells using a small brush or spatula.

None of this should hurt, but it might feel a little uncomfortable just for a very short while. And any discomfort can be reduced by relaxing your muscles. The test is over before you know it, and if you've never had a pap smear before, you're likely to find that the worry of having it done was much worse than the test itself!

The sample is then sent to be analysed for abnormalities. If abnormalities are found then you will be sent for further testing. Most abnormalities are due to an infection or inflammation, which can be easily treated. But if pre-cancerous cells are present, then it's best to catch them and treat them as early as possible.

Who should have a pap smear, and how often?

The answers to these questions vary depending on where you live, (which I know is quite strange, given that we all have similar bodies no matter we come from!)

For example, in the UK, NHS advice is that everyone between the ages of 25 and 65 should go for a pap smear test every three years, but that you only need to have the test if you have ever been sexually active.

In the US the advice is very different; it is recommended that you have a pap smear three years after your first sexual intercourse, or at the age of 21, whichever comes first (ie. whether or not you are sexually active). US doctors also recommend having the test at yearly intervals.

In Australia, it's again a case of "different country, different advice"! The recommendation there is to begin having smear tests at the age of 18 or within two years of your first sexual contact, whichever comes first. And the recommended interval is two years.

And as for the upper age limit, again the advice varies. Some countries say that once you've reached the age of 65, so long as you've had normal screenings in the previous couple of years, your risk of cervical cancer is so low that pap smears are no longer necessary. However, the health authorities in other countries recommend that you should continue to get tested whatever your age.

So, it is best to find out what the recommended advice is where you live. And if you do fall into the group who needs to have a pap smear test then don't worry, and don't delay. Any slight discomfort that the test may cause you has got to be worth it, given that it might just save your life!

Video about pap smears and other important female health screening tests

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Comments 26 comments

LatestDud profile image

LatestDud 8 years ago from Gold Coast (Queensland, Australia)

Very Informative! Feeling more comfortable with the prospect already! Thank you Moon Daisy!

Moon Daisy profile image

Moon Daisy 8 years ago from London Author

Thanks LatestDud, no problem!

I'm glad I was able to help in some way.

Dottie1 profile image

Dottie1 8 years ago from MA, USA

I'd recommend doing some squat thrusts a week in advance to prepare yourself for this test. I would also rather this test than the mammogram, OUCH!!!!

Moon Daisy profile image

Moon Daisy 8 years ago from London Author

Ooh, I've never heard of this way to prepare!  Interesting!

Yes, I've heard that mammograms can be a bit painful, but also necessary sometimes! Thanks for your comment.

Princessa profile image

Princessa 8 years ago from France

Excellent hub. Every women should be fully informed about the importance of having a smear test. Having it done regularly has literally saved my life more than once now.

Thumbs up!

mistyhorizon2003 profile image

mistyhorizon2003 8 years ago from Guernsey (Channel Islands)

Ditto that Princessa, I have now had two lots of laser surgery for Pre-Cancer cells and I am still just 38. These cells would not have been discovered but for regular smear tests. Currently I am all clear, but it could have been very different if I hadn't acted on the results of the tests.

Princessa profile image

Princessa 8 years ago from France

Exactly Misty, I had the Pre cancer cells treatment with laser when I was just 25. This second time, although not directly, going for a smear test we discovered a cyst that had to be extracted ASAP. This is an exam that can save people.

mistyhorizon2003 profile image

mistyhorizon2003 8 years ago from Guernsey (Channel Islands)

Yes, so far I have had two cysts removed too Princessa.

Moon Daisy profile image

Moon Daisy 8 years ago from London Author

Princessa and mistyhorizon2003, thanks very much for your comments (and the thumbs up!).  I'm so glad that the smear tests helped you to discover the pre-cancerous cells and cysts and helped save your lives.  What amazing stories, and examples of why we should all go for regular testing.  Thanks for sharing your experiences.

RGraf profile image

RGraf 8 years ago from Wisconsin

These are important to keep up, but you don't have to like it. I dread them, but I know that they are needed to ensure catching conditions earlier instead of too late.

Great info!

Moon Daisy profile image

Moon Daisy 8 years ago from London Author

Yes, it's true. Just a few moments' discomfort for some peace of mind, and it might even save your life. Definitely worth it! Thanks for your comment.

Ajs 7 years ago

Well i have been wondering abot it since my mom told me that they had to get theirs early. because they had the worst periods ever. now im 13, and my periods are horrible. so idk what the average age is to get a pap smear? can someone help?

Moon Daisy profile image

Moon Daisy 7 years ago from London Author

Hi Ajs, I'm not sure of the connection between the need for a pap smear and how bad your periods are.

I would check on your local health policy on pap smears. The best place to ask would be at your doctor's surgery, or you could look online. Most places seem to recommend going for your first smear test within a couple of years of your first sexual intercourse.

The average age for getting a test would depend on where you live and what the recommendations are there.

Moon Daisy profile image

Moon Daisy 6 years ago from London Author

Thanks for your comment Jehnavi, and for the useful information and website. It looks like a really great resource for American women.

amymarie_5 profile image

amymarie_5 5 years ago from Chicago IL

I live in the US. I never realized that there was a difference in getting pap smears until my friend from Canada told me. For them it's three years too and many of the women she knows never had one. I take birth control pills and I have PCOS, so I have to have one every year so I can get my medication. I hate it, but I hate the dentist even more. It could always be worse! Great article.

mathira profile image

mathira 5 years ago from chennai

Very useful for women and your hub was very informative.

Princess124 5 years ago

Thank you so much for helping

sosa2024 4 years ago

well when male gets a pap smear how is that peformed do they just take there blood or is it something else

Moon Daisy profile image

Moon Daisy 4 years ago from London Author

Hi sosa2024, a pap smear is to check for cervical cancer. As males don't have a cervix, they don't need this particular cancer check.

I'm not sure which type of cancer you are concerned about, perhaps you mean testicular cancer? For this type of cancer, I believe that the first test that they would do is an ultrasound scan. They might also do blood tests, and depending on the results, may order a biopsy, where they take a sample of cells to see if they are cancerous.

dannasha 4 years ago

It does hurt a lot hate it

Oddie25 4 years ago

Is it bad that I have been sexually active for well over three years and have never had a pap smear?

Moon Daisy profile image

Moon Daisy 4 years ago from London Author

Hi dannasha, I'm sorry it hurts you. Everybody's different and each one of us has different levels of sensitivity. It's obviously a very important test as it can save your life. So when you think about it, despite the pain it's probably worth doing.

Moon Daisy profile image

Moon Daisy 4 years ago from London Author

Hi Oddie25, it's never too late to have a pap smear. You're probably fine, but why not have one just to check? It could save your life.

ShyFox 4 years ago

Ever since my first pap smear, I was happy to know that I was clear from infection. But I'll never feel comfortable about having sex in the future(because of the scary procedure)and it worries my boyfriend. It still scares me to this day.

Moon Daisy profile image

Moon Daisy 4 years ago from London Author

Thanks for your comment ShyFox. I'm sorry that you feel that way about having sex. Is it the pap smear that worries you? I get that as lots of people are worried about it. But you really do get used to it the more you have, and I'm sure you'll agree that it's worth it. Please try not to worry, a good result is the most important thing. (And even if the result is good, catching it early gives you a great chance).

kittythedreamer profile image

kittythedreamer 4 years ago from the Ether

Very informative...I always thought that "pap" was short for "papillomavirus". Thanks for correcting my thought on that!

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