Pap Smear: What to Do if Your Pap Smear Is Abnormal

Pap Smear_ What to Do if Your Pap Smear Is Abnormal

Papanicolau smear or Pap smear is one of the screening tests that allow your gynecologist to notice any precancerous cell abnormalities, before they turn into an invasive form of cervical cancer.

These findings, if early, can make the difference between life and death.

We already gave you information about how Pap smear is done, now we’ll try and mention what procedures might be recommended if your Pap smear is interpreted as abnormal.

Such treatment options include colposcopy, conization, cryocauterization, laser therapy and so on …

All these procedures have a high cure rate (over 90%), but your OBGYN will recommend the ones that are more suitable for your current situation.

The most common procedures, after an abnormal Pap smear test


Colposcopy is a minimally invasive and painless procedure that allows your gynecologist to look closer at your cervix. During this procedure your doctor basically uses a magnifying glass (called a colposcope) to look at the cervical lesion.

For a better view, the cervix is cleaned and soaked with vinegar (3% acetic acid). This acid turns the cellular abnormalities white, this is why doctors call them acetowhite lesions or acetowhite epithelium.

If your doctor finds any suspicious areas, a biopsy will be performed. This means a sample is taken from your cervical tissue and send to the laboratory for further analysis. If the result is positive for cancer, specific treatment options will be presented to you.

After a biopsy your doctor will recommend at least 7 days of sexual abstinence, internal douche or using tampons, in order for your small lesion to heal. If you are pregnant, you can still have a colposcopy done, since it’s still a very reliable test (90% success rate).


After your OBGYN has performed a colposcopy (it’s usually done to properly view the affected area on your cervix), conization might be the next step.

This procedure is a little more invasive than just viewing your cervix, since it means removing of the abnormal tissue area. A small cone-shaped specimen is being taken from around the endocervical canal, hence the name conization.

Because it is a painful procedure, anesthesia is performed in a hospital, but you will be released home shortly after. In most cases conization does not lead to complications (except for possible anesthesia complications and bleeding – only in about 10% of the cases), this is why you won’t need hospitalization.

There can be adverse effects on fertility, this is why conization is usually prescribed on women whose Pap smear suggests they may have invasion of cancer in nearby tissues or have severe changes on biopsy.

Cure rate is close to 100% with conization, as long as the cells along the margins are normal. You will be advised to abstain from douching internally, sexual activity and using internal tampons for about 3 weeks after the procedure.

Large-loop excision (LEEP) of the transformation zone

Large-loop excision of the transformation zone (LEEP) is a procedure done with a thin-wire loop that cauterizes the affected area on your cervix and the transformation zone (where the vaginal lining changes to the uterine lining).

Electrocautery is being administered and various tissue samples are being collected for analysis. The procedure is one of the most common used for Pap smear abnormalities and can be performed even under local anesthesia.


This is the most invasive treatment option for abnormal Pap smears and appropriate only for the women who are no longer interested in bearing a child. Your doctor will probably recommend this procedure only if other previous attempts have failed, as a last resort.

The treatments available after an abnormal Pap smear are various and effective. Your OBGYN will be able to recommend the best options for you.

Don’t forget that, even after you have been successfully treated, regular Pap smears are mandatory.

Do not forget to inform your medical examiner in the future about these results and the course of treatment your gynecologist used, since your medical history is very important.