SMEAR FEAR: When Pain (And The Fear of It) Stops You From Having A Smear Test
Nobody likes to talk about smear tests, do they? We just know it’s one of those necessary evils to get done and dusted – no drama. And everybody knows cervical screening is a no-brainer if you wish to save your life. Smear tests are incredibly important for women to do because cancer doesn’t discriminate, but if you suffer conditions that make your vagina a no-go area, the pap test process can be a traumatic, even painful, experience and that can be a huge barrier to overcome.
This post is not about scaremongering, nor is it about validating avoidance of cervical screening. Smears are a ‘must do’. To slash your risk of getting cancer, a smear is crucial. Rather, this post is to lend a voice to those who struggle with smears, and need support and encouragement.
A survey released earlier this year reported that 1 in 3 women won’t go for a smear test. That’s a heck of a lot of women, which at first glance, you could say is incredibly shocking/appalling/stupid. But the reality behind statistics isn’t so black and white. While some of that statistic accounts for a lack of education on the subject, the survey failed to mention the reason why some women are too distressed to book a smear test. Sometimes the reason women don’t entertain intimate examinations isn’t just a matter of being embarrassed – it’s genuine fear.
If you’re a survivor of sexual abuse or assault, suffered trauma following childbirth or previous vaginal procedures, or live with chronic pain or vaginal pain conditions such as vulvodynia or vaginismus, the thought of a smear test is enough to bring on a cold hard sweat. These women avoid smears like the plague because they’re too disturbed by the thought of an internal or harmed by past experience. I was one of these women.
Earlier this week I had a smear test, which I was relieved went well. ‘Well’ meaning I didn’t flinch, scream or cry, like I have done for every other smear I’ve ever had. I say this as someone who once suffered terribly with vaginismus, which meant internal examinations like the smear were virtually or completely impossible. I cannot articulate how much I dreaded that letter dropping through the door, telling me it’s time to book my appointment.
To paraphrase why anyone would find smear tests so terrifying to someone who’s never experienced intimate problems is a difficult one. For me, the reality of a smear was far more stressful that anyone ever suggests because a smear simply meant pain.
I’ve actually never talked (publicly) about this, but I had vaginismus for many years. For a long time I was convinced I had something physically wrong with me, and that I’d never be able to have a smear test without feeling pain. In fact, sex was a massive problem for me, so much so it was the reason behind why I thought I’d never have kids. I figured if I couldn’t cope with a smear or sex, childbirth was simply unfeasible. If you noticed I said ‘had’, it’s because I don’t suffer with it anymore. But that’s a story for another time.
Vaginismus and smear tests are not a great mix. Knowing exactly what I was like, I’d walk into the nurse’s room with my realistic/pessimistic attitude. I always assumed it would be a painful experience, so half the time it was just that. Sometimes the way the brain works really does not help you.
The worst experience I ever had was going back about 9 years; I had a smear taken by the most heavy handed and sadistic old school matron-style nurse I’d ever met. When I vocally cried out in pain and repeatedly asked her to stop, she didn’t, and when she told me that “it only hurt because I hadn’t had children” I left in tears. She violated me and I was hurt. Now that was a one off. I’ve never met another nurse like her since, neither have I heard of this happening to anyone else. But it’s this kind of abhorrent bahaviour that makes smears a million times worse to deal with, while successfully doing disservice to the nurses and GPs doing the NHS proud, respectfully screening millions of women every year.
Thankfully for most people a smear test is painless. It’s not comfortable and of course isn’t the least bit pleasurable, but it’s relatively quick, and over before you know it. But if you have a condition that causes you pain, whether it be physical or mental, having a smear test is like writing a cheque for the pain. Knowing you’re about to receive pain or even discomfort is really, really hard to put yourself through, and nobody, nobody, would choose to do that. To expose your vulnerability feels like violation against your body. That’s brave.
When I feared my smear test because of my vaginismus, I always made sure whoever was doing my test knew about my anxieties. That way, I felt more in control of the circumstance. The nurse or doctor would be extra gentle (or so it felt) and would offer to use a small speculum, explaining everything before they did it, talking me through it and encouraging me as they went. Of course it was a horrible experience when it was asking the impossible of me, but I’ve always believed there’s just no way out of it. Even for me.
To anyone who’s undecided about going for a smear, I’d say even your impossible is possible, and there are ways and means to make the procedure more bearable and less uncomfortable.
You can request who’d you’d like to do your smear – whether that’s a trusted GP or a favoured nurse and you can have a friend to hold your hand. You can also ask for a paediatric size speculum, like I did. Have the speculum warmed up. Lie in an alternative position, maybe even going around the time of your ovulation so you’re more naturally lubricated may help. While there are certain things that do need to be done, it’s your smear – you call the shots. And if you need it to stop, it’s stops.
However you need to prepare yourself, please tell me you’ll do it. A smear test may be your mountain, but you can conquer it and it’ll potentially save your life.
Some helpful further reading: