When I visit the gynecologist for my annual pap smear, I don’t do any sort of preparation. It’s just a preventive exam, right? However, I was surprised to find many online sources recommending that people with vaginas avoid penetrative sex before a pap smear.
None of the gynecologists I’ve visited have ever given me this recommendation, so I wanted more insight. I reached out to several experts for advice.
Do you need to avoid having sex before a pap smear?
“This is true to an extent,” says Barbara McLaren, Board Certified OB/GYN and Co-Founder of Kushae feminine wellness products. “A pap smear is a scraping of the surface cells of the cervix to detect any changes in the appearance of normal, healthy cells. Having sex prior to a pap smear can impact the interpretation of this exam, because sex can cause inflammation in the cells. [This inflammation] will be visible when the specimen is reviewed under a microscope for abnormalities.”
“While inflammation is a natural occurrence following penetrative sex, it also can be a sign of an infection,” Dr. McLaren continues. “When we see ‘inflammation present’ in the pap report, we don’t necessarily know whether that inflammation is from sex or from an infection, so it can make it a little more difficult to diagnose certain things. In addition to inflammation, semen may still be in the vagina 24 hours after having sex, making evaluation of your vaginal discharge more difficult. This is another reason to withhold from penetrative vaginal sex one to two days prior to your pap smear.”
How long should you avoid having sex before a pap smear?
“For the vast majority of women, the general rule of thumb is that it’s best to avoid sex for 24 to 48 hours before your annual pap smear,” McLaren explains. “Some women prefer to avoid sex 72 hours before their exam because sperm can survive inside the vagina for up to 72 hours.”
Does this apply to penetrative sex only?
“Just penetrative sex,” McLaren confirms. “Oral and anal sex are fair game before your pap smear. In this exam, we’re collecting a sampling of cells in the cervix, so sex without vaginal penetration should be fine.”
What else should you avoid before your pap smear?
“Be mindful and try to avoid anything you’re inserting into the vagina,” says McLaren. That includes:
“And no douching!” she adds. “Douching is not healthy and is never something I recommend.”
What shouldn’t you worry about before a pap smear?
Don’t worry about shaving! “So often, patients start their pelvic exam by saying sorry that they haven’t shaved down there. I call them the ‘vagina apologists,'” says McLaren. “Let’s clear this up: You do not have to be shaved! Gynecologists can still see everything we need to see regardless of your state of grooming down there. It’s just a matter of personal preference for each woman.”
Also, having your period, irregular bleeding, or spotting does not mean you have to cancel your appointment. “It used to be that we could not perform pap smears at all during someone’s period … Now, the technology is so advanced that we are able to read the result of the pap even if a little blood is present,” she says.
However: If you are bleeding heavily (whether you still have your period or you are menopausal), you may need to reschedule your appointment. Call your doctor to make sure.
If you had sex in the 24-hour window, should you still get your pap smear?
Don’t cancel your appointment just yet! According to McLaren, it may be okay. “If you have had sex within 24 hours of your pap smear, your doctor will still do the pap test. But, there’s a likelihood that your results may come back showing some inflammation that needs to be investigated further,” she says. “It’s important that we make sure the inflammation was just from sex and not from some other source, like an infection. This follow-up exam would be to rule out an infection.”
Another opinion: You may be just fine having sex before your pap smear.
Jennifer Lincoln, OB/GYN, OB Hospitalist, International Board Certified Lactation Consultant (IBCLC), and viral TikToker points out that recommendations aren’t consistent.
“If you Google this, you will see countless places that recommend avoiding sex before a pap smear — including the CDC. Some websites say 24 hours, others say 48,” Dr. Lincoln says. “Some say it’s okay if your partner wears a condom. Others say any kind of vaginal sex will distort results. The bottom line? I am unable to find any actual studies that back up these recommendations, which is super frustrating.”
Lincoln notes that this recommendation may not be necessary now that the technology has advanced.
“I think this idea of needing to avoid sex before a pap may have been more important with our older generation of pap tests, when we collected cervical cell samples and smeared them on a slide,” she says. “I could see how having residual ejaculate could make reading the slide more difficult. However, our newer generation of pap tests are liquid-based and processed differently. So, it is less clear to me how having sex would lead to an issue with getting accurate results.”
With this in mind, Lincoln believes that gynecologists need more research before they give out this information. The reason? She doesn’t want to discourage people from getting their annual pap smear.
“I can’t stand ‘just in case’-isms,” she says. “We as women especially are told to do or avoid so many things ‘just in case.’ Give me data before you tell me I can’t have sex!
“This might seem minor. But, when we put up MORE barriers to important things like cervical cancer screening, we make it less likely for people with a cervix to get the screening they need … It may sound dramatic, but we have to always make sure the recommendations we make to our patients are based in science and not old wives’ tales.”
So, what should you do? Until we get a definitive answer, talk about it with your doctor when you schedule your next annual visit. Your gynecologist will give you a recommendation based on your personal health needs. Hopefully, your visit will be smooth sailing from here.