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It’s safe to say that no one really looks forward to a Pap smear…maybe you even pay special attention to your period tracker beforehand to see if you might have a heavy flow day and a good excuse to postpone. However, the Pap smear, also known as a Pap test, which tests for abnormal cells on the cervix that could lead to cervical cancer, is an indicator of your cervical health and a super important preventative health measure to take.
If you have your annual OB/GYN visit locked in already, what can you do to prepare for the Pap (and any other exams you might be receiving)? It turns out, sex before a Pap smear might not be the move. OB/GYNs weigh in on why, plus how long leading up to your appointment that sex should be off the table, and other ways you can prep yourself, physically and mentally, for the visit.
What does a Pap smear test for?
Though it can sometimes feel like your healthcare provider is down at the other end of the examination table for a long time, the Pap test itself only takes a few seconds. A doctor will use a speculum to open up the vagina for better visibility and access to the cervix and then will use a brush to take a few cells from the cervix to see if there are any abnormalities, explains Cheruba Prabakar, MD, FACOG, a board-certified OB/GYN and fellowship-trained minimally invasive surgeon.
After the swab, your doctor will run the tests for the cells from your cervix and see what the results are. According to a 2024 survey from BD Health, 59% of women think it ends there, that the Pap test is the most accurate way to screen for cervical cancer. However, if you’re over the age of 30, your doctor will likely run the test for a Pap (to evaluate the cervical cells) as well as for HPV. This is to test for active strains of the cervical cancer-causing virus in your system. “The virus can stay in your system for many years,” says Dr. Prabakar. “Often women under 30 will clear it from their bodies.” The virus, if present after age 30, is more likely to create abnormal cells, she adds, so it’s important to check for both any active high-risk strains of HPV and any cell abnormalities on the cervix.
Is it a bad idea to have sex before a Pap smear?
Now that you know what’s happening behind the curtain (or the stirrups, to be more exact), here’s where your part comes in. It’s not the best idea to have sex before a Pap test. “Most providers say to hold off at least 24 hours from any type of sexual activity, and some providers will recommend 48 hours,” says Somi Javaid, MD, Founder and Lead Chief Medical Officer at HerMD. Because your doctor is looking for any kind of abnormality in cervical cells, any kind of foreign substance present, which can include semen, lubes, residue from condoms, or any other spermicidal products, might obscure the view or make it more difficult to collect those cells. Your provider will also look at the whole vulva area, so it’s a good idea to hold off on sexual activity since that could be a potential irritant to the vagina or vulva skin, Dr. Javaid adds.
There are no absolute guidelines from OB/GYNs about when to have or not have sex before a Pap smear. To be safe, Dr. Prabakar tells patients that it’s safest not to have sex or use any vaginal creams or products that morning before they come in for an appointment. One of the main reasons that test results might come back inconclusive is having sex right before a Pap smear, she adds. There are a few other ways you can make sure you’re ready for a Pap smear.
How to prepare for a Pap smear
Skip creams, gels, and other products. If you’re in perimenopause or menopause, there’s a chance you’re using estrogen creams or other products like vaginal moisturizers. It’s best to hold off on those before your test, says Dr. Prabakar. “Medications, suppositories, gels, and creams can all interfere with the collection and interpretation of cells on your cervix, so it is best to avoid these for 24-48 hours prior to a Pap test if you can,” adds Dr. Javaid.
Track your period
This can be easier said than done, but if you have an idea of when your period is about to arrive, try to schedule a Pap smear around it. If you just started bleeding and have a light period, it’s possible to brush any blood off with a sponge before taking the cervical cell sample, explains Dr. Prabakar. If your period is pretty heavy, it’s best to reschedule, since the blood can affect the Pap or HPV test results, she says.
Let your provider know if you’re anxious
It’s just as important to mentally prepare as physically prepare for the Pap test. For many reasons, including sexual trauma, people have anxiety about pelvic exams — Dr. Prabakar encourages patients to tell their provider if they have a trauma history, or at the very least that they're feeling anxious about the test. Then, the provider can make some adjustments, like using a smaller speculum tool to make things more comfortable or giving patients techniques to relax the pelvic floor area, according to Dr. Prabakar. You can also bring headphones and listen to music or a meditation, or bring a support person to be there with you during the exam, suggests Dr. Javaid.
Come prepped with questions
Whether you’ve had an abnormal Pap smear in the past or this is your first time, Dr. Javaid recommends jotting down a list of questions you might have about the test or any other reproductive or sexual health concerns. It’s ideal for you to know your personal health history, including your diet and exercise routine, sexual, and contraceptive habits, and have a list of medications you’re on, too. This is not for your provider to judge you, Dr. Javaid says, but to have a full picture of your health and sexual wellness.
Take preventative measures
There are some effective steps you can take to avoid high-risk strains of HPV and therefore cervical cancer, one of them being the HPV vaccine. It’s now possible for all adults, regardless of gender, to get the vaccine up to age 45, if you didn’t get it already, Dr. Prabakar explains (just check with your doctor to make sure you’re a candidate, according to the CDC). You may still be eligible even if you’ve had certain strains of HPV in the past, especially if they were low-risk strains, she adds.
What to know about the Pap test results
And now… you wait. “Depending on the lab that your physician sends it to, typically two to four days is the turnaround for a Pap or HPV test,” says Dr. Prabakar. By that point, your provider can notify you of the Pap (and HPV, if you’re over 30) results. From there, it’ll depend on whether you’ll need a procedure to take a closer look at the cervix to evaluate any abnormal cells, or whether you’ll have another test in a couple of years, Dr. Prabakar explains. Even if you have abnormal cells or have a positive HPV test, this is not a guarantee that you have or will get cervical cancer in the future. Your doctor can answer any questions you have that are specific to your results, as every person is different. What’s most important is that you’re already being proactive about your cervical health.
Mara Santilli is a journalist reporting on health and wellness and how social and political systems influence the well-being of certain groups, including but not limited to Black and brown communities, women, and the LGBTQ+ community. Her editorial work has appeared in publications such as Shape, Marie Claire, Cosmopolitan, Women’s Health, InStyle, Glamour, and more. Outside of reading and writing, she enjoys traveling (especially to Italy), singing, dancing, musical theatre, and playing guitar and piano.