Bleeding After a Pap Smear: Should I Worry?

It isn’t always a fun thing to do, but your annual pap smear is a necessary evil in life. Cervical cancer is one of the “silent cancers” and getting checked every year is very important for your health. During a pap smear, the doctor needs to scrape a few cells to check for the HPV (human papillomavirus) or cancerous changes. The risk of bleeding afterwards is minimal, but can happen. This article will help you understand the procedure and what to do if you notice some spotting after pap smear.

Is Bleeding After Pap Smear Normal?

This happens to both pregnant women and women who are not pregnant. Experts agree that a small amount of bleeding or spotting after Pap smear is nothing to worry about. The cervix and vaginal area are very tender and have blood cells very close to the surface. During a normal routine pap smear, even normal scraping can cause a little bleeding. The bleeding usually stops on its own.

What Causes Bleeding After a Pap Smear?

In non-pregnant women, bleeding  is more likely if you are taking birth control pills that raise hormone levels and make the cervix more sensitive. Infections like yeast, chlamydia, Trichomoniasis, and gonorrhea can also cause your cervix to be tender and possibly bleed. If you do have bleeding after pap exam and you are at risk for an STD (sexually transmitted disease) it is a good idea to get checked.

In women who are pregnant, the blood vessels are more sensitive and bleed easier. Pregnant women need to have a pap smear early in pregnancy as part of a routine prenatal check. The doctor will often only use the “swab” to collect cells and may leave out the “brushing” that is often used to gather cells from the inside of the cervix. This can help reduce the risk of bleeding.

Another issue that can cause bleeding is a cervical polyp. These are fingerlike projections coming from the cervix that are filled with blood. If a polyp breaks open during the test, it can actually cause more than just spotting.

When Is It Serious?

While spotting after Pap smear or even a little bleeding is nothing to worry about, larger amounts should be checked by your doctor. The main worry about any bleeding is that it could be a sign of an infection. If you are pregnant and have an STD, the infection could cause problems for your baby. If you are not pregnant, the infection puts you at risk for complications like pelvic inflammatory disease.

A pap smear may cause light spotting for 1 to 2 days. If you have the following symptoms after a Pap smear, call your doctor back right away. You should also see your doctor if you have spotting longer than 3 days. The following situations are also serious:

  • Severe cramps
  • Heavy bleeding using more than 1 pad an hour
  • Dark or very bright red blood

How to Deal with Bleeding After Pap Smear

If you have mild spotting or bleeding immediately after your pap test, just place a pad in your underwear either at the doctor’s or after you get home. Take a pad in your purse just in case.

Change your pad every hour so that you can tell if the bleeding is getting worse or lighter. If you have bleeding after your pap smear, you may want to refrain from sexual intercourse or using tampons for a day or two until the cervix heals. Pressure on the cervix could cause the bleeding to start again after it has stopped.

Even if there is a slight risk of bleeding, it is very important to have a pap smear done at the following intervals:

  • Non-Pregnant – Every one to three years, or sooner if you have an abnormal pap smear.
  • Pregnant – At the first prenatal work-up and as necessary during the pregnancy if a pap smear is abnormal.

More Things to Do After a Pap Smear

If you are not spotting or bleeding after pap smear, you will be able to do everything you normally do. Follow the instructions above if you are bleeding and ask your doctor what you should do. Other things to remember are:

1)      Ask when the results will be available. You may need to call and check a week or two later. Some offices do not call if the results are normal.

2)      Ask about follow-up testing. Ask your doctor what you should do if a pap test is abnormal. You may need to schedule another test in a few months for a re-check.

3)      Ask if you should use a condom. There is a slight chance that bleeding after a pap test could signal a “sexually transmitted disease.” Your doctor may advise that you use a condom with your partner until all the results are in.

4)      Make sure you do follow-up care. Leaving abnormalities or infections untreated can have serious consequences. Untreated “HPV” can lead to cervical cancer and is often without any symptoms until the cancer is advanced. Make sure if you have abnormalities that you return for recommended follow-up testing and care.

5)      Your partner may need tested. If you have HPV, you may need to have your partner tested. A small percentage of men can get HPV and this can lead to reproductive cancer in men.