Women should follow all of the preparatory steps recommended by their physician. In addition, they should:

• Avoid sexual intercourse for two days prior to the test.
  
  
• Avoid douching or using any vaginal medicines or spermicidal foams, creams or jellies for two days before the Pap smear. These may wash away or obscure abnormal cells.
  
  
• Try not to schedule a Pap smear during a menstrual period. The best time for a Pap smear is 10 to 20 days after the first day of the last menstrual period.

Pap smears are usually performed as part of a woman’s regular pelvic exam, which will also include an examination of the external genitals, uterus, ovaries, other reproductive organs and the rectum.

A Pap smear is performed in just a few minutes in a physician’s office. The patient will usually be asked to remove her clothing and change into a hospital gown. The patient then lies down on an examination table with her knees bent and to the sides, and heels resting in supports called stirrups. A sheet covers the woman’s legs and stomach. The physician (or physician assistant, nurse-midwife or nurse practitioner) gently inserts an instrument called a speculum into the woman’s vagina to widen it and cleans the cervix with a cotton swab. The swab, a small brush or a tiny spatula are used to obtain a sample of cells from the cervix. The cells are then smeared onto a glass slide for examination in a laboratory.

A newer approach to cell transfer has the physician obtain the cell sample before rinsing the instruments in a special liquid that preserves the cells for examination. The specimen is then filtered in a machine that reduces the amount of blood and mucus (thin prep). This can help make the sample easier to interpret.

A Pap smear is generally painless, although some women report minor discomfort during the procedure.