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Is an abnormal Pap always caused by an STD?

Alynn B. Alexander, MD
OBGYN (Obstetrics & Gynecology)
99% of abnormal Pap smears that are classified as dysplasia or precancerous cells are caused by human papillomavirus, which is acquired by sexual activity. There could be other abnormalities like inflammation or a shift in vaginal flora that’s not associated with an STD, but cervical dysplasias are almost always STD-related. 
Kevin W. Windom, MD
OBGYN (Obstetrics & Gynecology)
HPV is the cause of 90% of abnormal Pap tests. Sometimes other STDs like trichomanis can cause abnormal Pap test. Bacterial vaginosis, yeast infections, lack of estrogen can also cause abnormal Pap test and these problems are not sexually transmitted.
Donna Ketcheson, RN
Midwifery Nursing

Yes, almost always an abnormal pap smear is caused by the human papillomavirus (HPV) of which there are over 100 different types and are transmitted by skin-to-skin contact. If it is caused by HPV, then most likely you will be evaluated with a colposcopic exam. Remember that a pap smear is only a screening test, and not a diagnostic test. Your practitioner will view and evaluate your cervix/vagina/vulva with the colposcope (binoculars on a stand) and may take a small biopsy of tissue to assess the level of abnormality.

Sometimes a pap smear is "abnormal" due to lack of estrogen in the vagina or inflammation or other sexually transmitted diseases such as trichominiasis and, in that case, the cause will be treated and the pap repeated. Also, an HPV test can be done to see if the virus is present to help determine the next course of action.

In any event, remember that the pap smear is a screening test and will need further evaluation such as an office visit or a colposcopic exam to determine the cause of the abnormal pap.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.