A woman should have a Pap smear when she is not menstruating. The best time for screening is between 10 and 20 days after the first day of her menstrual period. For about 2 days before testing, a woman should avoid douching or using spermicidal foams, creams, or jellies or vaginal medicines (except as directed by a physician), which may wash away or hide any abnormal cervical cells.
A Pap smear can be done in a doctor's office, a clinic, or a hospital by either a physician or other specially trained health care professional, such as a physician assistant, a nurse practitioner, or a nurse midwife. With the woman positioned on her back, the clinician will often first examine the outside of the patient's genital and rectal areas, including the urethra (the opening where urine leaves the body), to assure that they look normal. A speculum will then be inserted into the vaginal area (the birth canal). The speculum is an instrument that allows the vagina and the cervix to be viewed and examined. A cotton swab is sometimes used to clear away some of the mucus.
A small brush called a cervical brush is then inserted into the opening of the cervix (the cervical os) and twirled around to collect a sample of cells. This sample, because it comes from inside the cervix, is called the endocervical sample ("endo" meaning inside). A second sample is also collected as part of the Pap smear and is called the ectocervical sample ("ecto" meaning outside). These cells are collected from a scraping of the area surrounding, but not entering, the cervical os. Both the endocervical and the ectocervical samples are gently smeared on a glass slide and a fixative (a preservative) is used to prepare the cells on the slide for laboratory evaluation.
A bimanual (both hands) exam usually follows the collection of the two samples for the Pap smear. The bimanual examination involves the examiner feeling the ovaries and uterus with one hand on top of the abdomen (belly) and inserting two fingers of the other hand inside the vaginal canal.
The results of the Pap smear are usually available in 2 to 3 weeks. If a woman has not learned of her results after a month, she should contact her clinician's office.