A Pap smear is a test doctors use to check if a person has any precancerous or cancerous cells in their cervix. While a Pap smear may involve a pelvic exam, it is not a test for chlamydia.

Chlamydia is a sexually transmitted infection (STI) caused by the bacteria Chlamydia trachomatis.

The Centers for Disease Control and Prevention (CDC) explain that doctors may take a cervical swab to test for chlamydia and scrape cervical cells for a Pap smear test.

Doctors often combine a Pap smear with a test for human papillomavirus (HPV), another common STI. HPV infections can become chronic, or long lasting, and increase a person’s risk of developing cervical cancer.

This article explains why doctors do Pap tests and the tests and treatments for chlamydia.

A healthcare professional performing a Pap smear.Share on Pinterest
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A Pap smear test will not be able to detect chlamydia.

Doctors use a Pap smear test to identify abnormal cells around the cervix that might become cancerous. The cervix is the lower part of the uterus, located at the end of the vaginal opening.

The CDC recommends regular screening for both cervical cancer and chlamydia. Most doctors offer Pap smears every 3 years from the age of 21 and chlamydia screening every year for people between the ages of 15 and 24.

According to the American Cancer Society (ACS), a Pap smear tests for cervical cancer.

The aim is to find precancerous cells and treat them before a person develops cancer.

If the tests reveal any abnormal cells, doctors usually recommend further testing.

Different organizations may have different testing recommendations. The ACS recommends starting screening at 25 years.

The Office on Women’s Health (OASH) recommends all females between 21–65 years have regular Pap smears, although the frequency of the tests may vary.

However, females older than 65 may still require pap smears, depending on their medical histories. A person over 65 years with a history of abnormal Pap smear results may require more testing.

A person should consult a gynecologist about Pap smear recommendations.

For the test, a doctor inserts a speculum into the person’s vagina. This holds the vaginal walls open and allows the doctors to see the cervix.

The doctor then scrapes the surface of the cervix with a small brush to collect some cells. They then send the cells to a laboratory to check for abnormalities that might indicate cancer or HPV.

Most people get their Pap smear results within 3 weeks of testing. According to OASH, the results will show one of the following:

  • Normal: When there is no evidence of abnormal cells, and there is little likelihood of the person having cervical cancer
  • Abnormal: When doctors detect changes in the cervical cells. An abnormal result does not automatically mean a person has cancer or precancerous cells, but doctors will want to carry out further tests.
  • Unclear: An inconclusive result could be for various reasons, such as the specimen being inadequate or unknown cells being present. In these situations, a doctor will likely suggest further testing.

According to the CDC, chlamydia is the most frequently recorded bacterial STI in the United States and is most common among young people.

Anyone can get chlamydia through vaginal, anal, or oral sex with a person who has the infection. The CDC reported that 1.8 million people had chlamydia in 2019.

However, this figure may not represent the full number, as many people with chlamydia do not experience any symptoms and do not report the condition.

OASH explains that untreated chlamydia can cause pelvic inflammatory disease (PID), leading to infertility.

They stress the importance of yearly testing, with additional tests if someone experiences any symptoms. A person should also undergo additional tests if their partner has chlamydia.

Chlamydia is often called a “silent infection” because not everyone experiences symptoms.

Even if a person does have symptoms, they may not associate them with chlamydia, as they may appear until several weeks after having sexual intercourse.

Symptoms include:

Doctors use nucleic acid amplification tests (NAATs) to diagnose chlamydia. They take samples of genital fluids or urine and send them to a laboratory for analysis.

Doctors can collect samples of vaginal fluids by taking a swab during a pelvic exam.

The chlamydia bacteria can also collect in the urethra, throat, and rectum, so a doctor may take swabs from multiple sites. Rather than a cervix swab, a doctor can also collect a urine sample to test the lower genital tract, but this may be less accurate. Testing males for chlamydia usually involves a urine sample.

People can also order tests to do from home. They should follow the instructions carefully and send the samples to a doctor’s office or lab in the mail.

A doctor will diagnose chlamydia if a person has a positive test result.

The person may receive their test results and diagnosis a few days after having the test.

After receiving a diagnosis, a person will start treatment for chlamydia with the help of medical professionals.

Chlamydia is a bacterial infection that doctors treat with antibiotics. The CDC recommends 100mg of doxycycline twice daily for 7 days.

Alternatively, a doctor may prescribe a one-off, 1-gram (g) dose of azithromycin or 500 milligrams (mg) of levofloxacin once a day for 7 days.

The CDC recommends that people abstain from sexual activity for the duration of their treatment or for 7 days after a one-off dose of azithromycin.

This section answers some frequently asked questions about pap smears and chlamydia.

What STIs are checked during a Pap smear?

Pap smears are not STI tests; however, doctors can test the same sample for HPV. If the results identify HPV DNA in the sample, it means the person has the virus.

HPV infections usually clear up on their own, but the CDC notes that they can linger.

Researchers associate persistent infections with some types of high risk HPVs with cervical cancer and, less frequently, cancers of the vulva, vagina, anus, and penis.

Can your gyne tell if you have chlamydia?

A gynecologist cannot tell if a person has chlamydia just by examining them but will collect a cell sample for laboratory testing.

If a person has had untreated chlamydia for a while, it can spread to the upper reproductive tract, the uterus, and the fallopian tubes. This can lead to pelvic inflammatory disease (PID).

PID can cause pelvic pain, ectopic pregnancy, and infertility.

Pap smears are not tests for chlamydia. Instead, they check for cancerous and precancerous cells around a person’s cervix.

Chlamydia is one of the most common STIs in the U.S., and the CDC recommends that people ages 14–24 have a test at least once a year.

The CDC also recommends people between the ages of 21–65 have Pap smear tests at least once every 3 years if the results are normal. It also recommends that people between the ages of 30–65 have Pap smears every 5 years but might also consider an HPV test.

For those ages 65 years and older, a doctor will decide whether or not to continue screening. A person who is not at risk of developing cancer may not need further testing.

People still require regular health check-ups and should consult a doctor if they experience any abnormal symptoms, whether or not a Pap smear is due.