A pelvic exam and Pap test are small parts of your routine care that can make a big difference for your long‑term health. If you are wondering how often should a woman get a pelvic exam and Pap test, you are not alone. The answer depends on your age, medical history, and risk factors, but there are clear guidelines that can help you talk with your provider and plan ahead.
Below, you will find a simple breakdown by age and situation, plus what each test actually checks for so you know why it matters.
Pelvic exam vs. Pap test
Although they often happen at the same visit, a pelvic exam and a Pap test are not the same thing.
A pelvic exam is a physical exam of your vulva, vagina, cervix, uterus, ovaries, and sometimes your rectum. Your provider looks and feels for any signs of infection, pain, growths, or other changes. According to Cleveland Clinic, pelvic exams usually become part of routine preventive care from around age 21 and may be recommended yearly or every few years depending on your health and risk factors (Cleveland Clinic).
A Pap test (Pap smear) is a specific screening test for cervical cancer. During the pelvic exam, your provider gently inserts a speculum and collects cells from your cervix with a soft brush or spatula. These cells are sent to a lab to check for abnormal changes that could become cancer if left untreated (Cleveland Clinic).
You can have:
- A pelvic exam without a Pap test
- A Pap test as part of a pelvic exam
- Both together at the same visit, which is very common
How often should you have a Pap test?
The timing of Pap tests changes with age and can also depend on whether you are getting an HPV test at the same time.
Ages 21 to 29
Most major organizations agree on a clear starting point.
- You should have your first Pap test at age 21.
- From 21 to 29, the United States Preventive Services Task Force (USPSTF) and National Cancer Institute recommend a Pap test every 3 years if your results are normal (National Cancer Institute, USPSTF).
Cleveland Clinic also advises that women with a cervix aged 21 to 30 get a Pap smear at least once every three years to detect abnormal cervical cells early (Cleveland Clinic).
The American College of Obstetricians and Gynecologists (ACOG) says that for ages 21 to 29, Pap testing every 3 years is preferred. HPV testing alone can be an option for some people ages 25 to 29, but Pap tests are still the main approach in this group (ACOG).
Screening younger than 21 is not recommended because cervical cancer is very rare at that age and early screening can cause more harm than benefit, such as unnecessary procedures and anxiety (USPSTF).
Ages 30 to 65
From age 30 through 65, you usually have three options for cervical cancer screening, and all are considered effective when used at the right interval:
- Pap test alone every 3 years, or
- HPV test alone every 5 years, or
- Pap test and HPV test together (cotesting) every 5 years
These options are recommended by USPSTF and the National Cancer Institute (National Cancer Institute, USPSTF), and ACOG supports the same three strategies (ACOG).
Cleveland Clinic notes that between ages 30 and 65, many people can have a Pap smear every 5 years, often with an HPV co-test, depending on their individual health history and past results (Cleveland Clinic).
These longer intervals are safe because a 3 year interval with cytology alone and a 5 year interval with HPV testing or cotesting provide strong protection while avoiding too many false alarms and unnecessary follow up procedures (USPSTF).
After age 65
You might be able to stop Pap tests after age 65, but not everyone should.
You may be able to stop cervical cancer screening if:
- You are over 65
- You have a cervix
- You have a history of regular, normal screening results
- You do not have a history of high grade precancerous lesions or cervical cancer
In this situation, both the National Cancer Institute and USPSTF say that further screening usually does not add benefit and can be stopped (National Cancer Institute, USPSTF). ACOG also supports stopping after 65 if you have never had abnormal cervical cells or cervical cancer and have had two or three consecutive negative tests, depending on the type of test used (ACOG).
If you have not been screened regularly, had recent abnormal tests, or have certain risk factors, your provider may recommend continuing screening after 65 (National Cancer Institute).
After a hysterectomy
If you have had a total hysterectomy with removal of your uterus and cervix, your need for Pap tests depends on why you had surgery.
- If your hysterectomy was for non cancer reasons, such as fibroids, and you have no history of cervical precancer or cancer, you generally do not need further cervical cancer screening (National Cancer Institute, USPSTF, MedlinePlus).
- If your hysterectomy was related to cervical cancer or precancer, you may still need Pap based testing of the vaginal tissues as part of follow up care. Cleveland Clinic notes that people who had hysterectomy for cervical, ovarian, or uterine cancer might still require Pap tests to monitor for vaginal tissue cancer, guided by their provider (Cleveland Clinic).
Always check with your clinician before assuming you can stop screening.
How often should you get a pelvic exam?
Unlike Pap tests, the schedule for pelvic exams is more flexible and depends heavily on symptoms and personal history.
General guidance for pelvic exams
Cleveland Clinic notes that women should have their first pelvic exam by age 21. After that, pelvic exams typically become part of routine preventive care and may be recommended every year or every few years, depending on your age, risk factors, and overall health (Cleveland Clinic).
They also highlight that:
- Some providers suggest annual pelvic exams
- Others recommend every 3 years up to about age 65, especially if you do not have symptoms and your previous exams have been normal (Cleveland Clinic)
- After menopause, pelvic exams are still often advised because cancer risk increases with age and regular exams may help detect certain cancers earlier (Cleveland Clinic)
However, ACOG takes a slightly different approach. They recommend pelvic exams when you have symptoms, such as abnormal bleeding or pelvic pain, or when your medical history indicates a need, rather than automatically every year for everyone without symptoms (ACOG).
Adolescents usually do not need a pelvic exam at their first gynecologic visit unless there is a specific problem (ACOG).
Pelvic exams during pregnancy and procedures
Certain situations do call for pelvic exams, even if you are not due for routine screening:
- During pregnancy, particularly at your first prenatal visit, a pelvic exam is commonly recommended, and you may also have a Pap smear at that time if you are due for one (Cleveland Clinic, ACOG).
- Pelvic exams are also needed for some procedures, such as inserting an intrauterine device (IUD) or performing an endometrial biopsy (ACOG).
When more frequent screening might be needed
Most of the schedules above apply to people at average risk. If you have certain risk factors, your provider may recommend more frequent Pap tests or continued screening beyond the usual age range.
You may need individualized screening if you:
- Have a history of cervical cancer or high grade cervical precancer
- Are HIV positive
- Have a weakened immune system
- Were exposed to diethylstilbestrol (DES) in the womb
ACOG notes that women with these higher risk factors may require more frequent cervical cancer screening than standard guidelines suggest (ACOG).
If you are unsure whether you are considered high risk, this is an important topic to raise at your next visit.
Annual visits vs. screening tests
One point that can be confusing is the difference between how often you see your ob‑gyn and how often you need Pap tests or pelvic exams.
ACOG and MedlinePlus both encourage you to have regular health visits, often once a year, even if you do not need a Pap test or pelvic exam every time (ACOG, MedlinePlus). These well‑woman visits are a chance to talk about:
- Birth control options and family planning
- Menstrual concerns
- Menopause symptoms
- Sexually transmitted infection (STI) testing
- Vaccines, such as the HPV vaccine
- Breast and pelvic health concerns
- Any new or bothersome symptoms
You can think of Pap and pelvic exams as tools your provider uses when needed, while the yearly visit is your regular check in for overall sexual and reproductive health.
Screening tests follow a schedule, but your questions and concerns do not have to wait. If something feels off, do not wait until your next “due date” to call your provider.
How to use these guidelines in real life
Guidelines are meant to support, not replace, the conversation you have with your clinician. Here is how you can put this information into action:
-
Know your age group and basic schedule.
For example, if you are 27, you likely need a Pap every 3 years. If you are 40, you might choose between Pap every 3 years or cotesting every 5 years. -
Keep track of your last Pap test.
If you are not sure when it was or what the result was, you can ask your provider’s office for your records. -
Talk about your risk factors.
Let your provider know about any history of cervical abnormalities, immune problems, HIV, or DES exposure so they can tailor the plan for you (ACOG). -
Ask whether you need a pelvic exam at each visit.
Some years, you might have a full pelvic exam and Pap. Other years, you might just have a conversation, breast exam, or other tests based on your needs. -
Speak up about symptoms between visits.
New pain, unusual bleeding, changes in discharge, or other pelvic symptoms are reasons to call, even if you are not “due” for screening.
If you remember only one thing, let it be this: you do not need a Pap test or pelvic exam every single year for life, but you do benefit from regular contact with a trusted provider, following a schedule that fits your age, history, and risk level. Use these guidelines as a starting point, then work with your clinician to decide what is right for you.
