I Had an Abnormal Pap and I’m Worried—What Now?
First: take a breath. An abnormal Pap smear does not mean you have cancer. In fact, it usually means your provider caught something early—which is exactly what we want.
What is an abnormal Pap?
A Pap test looks at the cells on your cervix (the opening to your uterus) to check for any changes. These changes are often caused by HPV, the most common sexually transmitted infection in the U.S. According to the CDC, about 80-90% of sexually active people will get HPV at some point in their lives.
When your Pap is abnormal, it means some cells don’t look completely typical. This doesn’t mean cancer—but it does mean your provider may want to take a closer look.
Quick Refresher: What Is HPV?
HPV (human papillomavirus) is a virus that spreads through skin-to-skin contact, including sex. Most of the time, the body clears it on its own without any symptoms. But certain strains can cause genital warts or in this case, changes in cervical cells that, if left untreated, could eventually turn into cancer. That’s why we screen—and why the HPV vaccine is such a game-changer (learn more about that here).
So what happens next?
Most likely, your provider will recommend a colposcopy, which is a magnified exam of your cervix. It’s a lot like a Pap, but with a special microscope and a vinegar solution that highlights any areas that look suspicious. If anything looks concerning, your provider may take a biopsy—a small sample of cells to test in the lab.
Important to know:
Most people who need a colposcopy do NOT end up having cancer.
Many of the changes found are low-grade and go away on their own.
Colposcopy helps make sure if treatment is needed, it’s timely and effective.
Learn more about colposcopies here.
What if my biopsy shows something serious?
Even then, most abnormal cell changes—especially if caught early—are treatable. Depending on the results, your provider might recommend:
Watchful waiting (especially if changes are low-grade or you’re under 25)
A LEEP procedure, which removes abnormal tissue using a thin electrical wire loop (quick, outpatient)
A cold knife cone biopsy or laser therapy (less common, but used in some cases)
If you're trying to get pregnant or are pregnant, your provider will walk you through safer timing or alternative options. You can and should talk about fertility when discussing treatment.
Don’t Forget: You Can—and Should—Ask for Pain Relief
If you’re nervous about pain, you are NOT being dramatic. In May 2025, ACOG released updated guidelines making it clear that pain relief should routinely be offered for colposcopies and in-office biopsies. That includes options like numbing agents, anti-anxiety meds, and more.
If your provider doesn’t bring it up? Ask. You’re allowed to advocate for your comfort.
How common is this, really?
Very. Abnormal Paps happen all the time—and millions of colposcopies are performed each year in the U.S. You are not alone in this.
When to Follow Up
Schedule your follow-up as advised
Ask about pain management and support
Get your results explained in plain language
Don’t skip future screenings—this is how we stay ahead
Final Thoughts
This might feel scary. But you’re not alone—and this doesn’t mean the worst.
Abnormal Pap smears are common. Most cell changes are low-grade. And early intervention saves lives.
It’s okay to ask for time, support, and clarity. It’s okay to be nervous. But let’s balance the fear with facts—because information is power.
And if your provider brushes off your concerns, doesn’t explain your options, or minimizes your pain? Find a better one.
You deserve to feel seen, supported, and safe—every step of the way.
For more information on this topic:
American Cancer Society: What to Expect After an Abnormal Pap Smear or HPV Screening
