A smear test may not be on your list of favourite activities, but it’s important. Cervical screening not only checks for abnormal cells that might lead to cancer (caused by the HPV virus) but also ensures those cells are managed properly if necessary. The test, however, can be intimidating for various reasons, including the potential discomfort during the procedure. You’re not wrong, it’s not amazing; but let’s make it easier!
While some find smear tests just mildly inconvenient, experiencing some discomfort, especially during the speculum insertion, is normal for others. Conditions such as endometriosis, vaginismus (involuntary vaginal tightening), or vaginal dryness during menopause may result in pain during the test.
However, you don’t have to endure discomfort silently. If any part of the test becomes painful, you can inform your healthcare provider, who should be able to offer guidance on making the experience more comfortable. There are also steps you can take before and during the test to minimise any discomfort.
What to expect during a pap smear test
During a smear test, a healthcare practitioner uses a speculum to gently hold the vaginal walls apart, allowing access to the cervix. The insertion of the speculum and its opening may feel like pressure or discomfort, but it should not be painful.
Some individuals may also experience discomfort or unusual sensations when the brush is used to collect cells from the cervix, but this, too, should not be painful.
Coping with discomfort or pain during a pap smear
If you’re concerned about experiencing pain during cervical screening, there are steps you can take to prepare and support yourself. If you’re anxious about the test or have conditions like vaginismus that can be exacerbated by anxiety or stress, a little preparation goes a long way.
Here are some general steps we recommend:
1. Communicate: It’s perfectly normal to feel apprehensive about a smear test, especially if you anticipate discomfort or pain.
Sharing your concerns with your doctor can help alleviate some of the pressure. Express your feelings and any relevant medical history if you haven’t already spoken to them.
2. Allocate enough time: Rushing to or from your appointment can increase stress. Ensure you have enough time, perhaps by booking an extended appointment slot. This allows more time for discussion and reduces the feeling of being rushed.
3. Bring some company: Having a trusted person accompany you to the appointment can help you feel more at ease. It also ensures you have someone to advocate for your needs if anxiety makes it challenging to speak up.
4. Request adjustments: Everyone’s needs are different, and several adjustments can enhance your smear test experience.
You can ask about using a smaller speculum or even self-inserting the speculum if that’s more comfortable for you. Other possible adjustments may include using vaginal oestrogen cream or pessary for vaginal dryness or adopting a different position, such as lying on your side with your knees bent.
5. Practice relaxation techniques: Pain during a smear test often results from tense muscles around the cervix.
Relaxation techniques, such as breathwork, can help alleviate this tension. Diaphragmatic breathing, for instance, can facilitate pelvic floor relaxation, which is crucial as an overactive pelvic floor can contribute to discomfort during penetration, including smear tests.
To begin, try these steps:
- Take a deep breath into your lower ribs, expanding them and allowing your belly to soften
- As you inhale, visualise the vaginal opening
- Exhale normally
- Repeat this process five times before or during the examination
By following these steps and being proactive in communicating your needs and concerns, you can make your smear test a more comfortable and less intimidating experience.
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