Bleeding after a smear test: is it normal and why does it happen?

If you experience bleeding after your cervical screening (smear test), we know that it can be alarming, especially if it’s your first test. But try not to panic – it’s fairly common, and many causes of bleeding are not likely to create future problems. It’s important to say, first of all, that if you are worried about it, or you feel that it’s a large amount of blood, it’s always best to speak to your nurse or doctor. 

Why does it happen?

Cervical screening involves taking a sample of cells from your cervix, which is a sensitive area. The brush used to take the sample of cells is soft but, because the area is very delicate, it could bleed even if it’s touched lightly. 

At your test, the nurse or doctor should also take a look at your cervix to check it all looks healthy. This means that they will let you know about anything visible which might need treating. An infection in your cervix, known as cervicitis, can also cause bleeding. If your nurse or doctor thinks you might have cervicitis, they will do more tests and decide whether it needs treatment, such as antibiotics.

However, bleeding usually happens due to the cervix being irritated by the test, rather than an indicator that something is wrong. A small amount of blood (also known as spotting), is normal. It’s quite common and it can happen for many reasons, which we talk through in the rest of this blog..

Cervical ectropion

Cervical ectropion is a very common reason you might experience some spotting. A cervical ectropion is a harmless, common condition which happens when cells from inside the cervical canal (called glandular cells) are present on the outside surface of the cervix. These cells are red, so the area may look red and your nurse or doctor can usually see it during cervical screening. It won’t cause problems for most people and doesn’t usually require treatment. 

An ectropion is also a common cause of bleeding after sex. So, if you’ve previously experienced that, light bleeding after cervical screening is not unusual.

Read more about cervical ectropion > 

Polyps or cysts

Polyps and cysts are small growths which can form on your cervix. They are not cancer and don’t increase your risk of getting cancer. The person doing your smear test can usually see these types of growths during the test and will let you know about them. Polyps and cysts don’t always cause problems, but they can sometimes cause unusual bleeding, including after a smear test if the polyp or cyst is touched during the test. If you have a polyp, your nurse or doctor might suggest you have it removed.  

Pregnancy 

If you’re pregnant, your cervix has a lot more blood flow and has more blood vessels. This means that if it’s irritated, it’s more likely to bleed. The further along in the pregnancy you are, the more likely you are to bleed when your cervix is touched. It’s not usually advised that you have a smear test when you’re pregnant, but we mention this as even very early on in a pregnancy you might find you bleed more easily. Even though bleeding during a pregnancy may be alarming, try not to panic – talk to someone if it gets worse or it does not stop after a few hours.

Menopause

After the menopause, many people experience something called vaginal atrophy. This means that the walls of the vagina break down, and this is why cervical screening can be more painful. It can also make you more likely to bleed if you’re in this category.

However, it’s important not to confuse this with other types of post-menopausal bleeding, unrelated to a smear test, which always needs reporting to your nurse or doctor. 

So should I be worried?

Any light bleeding you have should stop by itself after a few hours. You might want to bring a panty-liner or sanitary pad with you to the test and remember that it’s not unusual to need to use one! 

If any bleeding is soaking through 1 sanitary pad every hour, gets heavier, or doesn’t stop after a day, it is important to tell your nurse or doctor. They can make sure everything is okay and give you support.

Do you have more questions about cervical screening? Get in touch with our support services >