How to make a smear test easier and less painful

Author: Veronica Danger
Qualified Naturopath | BHSc(N)

Last reviewed: July 6, 2026

A pap smear is not on anyone’s list of favourite activities, but it matters, and it does not have to hurt. Cervical screening looks for the cell changes caused by HPV, the virus behind almost all cervical cancer, so it is one of the simplest ways to catch a problem early.¹ You are not wrong that it can be uncomfortable, but there is a lot you can do to make a smear test easier.

We do not do speculum exams or pap smears at My Vagina – that is your GP, practice nurse, or a women’s health or sexual health clinic. What we can help with is the part most people actually dread: the tension, dryness and pain that make the exam hard in the first place.

Does a pap smear have to hurt?

For most people a smear test feels like pressure or a brief odd sensation rather than pain. Some discomfort as the speculum is opened, or when the little brush touches the cervix, is normal and settles quickly.

Real pain is a different thing. It is common, but it is not something you simply have to put up with – and it usually has a cause that can be worked on. If any part of the test hurts, say so at the time. Your clinician can slow down, adjust, or stop, and there are things you can set up beforehand to make it easier.

Why pelvic exams and pap smears hurt for some people

When a smear test is really painful, there is often something underneath driving it. The common ones are worth knowing, because most of them are treatable.

A tight or overactive pelvic floor, or vaginismus – the muscles around the vaginal opening tense up involuntarily, which makes any insertion sore. Pelvic floor physiotherapy improves this, with less pain and better muscle control.⁴
Vaginal dryness and thinning tissue, especially around menopause – lower oestrogen makes the tissue more fragile and the exam more tender.⁶
Vulvodynia and other vestibular pain, where the entrance is sensitive to any touch or pressure.
Endometriosis, which can make deeper pressure during an exam painful.
Anxiety, which quietly tightens the pelvic floor before the speculum ever goes near you, so the tension itself becomes the pain.

Knowing which one is yours changes what helps. Dryness needs moisture and oestrogen support, a tight pelvic floor needs down-training, and anxiety needs a calmer set-up on the day.

How to make a smear test easier

A little preparation goes a long way, especially if you are anxious or have had a painful exam before. Here is what we would set up.

Say what you need

It is completely normal to feel apprehensive, and telling your clinician takes the pressure off. Mention any past painful exams, anxiety, or a condition like vaginismus or endometriosis before you get on the table, so they can go gently and check in as they go.

Book enough time and bring support

Rushing makes everything tenser. Ask for a longer appointment so there is time to talk first and nothing feels hurried. Bringing a trusted person can help you feel safer, and gives you someone to speak up for you if nerves make that hard.

Ask for adjustments

You are allowed to ask for changes, and good clinicians expect it. A few that make a real difference:

A smaller speculum.
Inserting the speculum yourself, which many people find more comfortable and more in control.
A dab of water-based lubricant on the speculum – a small amount lowers insertion pain and does not stop the sample being taken.²
A different position, such as lying on your side with your knees bent.
Vaginal moisturiser in the days beforehand, or local oestrogen if dryness is the problem (more on that below).

Time it well

Book for a time when you are not on your period if you can, empty your bladder first, and try not to schedule it on top of a stressful day. None of this is essential, but small things add up to a calmer body.

Breathing and relaxing the pelvic floor

Pain during a smear test often comes from the muscles around the vaginal opening tensing up. Slow, relaxed breathing settles the nervous system and raises your pain threshold, so it is one of the most useful things you can do in the moment.⁵

Diaphragmatic breathing, where the lower ribs and belly expand rather than the chest, helps the pelvic floor let go. To try it:

Breathe in slowly into your lower ribs, letting them widen and your belly soften.
As you breathe in, picture the vaginal opening softening too.
Breathe out gently and unhurried.
Repeat five or so times before, and during, the exam.

If you tense up the instant anything approaches, that is worth taking seriously rather than pushing through. A pelvic floor physiotherapist can teach you to release those muscles, which pays off well beyond the exam room.

Treating the cause so it is easier next time

Prep on the day helps, but the bigger win is sorting out whatever is making the exam painful. This is where a naturopathic, root-cause approach sits alongside your regular medical care rather than replacing it.

Dryness and thinning tissue

If low oestrogen is thinning the tissue, local vaginal oestrogen reliably relieves dryness and tenderness and makes exams far more comfortable.⁶ If you would rather start gently, or add to that, a plant-based option like a fennel and sea buckthorn pessary can help support moisture and tissue quality. Regular vaginal moisturiser in the lead-up helps too.

A tight pelvic floor or vaginismus

An overactive pelvic floor responds well to down-training – breathwork, gradual desensitisation, and pelvic floor physiotherapy, which improves pain and muscle control in the research.⁴ Working on the nervous-system side, the anxiety and bracing, matters just as much as the muscles themselves.

Ongoing or cyclical pain

Pain that shows up with your cycle, with sex, or with other symptoms deserves a proper look at what is driving it, whether that is endometriosis, vulvodynia, or a hormonal picture. This is the kind of underlying, root-cause work we can help with, so an exam is not something you have to brace against every time.

When to get it checked, and why not to skip screening

If exams are always very painful, or the pain comes with bleeding, deep aching, or unusual discharge, see your GP, a women’s health clinic, or a pelvic floor physiotherapist. There is almost always a treatable reason, and you do not have to keep white-knuckling it.

Whatever you do, try not to let the fear of a painful exam stop you screening. In many places you can now do an HPV self-collection swab yourself, which is just as accurate for the HPV test and gets more people screened who were putting it off.³ Ask your clinician what is available where you are.

Frequently asked questions

Is it normal for a pap smear to hurt?

Mild pressure or a brief odd feeling is normal. Actual pain is common but not something to just endure – it usually points to a treatable cause like a tight pelvic floor, dryness, or an underlying condition, so it is worth mentioning and worth sorting out.

Can I insert the speculum myself?

Often, yes – many people find self-insertion more comfortable and less exposing, and clinicians are usually happy to allow it. Ask when you book or at the start of the appointment.

Does lubricating the speculum affect the results?

A small amount of water-based lubricant lowers insertion pain, and your clinician can apply it in a way that does not interfere with the sample.² If you are worried, just ask them how they handle it.

Can self-collection replace the speculum exam?

For the HPV test, self-collection is a real option in many screening programmes and is just as accurate at detecting HPV.³ If the swab finds a high-risk type, you may still be asked in for a clinician-taken sample, but for many people it removes the speculum from routine screening altogether.

This article is general information and not a substitute for personalised medical advice. If a pelvic exam or pap smear is painful, or you are worried about your symptoms, please see your GP, a women’s health clinic, or an experienced pelvic health practitioner.

References

Walboomers JMM, Jacobs MV, Manos MM, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999;189(1):12–19. https://pubmed.ncbi.nlm.nih.gov/10451482/
Hill DA, Lamvu G. Effect of lubricating gel on patient comfort during vaginal speculum examination: a randomized controlled trial. Obstet Gynecol. 2012;119(2 Pt 1):227–231. https://pubmed.ncbi.nlm.nih.gov/22270273/
Landy R, Hollingworth T, Waller J, et al. Non-speculum sampling approaches for cervical screening in older women: randomised controlled trial. Br J Gen Pract. 2022;72(714):e26–e33. https://pmc.ncbi.nlm.nih.gov/articles/PMC8714504/
Ghaderi F, Bastani P, Hajebrahimi S, Jafarabadi MA, Berghmans B. Pelvic floor rehabilitation in the treatment of women with dyspareunia: a randomized controlled clinical trial. Int Urogynecol J. 2019;30(11):1849–1855. https://pubmed.ncbi.nlm.nih.gov/31286158/
Busch V, Magerl W, Kern U, Haas J, Hajak G, Eichhammer P. The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing – an experimental study. Pain Med. 2012;13(2):215–228. https://pubmed.ncbi.nlm.nih.gov/21939499/
Lethaby A, Ayeleke RO, Roberts H. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev. 2016;8(8):CD001500. https://pmc.ncbi.nlm.nih.gov/articles/PMC7076628/