Many women feel anxious when they get a call saying their Pap smear results came back “abnormal.” One of the most common questions I hear in my clinic is whether bacterial vaginosis (BV) can cause an abnormal Pap smear. The short answer—yes, it can. Let’s talk about how that happens, what it means for your health, and what you should do next.
What Is a Pap Smear?
A Pap smear checks the cells of your cervix for early signs of abnormal changes that could lead to cervical cancer. During the test, a small brush collects cells from your cervix and sends them to a lab for analysis. Most of the time, results come back normal. But sometimes, inflammation, infection, or even simple irritation can make those cells look unusual under a microscope.
What Is Bacterial Vaginosis (BV)?
BV is one of the most common vaginal infections among women of reproductive age. It occurs when the normal balance of bacteria in the vagina shifts. Instead of healthy Lactobacillus bacteria dominating, other types—like Gardnerella vaginalis—grow excessively. This imbalance can cause symptoms such as a thin, grayish discharge and a “fishy” odor. However, some women with BV notice no symptoms at all.
Can BV Cause an Abnormal Pap?
Yes, BV can cause an abnormal Pap smear. When there’s an active vaginal infection, it can lead to inflammation and changes in cervical cells. The lab might detect these changes and label the result as “abnormal.” This doesn’t mean you have cancer—it simply means your cervix is irritated or infected, and more evaluation is needed.
Does BV Cause Abnormal Pap Smears Often?
BV-related changes are fairly common. If you have bacterial vaginosis at the time of your Pap test, your provider might see inflammatory cells or reactive changes. These changes can look similar to mild dysplasia, which is why follow-up testing or treatment may be recommended. Once the infection clears, a repeat Pap test often shows normal results.
BV vs. Yeast Infection: How They Differ in Pap Results
It’s not just BV that can affect your Pap smear. Yeast infections can also cause inflammation that mimics abnormal results.
Pap Smear and Yeast Infection
A pap smear yeast infection can show reactive or inflammatory cells due to irritation. The key difference is that yeast infections often cause itching and thick, white discharge, while BV causes odor and thin discharge. Both conditions can interfere with Pap accuracy if present during testing.
Does BV Mean You Have HPV or Cancer?
No. BV itself doesn’t cause HPV or cervical cancer. However, long-term vaginal inflammation from BV can make your cervix more sensitive to infection and cellular changes. In some studies, women with untreated BV were more likely to test positive for HPV, possibly because inflammation made it easier for the virus to persist. But BV alone doesn’t turn into cancer.
Can BV Cause Abnormal Pap Smear Results Repeatedly?
If BV keeps coming back, it may affect Pap results multiple times. Chronic inflammation can make the cervical environment unstable. That’s why treating BV completely—and giving your body time to heal before repeating the Pap smear—is important. Many providers suggest retesting 3–6 months after successful BV treatment to get a clearer picture.
How to Manage BV Before a Pap Smear
If you have symptoms of BV, it’s best to treat it before getting a Pap smear. This helps avoid false-positive or unclear results.
Tips Before Your Pap Test
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Schedule your Pap test when you don’t have symptoms or discharge.
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Avoid douching, vaginal sprays, or scented products.
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Tell your provider about any symptoms before your test.
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Complete the full course of antibiotics if BV is diagnosed.
Your provider might delay your Pap test until the infection clears. This helps ensure the sample reflects true cervical health, not temporary inflammation.
What Happens if You Have BV and Get an Abnormal Pap?
If your Pap smear shows abnormalities and you also have BV, your provider may treat the infection first. After treatment, you’ll likely repeat the Pap test in a few months. In most cases, results return to normal once the inflammation resolves.
When to Repeat Testing
If abnormal cells persist, additional tests such as HPV screening or a colposcopy (a closer look at the cervix) may be done. This helps rule out other causes like HPV or precancerous changes.
Why Some Women Get Recurrent BV
Recurrent BV is frustrating. It often happens because the vaginal bacteria balance doesn’t fully restore after treatment.
Common Causes
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Unprotected sex or multiple partners
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Scented soaps or douches
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Hormonal changes
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Stress or weakened immunity
Managing these factors helps reduce recurrence and lowers your risk of confusing Pap results.
Tips to Support Vaginal Health
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Maintain good hygiene, but avoid over-cleaning.
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Eat probiotic-rich foods like yogurt.
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Avoid smoking, as it can disrupt bacterial balance.
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Use condoms to protect against bacterial transfer.
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Stay consistent with annual or scheduled Pap tests.
Can BV or Yeast Infection Change HPV Test Results?
Sometimes. Infections like BV and yeast can interfere with HPV testing accuracy by altering the sample’s cellular makeup. If your results seem unclear, your provider may repeat the test after treating the infection.
When to See a Healthcare Provider
You should contact your healthcare provider if you have:
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Unusual vaginal odor or discharge
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Itching or irritation
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A history of abnormal Pap results
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Recurrent BV despite treatment
Early intervention can prevent misread Pap results and improve your long-term cervical health.
Takeaway
Bacterial vaginosis can cause abnormal Pap results by irritating or inflaming cervical cells. While it can be stressful to hear “abnormal,” BV-related changes are typically temporary and reversible with proper treatment. Regular Pap smears, prompt infection care, and open communication with your healthcare provider keep your cervical health in check.
FAQs
Can BV cause abnormal Pap results?
Yes. BV can cause inflammation that makes cervical cells look abnormal under a microscope.
Does BV cause abnormal Pap smears often?
It can. Many women with BV show mild changes on their Pap that disappear after treatment.
Can BV cause abnormal Pap repeatedly?
Yes, especially if the infection is chronic or not fully treated. A repeat Pap is often recommended after recovery.
Does a Pap smear detect BV or yeast infection?
A Pap smear isn’t meant to diagnose infections, but it can show signs of inflammation, suggesting BV or yeast.
Should I get a Pap smear if I have BV?
It’s better to treat BV first and wait a few weeks before your Pap to get accurate results.
Can BV cause abnormal Pap smears without symptoms?
Yes. Even asymptomatic BV can alter vaginal pH and affect cervical cells, leading to misleading results.
By understanding how BV and other infections influence Pap results, you can take proactive steps for clearer tests and better cervical health.
Disclaimer: This is informational content, not a substitute for professional medical advice.
Meghan Killilea Galli, APRN, FNP-BC, is a board-certified Family Nurse Practitioner based in Connecticut with over 5 years of clinical experience in urology, women’s pelvic health, and primary care. She currently practices with Hartford HealthCare and Griffin Faculty Practice Plan, where she provides evidence-based, patient-centered care. Meghan founded Health Gardeners to make reliable health information accessible for Hartford residents and beyond. Read More 