Your First Pap Smear: What to Know and Expect

Answers to frequently asked questions about your first pap test

Woman at the Gynecologist
Keith Brofsky/Getty Images

It's very common for women to feel anxiety about having their first Pap test, largely because they aren't sure of what goes on during a Pap smear. Rest assured, a Pap smear is simple, painless, and takes only minutes to perform — but even still, there are often many questions about what to expect at the appointment, such as those listed below.

What is a Pap Smear?

A Pap smear is a simple test that screens for cervical cancer. The test involves the collection of cells from the cervix to be examined under a microscope. It is not a diagnostic test, however, and if any abnormalities are discovered, more testing may be needed.

Why Is the Test so Important?

A Pap smear can detect abnormal cervical changes before they can become cancerous. It is a highly effective tool for cervical cancer screening and prevention.

When Should You Have Your First Pap Smear?

In 2009, guidelines were changed by the American College of Obstetricians and Gynecologists (ACOG). Updated guidelines suggest that women should have their first Pap smear at age 21. The old guidelines recommended women have their first Pap three years after becoming sexually active or at age 21 -- whichever came first. If you are well over the age of 21 and have never been screened, know that it is never too late to have your first Pap smear.

How Do I Prepare for the Procedure?

Try to schedule your Pap smear when you are not menstruating. If your cycle is unpredictable, and you start your period when it will coincide with your appointment, call your doctor's office as soon as possible to see if the doctor may recommend rescheduling.

To ensure that you get the most accurate results, it is recommended that you avoid vaginal intercourse, douching, and tampons 48 hours prior to your Pap smear appointment. Spermicidal foams, creams, or inserts should also be avoided.

What Should I Expect During the Appointment?

During your first appointment you should expect the following list of things to happen:

  • First, you will be asked to undress from the waist down. You will be given a sheet to place over your mid-section and upper thighs, so you will not be completely exposed.
  • Next, you will be asked to lay on the exam table and place your feet in stirrups, to hold your feet in place during the examination. Stirrups are usually cold, so you may want to bring a pair of socks to wear.
  • A lubricated speculum will then be inserted into the vagina. Remember to take deep breaths and to relax. This will also help the vaginal muscle to relax, making the exam less uncomfortable.
  • Using a small mascara-like brush or swab, a doctor will take sample cells from the cervix. This is done by very gently rubbing of the cervix with the brush or swab. Some women have no sensation when this is done, while some experience mild discomfort, like mild menstrual cramps.
  • The sample is then placed in a tube with a special preservative or a slide and then sent to a lab for processing.
  • After the sample is taken, the speculum is removed gently from the vagina. You are then able to sit up and begin dressing. The Pap smear is now over!

    When Should I Expect the Results?

    Before having the Pap smear, ask your doctor what the office policy is on notifying patients of their results. Result generally come within two to three weeks. Most doctors office notify women with normal results through the mail. Abnormal results sometimes require follow-up and are usually discussed in the office. If you have not received your results after three weeks, you may want to contact your doctor's office.

    How Frequently Should I Have a Pap Smear?

    How often you have a Pap smear depends on your age and previous Pap smear results. The latest guidelines from ACOG suggest that:

    • Women in their 20s should have a Pap smear every 3 years.
    • Women in their 30s to 65 years of age should undergo screening every 3-5 years.
    • Women aged 65-70, who have three consecutive normal Pap smears and no abnormal findings in 10 years, can discontinue screenings altogether if they choose.
    • Women who have undergone a total hysterectomy due to a noncancerous condition and have not previously had abnormal Pap smears can also discontinue screenings.

    Remember that these are general guidelines. Always follow your doctor's recommendation concerning the frequency of cervical cancer screening. Based on previous Pap smear results and other risks, your doctor may want you to be screened more frequently.​

    View Article Sources
    • "Detailed Guide: Cervical Cancer." Key Statistics About Cervical Cancer. American Cancer Society. 
    • "The Pap (Papanicolaou) test". American Cancer Society. 
    • "Pap Smear (Pap Test): Resource Overview". The American College of Obstetricians and Gynecologists. 
    • "New Guidelines for Cervical Cancer Screening, September 2013".The American College of Obstetricians and Gynecologists.