Spotting, Cramping, Or Bleeding After A Pap Smear: What It Means

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Why Am I Bleeding After My Pap Smear and How Long Will It Last?

Medically reviewed by Holly Ernst, PA-C — Written by Kimberly Holland — Updated on April 25, 2023

Causes
Concerning symptoms
Duration
Takeaway

It’s not uncommon to experience cramping or mild bleeding after a Pap smear. But heavy bleeding or severe cramping shouldn’t occur.

A Pap smear is a screening procedure that can detect cervical cancer. This practice, also called a Pap test, can also detect unusual cells, such as those caused by sexually transmitted infections (STIs) or precancerous conditions.

To perform a Pap smear, your doctor will need to collect a sample of cells from the surface of your cervix. The cervix is the opening of your uterus.

During a pelvic exam, you’ll lie on your back on a table. Your doctor will place your feet in stirrups and use a speculum to widen the opening of your vagina. The speculum helps your doctor see your upper vagina and cervix. They’ll use a scraper or brush to collect a sample of cells from your cervix. That sample is then sent to a lab for analysis.

Read more to learn what’s normal and abnormal following a Pap smear.

Causes of bleeding or spotting after a Pap smear

Some bleeding or spotting after a Pap smear is normal. Heavier bleeding may be a sign of another condition or issue.

Cervical scratch

In order to get a sample of cells, your doctor must scrape or scratch the delicate lining of your cervix. This can cause bleeding and sensitivity. However, bleeding from a cervical scratch is typically very light and ends on its own in a matter of hours or a few days.

Cervical sensitivity

Blood will surge to your cervix and other reproductive organs following a Pap smear and pelvic exam. This can increase bleeding from a scratch or irritated spot on your cervix.

Increased cervical blood vessels

If you’re pregnant during a Pap smear, you may see more bleeding following the test. Your cervix develops additional blood vessels during pregnancy. These can bleed following a test, but the bleeding should end within a few hours or no more than two days.

Cervical polyps

Cervical polyps are small, bulblike growths that develop on the opening of your cervix. During a Pap smear, a cervical polyp may bleed, which increases the amount of surface tissue that’s bleeding.

Birth control pills

Birth control pills and other forms of hormonal contraception increase your hormone levels. This can make your cervix more sensitive and may cause more cramping or pain. This may make bleeding more likely after a Pap smear.

Infections

Yeast infections, as well as STIs, can cause cervical bleeding after a Pap smear. These infections may make your cervix more tender, and blood vessels may bleed more following the procedure.

Friable cervix

This condition causes the tissues in your cervix to be overly sensitive and easily irritated. If you have a friable cervix, you may experience heavier spotting and bleeding following a Pap smear. Spotting also isn’t uncommon after other activities, such as sex, with this condition.

Cervical cancer

One of the primary symptoms of cervical cancer is irregular vaginal bleeding. This bleeding is likely coming from your cervix. Anything that irritates the cervical tissues, such as a Pap smear, can cause additional bleeding.

Concerning symptoms

Light bleeding or spotting following a Pap smear is common. More serious bleeding is less common and may be a sign of a bigger issue. Concerning symptoms include:

bleeding larger amounts than typical spotting
severe cramping
bleeding that lasts longer than three days
bleeding that gets heavier, not lighter, following the exam
heavy bleeding that requires more than one pad in an hour
dark blood with clots or very bright red blood

Irregular bleeding is a common sign of cervical cancer. However, bleeding following a Pap smear can be a sign of many other issues, including an infection, an STI, or pregnancy. Don’t immediately assume unusual bleeding after a Pap test is a sign of cancer. But, you should talk with your doctor right away about your symptoms.

How long it generally lasts

If bleeding after a Pap smear is from normal causes, such as a cervical scratch, the bleeding should stop within a few hours. Spotting may last up to two days, but the bleeding will become lighter.

Avoid sex and don’t use a tampon in the two to three days following a Pap smear if you’re experiencing bleeding. The additional pressure may cause bleeding to start again or become heavier.

The takeaway

Bleeding or spotting after a Pap smear isn’t unusual, even for people without infections, cancer, or other conditions. The delicate tissues of your cervix can bleed after a brush or swab scratches the surface. If you’ve had issues with bleeding in the past, ask your doctor if you should take any special precautions this time.

Likewise, take the time during your exam to ask your doctor when you can expect your results. Some offices require that you call for results. Others will email or mail your results to you. If the results show a potential issue, ask your doctor when and how follow-up tests will be ordered.

Don’t exert yourself if you’re experiencing cramping or soreness after the test. Give your body a bit of time to heal so you don’t accidentally worsen the bleeding.

Call your doctor if your bleeding is heavy, becomes worse, or doesn’t end after three days. Let them know about your bleeding and any other symptoms, such as soreness or cramps. This may help them with a diagnosis. They may also want you to make a return visit for another examination.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Bleeding during pregnancy. (2016).https://www.acog.org/Patients/FAQs/Bleeding-During-Pregnancy
Casey PM, et al. (2011). Abnormal cervical appearance:What to do, when to worry? DOI:https://doi.org/10.4065/mcp.2010.0512
Cervical polyps. (2012).https://www.health.harvard.edu/womens-health/cervical-polyps
Comparetto C, et al. (2015). Cervical cancerscreening: A never-ending developing program. DOI:https://doi.org/10.12998/wjcc.v3.i7.614
Pap and HPV testing. (2014).https://www.cancer.gov/types/cervical/pap-hpv-testing-fact-sheet
Papanicolaou test (Pap smear). (n.d.).https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022605/
Signs and symptoms of cervical cancer. (2016).https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/signs-symptoms.html

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Medically reviewed by Holly Ernst, PA-C — Written by Kimberly Holland — Updated on April 25, 2023

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Causes of bleeding or spotting after a Pap smear

Cervical scratch

Cervical sensitivity

Increased cervical blood vessels

Cervical polyps

Birth control pills

Infections

Friable cervix

Cervical cancer

Concerning symptoms

How long it generally lasts

The takeaway

How we reviewed this article:

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