Dear Alice,

I bled as a result of my last Pap smear. I've never had that happen before and it was a new gynecologist. She said that it was normal. Is that true?

— Confused about blood

Dear Confused about blood,

It's true — it's not unusual for a Pap smear to cause a small amount of bleeding. The procedure involves removing cells from the surface of the cervix with a small brush and a plastic spatula. Although the procedure is usually painless, the scraping can cause bleeding. Women who use hormonal contraceptives like birth control pills may be more prone to bleeding from a Pap smear because the hormones can make the cervix more sensitive.

Having a yeast infection or a sexually transmitted infection (STI), such as trichomonoiasis, chlamydia, or gonorrhea, may also make your cervix susceptible to bleeding. If you've been sexually active and have had a new partner(s) since the last time you were tested for STIs, it's a good idea for you and your partner(s) to be tested. A Pap smear tests for abnormalities in the cervical cells that may develop into cervical cancer. These abnormal cells are most often the result of human papillomavirus (HPV), which also causes genital warts. A Pap doesn't test for HPV itself or other STIs. If your health care provider doesn't ask you if you'd like to be tested for STIs specifically, you may need to ask for them directly. Like a Pap smear, getting tested for STIs on a regular basis is part of taking responsibility for your sexual health.

In the end, a bit of bleeding following a Pap is likely nothing more than a minor scrape. However, if you continue to have concerns, it's best to follow up with your health care provider.

Hope this helps!


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