Tired of painful Pap smears? Worried about your upcoming Pap test? Let’s talk about how to make Pap smears more comfortable!
But one of the things that people were talking about in the comments this month was that often pelvic exams and pap smears caused trauma, or really hurt, and doctors weren’t helpful when giving them.
A few years ago I wrote a post on how to make Pap smears more comfortable, with help from my followers on Facebook who gave some great advice. I thought the end of the pelvic floor series might be a good time to revisit this, because it is important!
Of course, I don’t want to cause panic where there isn’t any. You may not be nervous about your Pap smears, and you may have an awesome physician and come through with flying colours! Not everyone has terrible Pap smears. But in case you are worried, or if you’ve had bad experiences in the past, here is the combined wisdom of people reading this blog (plus some thoughts of my own) to help with them!
First: What is a Pap Smear?
A pap smear is a medical test where a doctor inserts a speculum (it looks like the picture below) into your vagina, and then uses what looks like a really big Q-tip to take a sample of cells from your cervix. The speculum is kind of like a hair straightener. It gets inserted when it’s closed, and then once it’s in, the doctor opens it up to give some space to insert the Q-tip like thing.
The cells are then analyzed to make sure there’s nothing cancerous or pre-cancerous, because cervical cancer can be a REALLY BAD THING. So you honestly do want to get this done.
Doctors start performing Pap smears after you’re sexually active, or at age 21 in the U.S. and 25 in Canada, even if you haven’t been sexually active.
At the same time as they perform the pap smear they usually do an internal exam, inserting their fingers inside and feeling for polyps or growths on the cervix that aren’t necessarily cancer, or for other abnormalities. My doctor has found polyps that I needed removed that way, so it is necessary to get done.
Seriously, no one likes this. But your health is worth it. So if you have to go through it, how do you make it less UGHHHHH?
1. Know how often you really HAVE to get one done
While a pap smear is necessary, it’s not always necessary every year. People are in different risk categories. If you were a virgin when you were married, for instance, and you married a virgin, your chances of getting cervical cancer are greatly diminished, since most cervical cancers are caused by STDs. If you have been vaccinated against HPV, you’re far less likely to get cervical cancer.
If you haven’t been sexually active and you’re planning on getting married soon, some doctors will want to perform one pre-emptively. It’s okay to ask if it’s really necessary (in many cases it’s not). At the same time, having a thorough exam can help the doctor see if you have a thick hymen which may need to be surgically removed (it’s rare; but I have had commenters who have experienced this). This doesn’t require an internal exam, but it’s good to know that everything’s a-okay!
If you’ve had Pap smears before and they’ve come back clear, most guidelines now are to wait a few years before a repeat (different countries have different guidelines).
However, one woman gives this warning:
Please don’t ever skip it! I know they say if you have had several good ones in a row you can go every three years…not safe! I had good results since I was 18. When I was 24 I found out I had cervical cancer, which fortunately was removed with surgery and I have been clear since. If I had only been going every three years, I might not be here. It’s a little uncomfortable but better that the multiple surgeries and biopsies I had for years!
Talk to your doctor about whether you’re at higher risk of cervical cancer and how often you should get the tests done, based on your history.
2. Realize that Your Doctor Has Already Looked at 15-20 Vaginas This Week Already
Seriously. It’s okay. All women have them. You don’t need to be shy.
Here’s a joke I’ve heard before that one fan shared:
There is an old joke about a girl doing crafts with her Mom, glue, paper, glitter etc. Mom says “hurry up and go wash up, I have a Dr.’s appointment”. Minutes later the Mom realizes she should probably wash up as well but it’s too late now for a shower so she just hurries to the bathroom and give herself a quick rinse with a wet cloth and off they go. At the Dr’s office she gowns up and lays on the table in the appropriate position. The Dr. comes in and smiles. He says – “Hmm, went the extra mile for us today, didn’t we?” Thinking he noticed her Brazilian wax job she smiled and nervously said, “I do what I can.” All the way home she pondered this, thinking it very strange. On her way into the bathroom to tidy up after her daughter as she was in a hurry before she noticed the wash cloth on the floor, covered in glitter. The same wash cloth she had used on her quick touch up before seeing the doctor. My advice – stay away from the glitter!
3. Wear Warm Socks–That Match!
I laughed at that piece of advice, but it’s probably a good one! You’re allowed to keep your socks on. And warmer feet do make you less nervous!
So does wearing a sweatshirt or bringing a blanket. Those rooms really can get cold, and it’s hard to relax if you’re shivering.
4. Wiggle Your Toes to Help You Relax–Plus Some Other Tips
The doctor will tell you to scooch your bum down the bed to get close, and to let your legs fall sideways while your feet are in the stirrups (rather than having your legs at right angles). Our instinct is to get as far away as possible and to stay tense. But that just makes the procedure hurt more!
One fan said this:
My CNP did mine and she told me to wiggle my toes. I was so focused on wiggling my toes that the pap didn’t hurt. Usually it’s uncomfortable for me, but it wasn’t bad this time. I’m guessing it helped me to relax.
Another relaxation technique:
Find a tile on the ceiling to stare at or close your eyes. Either way, then before it begins, start taking slow, deep breaths and focus on breathing in for 5, out for 5. This will help you relax. I do it for all paps, blood draws, and internal exams while pregnant.
And talking can help, too. It’s easier to relax if you’re focused on something else. So chat away! One woman writes:
And I like to chat with my doctor and the nurse while it’s going on–about anything else, haha. It makes it seem a lot less awkward.
5. Tell the Doctor If You Haven’t Been Sexually Active
Speculums (those scary looking metal tongs) come in different sizes. Ask for the smaller size if you’re a virgin–or even if you haven’t delivered a child yet.
6. Take Some IbuProfen Beforehand
It helps to ward off cramping, which can happen when the cervix gets too much “attention”. And ibuprofen is better for cramping than acetaminophen, too.
7. Pee Beforehand
Great advice! One fan says:
Also, make sure you don’t have to pee!!! I had to pee when I went for my first pap and relaxed muscles do not go along with trying not to pee on the doctor….
8. Give Yourself Something to Look Forward To
One fan recommends:
Also, leave room in your schedule to treat yourself afterwards (Starbucks, cupcake, whatever).
9. Get a New Doctor
If your doctor isn’t delicate, and if you leave the office feeling “used”, then try to get a different doctor. Different physicians have different skill sets, and it could be that your doctor just isn’t good at these. I went to a dentist for the first 18 years of my life and everything hurt like crazy. I thought that’s just what a dentist was. Then I moved to a new town, got a new dentist, and was amazed at how procedures didn’t have to hurt.
If you need some TLC, then find a doctor who will give it to you!
One fan tells this story:
When I was 12 weeks pregnant, I’d had a pap. I asked the doctor to “go slow” and he said, “why do you want it to last longer?”
I replied, “no I don’t want it to hurt.”
DEMAND RESPECT! Don’t ever let a doctor/man treat you this way! It’s inexcusable!
Another fan writes about how a good doctor can make all the difference:
I always had exceptionally uncomfortable paps until i met my doctor. While she inserted the speculum she told me to bear down a little like i was going to sneeze (this was our first visit-and I made her aware I was really sensitive and it usually very uncomfy to have a pap done). I didn’t feel it go in…or out. She took her time (wow this sounds not right). I thought it a fluke until i had a few tests in that region done and it was uncomfy like before. All of her patients say the same thing. We need to clone her and send her throughout the world.
Communication and letting the doctor know its your 1st time or that you’re really sensitive helps ALOT. And ask what techniques they use to get the job done.
10. Keep thinking … It’s 5 minutes out of your year and could save your life.
Don’t avoid it just because you’re nervous. One woman shares this:
I hate paps but 23 years ago it saved my life. One pap found cancer and it was fixing to spread. I was 27. If I hadn’t went to have a pap done I wouldn’t have known till it was to late. Would have never had the chance to see 5 beautiful grands or the chance to raise my son.
What about you? Have any that I missed? Let me know in the comments! Or share your stories about Pap smears.
Sheila Wray Gregoire
Founder of To Love, Honor and Vacuum
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