Can I Have Sex Before a Pap Smear?

Photo Of Gynecologist Sitting Near Medical Equipment

A pap smear collects delicate cervical cells and examines them under a microscope for precancerous changes. For the most accurate results, doctors recommend avoiding sex for two days before your exam, Glamour reports.

That includes oral sex, genital fingering and sex toys—even with a barrier protection method like a condom. Vigorous sexual activity introduces bacteria into the vagina that may make obtaining an accurate pap test result difficult.

Penetration of the Cervix

The cervix is a thin canal that connects your vagina to your uterus. It’s shaped like a donut and can feel kind of squishy when you put your finger inside of it. The part of the cervix that’s closest to your vaginal opening is called the ectocervix, and the section that goes all the way up to your uterus is the endocervix. The cervix is a pretty important part of the female reproductive system: It keeps bacteria out of your uterus, produces discharge to clean the area, and changes shape during sexual activity to facilitate or prevent pregnancy.

During sex, your cervix might ache or bruise, which is normal and probably caused by friction in the vaginal canal. If your cervix hurts during foreplay, try using lube, and be sure to use your fingers only when they’re clean and completely dry.

You might also hear people referring to penetrating the cervix during sex, but that’s not really possible because the external os (the opening on the cervix) is narrow and only opens during birth or when nurses or doctors use medication or medical devices to dilate it for procedures like IUD insertions and abortions. It can become deeper during states of arousal, and that might feel good for some people, but it shouldn’t be painful. If it is, talk to your partner about how it feels and find a position that decreases the depth of penetration.

Bacteria in the Vaginal Canal

The human microbiome has become a hot topic in research, and scientists are finding that disrupted bacterial communities are implicated in many health problems. But while much attention has been paid to the bacteria that live in the gut, there is increasing recognition that a person’s vaginal canal contains its own unique community of organisms that can have an impact on sexual function and even affect pregnancy outcomes.

A condition called bacterial vaginosis (BV) is a disruption of the balance of bacteria that normally lives in the vagina. Typically, women with BV have less of the bacteria called lactobacilli and more of another mix of bacteria. Infection with BV can cause a fishy smell in the vulva and discomfort during sex. It can also make it harder to get pregnant.

In addition to causing a decrease in pH in the vagina, BV can increase a woman’s risk of getting sexually transmitted infections (STIs) such as chlamydia and gonorrhea or pelvic inflammatory disease (PID). It can also interfere with conception.

Using douches (genital cleansing products) and feminine hygiene products that interfere with the normal balance of bacteria in the vagina can also lead to a buildup of BV. Douching may also contribute to a person’s sensitivity to sex and pain during sexual activity. The Office on Women’s Health recommends against douching because it can change the natural acidity and bacterial flora in the vagina.

Inflammation

During a Pap smear, your healthcare provider removes a sample of cells from the opening of the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. The Pap test looks for changes in the cells that may lead to cervical cancer.

Depending on the type of Pap smear you have, your doctor may take cell samples with a brush or a flat scraping device called a spatula. The smear is usually painless. After the smear, your doctor will put the cells in a container with a liquid to preserve them (liquid-based Pap test) or on a glass slide (conventional Pap test). Then they send the samples to a lab to be examined under a microscope.

The Pap smear does not check for STIs, like chlamydia and gonorrhea, but blood tests can detect those infections. You should tell your healthcare provider about any STIs you have, and your doctor will recommend appropriate care.

Pap tests can also pick up some signs of an abnormal pregnancy or an ovarian cyst. Ovarian cysts are fluid-filled masses in the ovaries that can cause symptoms similar to cervical cancer. If a Pap smear shows a cyst, your healthcare provider will want to do more testing to find out what’s causing it. They might also order an ultrasound of the pelvis to see if the ovary has any lumps or bumps.

Discharge

The discharge of a person’s sexual fluids is usually white and has a faint, pleasant scent. If the discharge changes color, texture or smells abnormally and also has symptoms like painful urination or pelvic pain, it could be a sign of infection with an STI such as chlamydia or gonorrhea. If you experience these symptoms, see a doctor for an exam of your vagina and a sample of the discharge for testing. The doctor may do a pap smear or a vaginal culture to check for infection and get a diagnosis. Then, the doctor can prescribe antibiotics to treat the infection and prevent complications.

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