Can Pap Smear with HPV Testing Be Done While Menstruating?
Testing should be postponed when a woman is menstruating, with one important exception: liquid-based cytology can be performed at any time during the menstrual cycle, while conventional cytology should ideally be scheduled for 10-20 days after the first day of menses. 1
Type of Test Matters
The timing recommendation depends critically on which cytology method is being used:
Liquid-based cytology (LBC): Can be performed at any time during the menstrual cycle, including during menstruation 1
Conventional cytology (slide-based Pap smear): Should ideally be scheduled for 10-20 days after the first day of menses 1
HPV Testing Considerations
HPV testing can be performed either as a separate test or by using material from the liquid-based cytology specimen 1
The same timing recommendations apply to HPV co-testing as they do for the cytology component 1
Practical Clinical Guidance
When mucopurulent discharge is present:
- The presence of mucopurulent discharge should not postpone cytology testing 1
- The test can be performed after removal of the discharge with a saline-soaked cotton swab 1
When other infections are identified:
- If specific infections other than HPV (e.g., chlamydia or gonorrhea) are identified at the visit, a repeat cytology test after appropriate treatment for those infections might be indicated 1
- However, in most instances (even in the presence of certain severe cervical infections), cytology tests will be reported as satisfactory for evaluation, and reliable final reports can be produced without the need to repeat the cytology test after treatment 1
Key Clinical Pitfall
The most common error is assuming all Pap tests must be postponed during menstruation. If your facility uses liquid-based cytology (which is increasingly standard), there is no need to reschedule the appointment due to menstruation. 1 Only conventional slide-based Pap smears require specific timing relative to the menstrual cycle.