Image Courtesy of Imagerymajestic at freedigitalphotos.net. Note: Women should start getting Pap smears at 21 years of age or within three years of becoming sexually active. So, if you start having sex when you’re 16, you should have your first Pap smear when you are 19. The test uses a small sample of cells that are gently scraped from the cervix and evaluated by lab technicians. If there are any signs of abnormal cells – called dysplasia – your doctor will notify you.