What causes an abnormal Pap test?

Most abnormal Pap tests are caused by HPV infections. Other types of infection—such as those caused by bacteria, yeast, or protozoa (Trichomonas)—sometimes lead to minor changes on a Pap test called atypical squamous cells. Natural cell changes that may happen during and after menopause can also cause an abnormal Pap test.

What increases your risk for an abnormal Pap test?

Human papillomavirus (HPV) can raise your risk for having an abnormal Pap test. Certain sexual behaviors, like having sex without condoms and having more than one sex partner, can put you at risk for getting HPV. Smoking and having an impaired immune system can also increase your risk for having an abnormal Pap test.

Do abnormal cell changes cause symptoms?

HPV, which causes most cervical cell changes, usually doesn't cause symptoms. But some people with cell changes may have abnormal vaginal bleeding. This may include bleeding between periods, heavy periods, or bleeding after sex. If another vaginal condition is the cause, you may have other symptoms, such as vaginal pain, itching, or discharge.

What will you need to do if you have an abnormal Pap test?

You may need more tests to find out if you have an infection or to find out how severe the cell changes are. For example, you may need:

• An HPV test. Like a Pap test, an HPV test is done on a sample of cells taken from the cervix.

• Colposcopy, a test to look at the vagina and cervix through a lighted magnifying tool.

• Another Pap or HPV test in about 6 to 12 months.

Treatment, if any, will depend on whether your abnormal cell changes are mild, moderate, or severe. In moderate to severe cases, you may have treatment to destroy or remove the abnormal cells.