OB-GYN (Obstetrician-Gynecologist) Questions Pap Smear

Why am I bleeding after my pap?

I get a pap smear done every 6 months. Sometimes, but not every time, I notice a little bit of blood afterwards. Why does this happen?

23 Answers

This is usually irritation of the cervix during the sampling.
Sometimes it could be from sharp bristles infection polyp of cervical erosion where the inside of the cervix gets exerted due to childbirth
Can be hard scrapping and can be infection related
When we do a pap smear we use a plastic spatula that gently scrapes the surface of the cervix to collect the cells - it is not unusual to bleed a little afterwards, however if it happens every time you have a pap discuss it with the doctor and she/he can evaluate you for a possible vaginal infection, ectropion (inner mucosa of the cervix is spread on the outside more than usual). We do pap smears every year so if you need a pap every 6 months there might already be some issues with your cervix that cause the bleeding with the pap.
If you have abnormal pap smears you might consider vaginal boric acid supp from amazon 2 times a week (not on your period) and start DIM 100-200 mg 2 times a day for 6 months. Of course discuss this with your doctor first.
It is common, sometimes blood vessels around the cervical os bleeds if there is lot of inflammation
This is a very common occurrence and often is not the result of anything harmful. If your pap smear results are normal then you do not need to worry about cervical cancer or pre-cursors to it. There may be an infection of the cervix, a benign polyp or simply increased sensitivity of the cervix to trauma. The more important question is why you are getting a pap smear every 6 months. We have generally moved away from such frequent screening in recent years. I would bring up your concerns to your provider.
If the cervix is a little inflamed at the time of a pap, it can cause some bleeding/spotting. Inflammation can be caused by infection, but more so secondary to normal bacteria that reside in the vagina. I'm sure if anything looked abnormal your gynecologist would swab or let you know.
When you have a pap smear done, we are using a brush to collect cells from your cervix. The tissue on and around your cervix is similar to the gums around your teeth. Occasionally you may notice some bleeding when brushing your teeth so similarly, you may notice some spotting after brushing some tissue off your cervix when having a pap smear.
It probably is the result of the little brush that is used to scrap the inside of the cervix and is nothing to worry about. Just make sure that you know the result of the pap test.

It's totally normal to have spotting or bleeding after a pap, that means they got a good sample. The more concerning question is why are you getting a Pap smear every 6 months?

Jaime A. Goldstein, MD
One of the most common reason to bleed after a pap is due to bleeding from the cervix, sometimes cells from the inside evert out due to contraceptive pills or excess estrogen. Either way the small amount of bleeding is not a reason for concern. Please discuss with your OBGyn if you are worried.
Stay healthy!
Dr. Prasad
Bleeding is likely related to the trauma from the brushes we use to collect cells from your cervix. Certain conditions can make your cervix more friable, with a tendency to bleed. Some examples would be an infection, ectropion or in severe cases, premalignant/malignant lesions.
It is quite common to have a bit of bleeding after a pap smear. A good collection of cells requires the use of a "brush" for the inner canal of cervix and a "broom" for the outer surface of the cervix. The surfaces are literally scraped to collect cells for analysis for both dysplasia as well as for the presence of hpv. Unless the bleeding is very heavy, what you describe is normal. My greater concern is why are you getting pap smears every 6 months? Do you have history of a leep conization for dyslasia? Cervicitis - a benign condition - can also cause bleeding after a pap smear. Do you also have bleeding after sex? Make sure that all of these paps you are having are normal and I would request copies of the actual reports to confirm this.
Sometimes the cervix is fragile with cervicitis or errotion, and also the endo cervix has columnar epithelium and is more susceptible to bleeding.
It's not uncommon to have bleeding or spotting after a pap. Most times it is simply irritation to the cervix. The cervix is often friable, meaning it bleeds when touched.

Depending on what your doctor sees at the time of the Pap Smear, he/she may decide to take a biopsy as well.

Always call your Doctor and let them know if you have had bleeding so they can treat you more specifically.
This is common and if your Paps are normal, this should be of no concern except for the nuisance. Usually its just the mechanical scraping of the cervical canal with the small brush that causes the light bleed, similar to a gum bleed with aggressive brushing.
It is not unusual, and nothing to worry about. The PAP test involves using a small brush to swab the cervix. It works by removing some loose cells which can then be examined for abnormalities such as pre-cancerous changes or even the presence of the human papilloma virus (HPV).

Although the brush is plastic, in some women even that minor trauma can cause bleeding. Some women also bleed after intercourse due to contact with the penis or sex toys with the cervix. If this happens frequently, a good speculum exam and recent PAP test is a good idea just to make sure the cervix is normal. Once you get the all clear from your doctor, even bleeding after intercourse is not a problem (even if annoying).

Best wishes,
Peter G. McGovern, M.D.

Medical Director
University Reproductive Associates
214 Terrace Avenue
Hasbrouck Heights, NJ 07604
P: 201-288-6330
F: 201-288-6331
Email: pmcgovern@uranj.com

Clinical Professor and Associate REI Fellowship Director
Division of Reproductive Endocrinology and Infertility
Department of Obstetrics, Gynecology and Women’s Health
Rutgers – New Jersey Medical School
185 South Orange Avenue, MSB-E506
Newark, NJ 07109
Many women have bleeding following a Pap smear even when the cells are normal. Usually this is due to the cervix being friable and easily disturbed due to a condition called cervical ectropion. It's important to make sure you get the results of your Pap smear and that the cells are normal and if not that further evaluation is performed.
Sometimes the cervix can have some inflammation present and touching it with the pap device may cause some bleeding. As long as the pap smear is negative, this bleeding is common, normal, and will resolve spontaneously. If it doesn't, see your gynecologist.
Hi! If you are bleeding only occasionally with the pap this can be normal. When we collect the cells from the cervix, we usually use a small broom. This can sometimes cause some bleeding. I assume you have abnormal paps because you are getting them every 6 months. If you have an infection of the Human Papilloma Virus (HPV), this also can cause you to bleed with your pap or with sex.

I hope that helps!
Hi there! Thank you for your question.

I have to assume that you have had abnormal Pap smears since you are getting them done every 6 months. There are several possible reasons why a woman can bleed after their Pap smear. First - it may due to the abnormal cells themselves. If a woman has HPV (human papilloma virus) in her cervical cells and HPV has caused some abnormal changes in the cells, they can bleed due to the disordered growth from the HPV and if they are progressing into precancerous cells (not common, but possible) then the cells bleed easily with Pap smears, or during or after sex. Secondly, and also very common, the brush used to scrape the cells from the cervix is abrasive and can cause the sensitive delicate inner cervical cells (the gland cells) to bleed just from the Pap brush. A third possible cause is the presence of a yeast infection or vaginitis, or sexually transmitted infections, all of which cause inflammation of the cells and result in them bleeding easily.

Hope that helps!
The cervix tissue is delicate on the canal area that leads to the uterus. It can be even more delicate as changes occur when on birth control. Using the pap brush to sample inside the canal is part of the routine pap. This mild trauma to the tissue is harmless, but can cause some spotting.

Dian Joy Ginsberg, MD, FACOG
Fellowship certified in Anti-Aging and Regenerative Medicine
CEO, Specialty Healthcare and Wellness
6750 W Loop South, Ste 425
Bellaire, TX 77401
As long as your pap is normal it is OK. Depending on your age your cervix could be everted ('flowered' out) exposing the inner cervical tissue which is more sensitive and prone to bleeding. Also in order to get a good quality pap sometimes we have to be more aggressive to really get a good batch of cells and that can cause bleeding. W are more likely to see bleeding in younger women ( less than 30) because of eversion or older women (over 55) due to thinning of tissue. Occasionally bleeding can occur with an irritated cervix secondary to a vaginal infection (STD and non STD). Let your provider know before your next pap and they can maybe see what category you might fall into. Hope this helps.