GYN Q&A: Your PapTest's women's health expert answers your most pressing concerns--here, all about pap tests

Sex + Health

GYN Q&A: Your PapTest’s women’s health expert answers your most pressing concerns–here, all about pap tests

-Lissa Rankin, M.D.

Lissa Rankin

What does it mean if I get back an abnormal pap test result?

Oooh. I know this one all too personally. I had my first abnormal pap smear when I first had sex with the guy who is now my husband. Poor guy–he feels bad, but most guys (including him) don’t even know they have it.

You tell your boyfriend about your abnormal pap smear, and he says, “That’s so weird. All my girlfriends have had abnormal pap smears.” Duh! It’s you, dude!

I was vigilant about getting my yearly paps, then-bam–all of the sudden, my pap smear was abnormal six months after I started sleeping with him. Why? Because I caught the human papillomavirus (HPV).

Most abnormal pap smears are caused by this virus, an extremely common sexually transmitted disease (STD) that will infect 75% of young women, if they don’t receive the new HPV vaccine. HPV comes in many types, but we group them into high risk and low risk. High-risk types tend to cause abnormal pap smears, whereas low-risk types tend to cause genital warts.

The pap smear is just a screening test for cervical cancer that signals to your doctor that we need to investigate the cervix further. If your pap smear is abnormal, chances are you have a high-risk strain of HPV and will need a colposcopy, a test your gynecologist can perform in the office by looking at your cervix with a special microscope that identifies abnormal cells. If we see abnormalities, we can take biopsies of the cervix, and the pathologist can then look at the biopsies to determine exactly what is going on.

Pap smear abnormalities are graded on a spectrum, from normal to invasive cervical cancer. In between, the pathologist will break the abnormality into atypical cells, low grade, high grade, CIS (cancer that hasn’t invaded), and invasive cancer. If it’s low grade or less, your immune system can often fight the HPV, and the cells can heal themselves. If it’s high grade, you will likely need to have a procedure to treat the abnormality (like I did) in order to prevent cervical cancer.

The good news is that almost all cervical cancer can be prevented. As long as you follow your doctor’s recommendations and don’t skip paps, you should never get cervical cancer. If you don’t already have HPV, talk to your doctor about whether you’re a candidate for the HPV vaccine, which can reduce your risk of developing an abnormal pap smear in the future.

And don’t worry! Most of the time, an abnormal pap smear is more of a nuisance than a serious health threat, as long as you follow up and get the care you need. And for those of you who don’t already know more about my own gyn visit than you want to know, I just had my follow up pap smear last week, and I’m clear!

Read more Gyn Q &As from Dr. Rankin: Dealing with PMS and Early Pregnancy Testing

Lissa Rankin is a gynecologist and author. She blogs at, and you can follow her on Twitter at @lissarankin

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7 thoughts on “GYN Q&A: Your PapTest

  1. The same thing happened to me in college with by boyfriend/now husband. Back then though, no one ever knew of HPV. I had the colposcopy and cryosurgery too, and was fine after all of that! I think this is more common than we think, but at the time, I thought it meant I was going to get cancer! Thanks for this great info!

  2. This great info. One question — I’ve read that American women are “over-tested” for pap smears. That after you test OK for a few years, you don’t need one every single year. Is this true?

  3. I tested normal on my pap from the time I was 17 until I was 22, and had an abnormal pap at 22 years old. So yes, you should get tested regularly, especially if you have multiple sex partners.

  4. While I have also heard that you can go a couple of years without a pap, the last time I did, I regretted it. I had HPV and it had advanced enough that a colposcopy cryosurgery couldn’t take care of it, and I needed a LEEP to have a growth removed. I still caught it before anything serious happened, but I wish I would have caught it earlier.

  5. but does it really hurt anything to get over-tested? I’d rather be safe than sorry unless it’s doing some damage by testing that I don’t know about??

  6. but does it really hurt anything to get over-tested? I'd rather be safe than sorry unless it's doing some damage by testing that I don't know about??

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