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Dr. Andrea Pinto Lopez

Dec 11, 20227 min read

What Causes Abnormal Pap Smears Besides HPV?

The information provided herein does not constitute an expert or medical advice, nor intended to replace such advice.


Pap smears are probably one of the most common diagnostic tests used to ensure female reproductive health. These tests are most commonly used to detect HPV and cervical cancer, but there are other things that can affect your Pap smear results.

If you want to know what causes abnormal Pap smears besides HPV, just keep reading!

What causes abnormal Pap smears besides HPV?

Although Pap smears are primarily done for HPV and cervical cancer screening, they can also detect other abnormalities in your reproductive system.

Reproductive tract infections

In addition to HPV, other infections can cause inflammation and microscopic changes that can be detected during a Pap smear, causing an abnormal result. According to the University of Michigan, infections that can alter the results of your Pap smear include:

However, it’s important to keep in mind that a Pap smear isn’t the most sensitive test to diagnose these infections or other types of STIs. You could receive a perfectly normal Pap smear result even if you also have symptoms of another STI. If you ever experience symptoms of an STI, it’s important to disclose them to your healthcare provider so they can run the necessary tests and prescribe treatment if needed.

In some cases, STI testing and Pap smears can be carried out during the same cervical exam. According to the Cleveland Clinic, this means that your healthcare provider may take a small sample of vaginal fluid to test for STIs, in addition to the sample of cervical cells used for the Pap test.

If you receive an abnormal Pap result that could be linked to an infection besides HPV, your physician could recommend repeating the test after the infection has been treated and cleared.

Inadequate preparation

Using certain products the days before your test can make it more difficult to obtain Pap smear results, and they can even obscure the presence of abnormal cervical cells. Engaging in intercourse can also alter these results, since sperm cells could still be present in your sample.

Some of the factors that can affect your Pap smear include:

  • Douching
  • Tampons
  • Vaginal creams
  • Vaginal foams
  • Spermicides
  • Menstrual blood
  • Intercourse

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What is a Pap smear?

Papanicolaou or Pap smears were invented by Greek physician Georgios Papanikolaou in the 1920s — hence the name of the test. According to the Mayo Clinic, a Pap smear is performed by collecting a small sample of cells from a woman’s cervix. The cervix is the lower, tubular portion of the uterus which is located at the top of the vagina.

After the sample has been collected, a microscope is used to look for abnormalities in your cervical cells. The main purpose of a Pap smear is to detect precancerous and cancerous changes that can be caused by certain strains of human papillomavirus (HPV) and can potentially lead to cervical cancer. This test is simple, affordable, and effective, which is why it’s widely used for cervical cancer screening around the world.

As long as the sample is collected correctly, Pap smears can detect even small precancerous changes, giving women a greater chance to receive treatment promptly. According to the World Health Organization, cervical cancer is the fourth most common type of cancer affecting women worldwide, and according to a study published by the Annals of Oncology, Pap smears and regular screening can reduce the incidence of cervical cancer by up to 80 percent.

So, we know that Pap smears are incredibly important for HPV and cervical cancer screening, but what can cause abnormal Pap smears besides HPV?

How often should I get a Pap smear done?

The guidelines that recommend when a woman should start getting Pap smears, and how often they should be performed can vary from one country to the next. In the United States, most physicians recommend getting Pap smears at the age of 21 — but only if you’re sexually active, since HPV is transmitted through intimate and sexual contact. In other countries, screening can start from ages 20 to 25.

According to Johns Hopkins Medicine, women ages 21 to 29 with normal Pap smears should get this test done once every three years — although your OBGYN could still recommend a yearly general checkup. Women over the age of 30 should receive primary HPV testing in addition to their scheduled Pap smear.

How to prepare for a Pap smear

As we mentioned above, inadequate preparation can alter the results of your Pap smear. To prepare for this test, you should:

  • Avoid douching, using vaginal products, and having intercourse for 48 hours before your test.
  • Schedule your Pap smear for a day when you’re not on your period, and at least five days after your period ends.

Pap smears are an incredibly helpful tool that helps us screen for HPV and cervical cancer, making it possible to detect even the earliest signs of these diseases. Thanks to Pap smears, many women around the world have been able to receive life-saving treatment. It’s important to get your Pap smears according to schedule, and to prepare for the exam to increase the chances of an accurate result.


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