Spotting After Pap Smear

Pap smear

Pap smear, or how it’s called the Pap test (shortened from the name of the doctor Papanicolaou, who developed the screening test) is the most common screening test in women which is used for early findings of abnormal cells in the cervix. This can happen due to infections, sexually transmitted diseases or cervical cancer. It is the best way for detection cervical cancer and it is one of the most important gynecological screenings since cervical cancer is the fourth most common cause of deaths among women worldwide.

How It’s Done?

Pap smear is a procedure where you lay down on a table with your legs spread open. Your doctor will use an instrument called speculum to keep the walls of vagina open to having a good access to the cervix. Then, he will scrape the surface of the cervix with a spatula, a plastic tool. You can feel a slight discomfort and/or push during this quick step. After that, the doctor puts the spatula into a glass slide and sends it to the lab. In the lab, they do a smear or a transfer of the cells on a glass and look under the microscope for any abnormal appearance of the cells.

Spotting After Pap Smear, Is It Normal?

Yes, it is normal. This happens due to some not so illogical causes. It doesn’t have to mean anything severe or that this occurs only to you. It usually subsides by itself, after a few hours or days. It can happen for a few reasons:

  1. Cervical Scratching With A Spatula

As the doctor scratches the surface lining of your cervix, which is sensitive, it causes small damages of the tissue, the same like small lacerations on the skin. Since this happens, the capillaries in the tissue are being ripped and they can lightly bleed, but it stops naturally due to vascular constriction and vessel repair.

  1. Bleeding As A Consequence Of The Polyp Laceration

Polyps are tissue growths from the surface of the mucous membrane which look finger-like and can be very vascularized so when this kind of polyp is being scratched with a spatula, it can lead to profusely bleeding, also from inflammation and maybe high levels of estrogen.

  1. Excessive Circulation Of The Cervix

This is also common, especially in pregnant women, where the cervix is full of blood inside the vessels, so when damaged, it can show in a way of heavier bleeding after Pap test. This is also normal and it will pass by itself.

Is It Dangerous If I’m Spotting While Pregnant And Will It Hurt My Baby?

This is not the case. Spotting after Pap test it is normal, even when you’re carrying a baby. You shouldn’t be worried about miscarriage or that something is wrong. The main reason spotting happens during pregnancy is because of the effect of the hormones where the cervix becomes more sensitive and the second one, because of the excessive flow of the blood in the uterus due to baby’s feeding and the blood supply of the placenta. Spotting doesn’t mean that you should skip Pap smear while you’re carrying, but contrariwise, it is important that you check yourself for some infections or sexually transmissive diseases since you are going to have a child.



Should You See A Doctor For Prescribing Some Therapy?

It depends. If it is a small bleeding, you should wear a pad and see if it gets worse or if it’s not getting better. If the bleeding is heavy and you have to change the pad every hour, or if you see bright red or very dark blood, you should schedule and appointment with your doctor. It can be a sign of infection or STDs.



Pap Smear Aftercare

When going for a check up, always wear a pad inside your bag so you could place it inside your underwear for safety precaution, just so you can feel more confident about not bleeding on your clothes. You should not have sexual intercourse while still spotting, wait for it to stop. Also, you should consider not using tampons too, because excessive pressure on your cervix can also cause bleeding since your cervix is still sensitive due to scrapping during Pap smear.

Pap Smear Findingsuterus-1089344_1280

  • Negative or normal finding means there are no abnormalities within your cervix, there are no infections and all cells are the same look and size.
  • Positive or abnormal finding means there are some irregularities between the cell appearance.


The categorization of the Pap smear samples are the following (as outlined by the National Cancer Institute):

  • Atypical squamous cells (ASC)are the most common abnormal finding.  It has two groups, ASC-US, and ASC-H. ASC-US: atypical squamous cells of undetermined significance, and ASC-H: atypical squamous cells, cannot exclude a high-grade squamous intraepithelial lesion.
  • Low-grade squamous intraepithelial lesions (LSILs) are considered mild abnormalities caused by HPV infection.
  • High-grade squamous intraepithelial lesions (HSILs) are more severe abnormalities that have a higher likelihood of progressing to cancer if left untreated.
  • Squamous cell carcinoma is cervical cancer.[1]

[1] National Cancer Institute