| Caroline Knight
Pap smear tests are not something we women look forward to. However, if we are to keep on top of the kind of cellular changes that can lead to cervical cancer, we may view them as a necessary part of female life. Fortunately we don’t need to have them very often – once every three to five years suffices, provided we haven’t got a history of abnormal cells. Although it can be an uncomfortable experience, should a Pap smear test be painful?
Let’s get straight to the point: under normal circumstances, the answer is no. However, we all have differences in our physiology and some of us have conditions that can make these things more difficult - or even painful. This article will address some of the possible reasons your Pap smear test hurt more than it should.
Why was your Pap smear test painful?
There are a few reasons you might have had a painful smear test. Below are the most likely causes:
Cervical ectropion/cervical erosion
Cervical ectropion (otherwise known as cervical erosion) is the name for when glandular cells (soft cells) have grown on the outside of your cervix. These cells normally grow inside the cervix, but in this instance they start to proliferate on the outside of it. The external glandular cells are more fragile and sensitive than those located inside your cervix, hence the pain during a cervical screening. If you’ve got cervical erosion, your Pap smear could make you bleed more than normal.
Cervical ectropion happens because of fluctuating estrogen levels, being pregnant, or on hormonal medication such as the contraceptive pill. It usually goes away on its own, and you may not even know you’ve got this until you get a cervical cancer screening. However there might be signs such as unexpected spotting or discharge.
A tilted uterus
You won’t have any symptoms of a tilted uterus (also known as a retroverted uterus). The first you might find out about it is when you have a painful Pap smear test. A tilted uterus means that your cervix is tilted slightly in the direction of your back. In other words, it is positioned more upwards than normal. This isn’t a problem, but it can make smear tests more challenging to conduct… so you might experience pain.
Due to the position of the cervix, your Doctor or nurse might find it tricky to access. Obviously this can get quite uncomfortable as they try different angles and move the speculum around. They might have to ask you to move into different positions, like sitting on your hands so that they can more easily locate the cervix.
Vaginismus or Vulvodynia
If you have either condition, you might find Pap smear tests painful. With vaginismus, you fear penetration and any attempt at it causes you severe anxiety. As a result your vaginal muscles can clamp shut involuntarily, making penetration difficult or painful. As smear tests can be a cause of anxiety, it’s highly likely that women with vaginismus will find them impossible or very painful. It is important to be honest with your Doctor or nurse so that they don’t inadvertently hurt you during the smear test.
If you have vulvodynia, even the slightest touch or pressure can cause you pain in the vulvar region. This is not normal and should be diagnosed by a specialist. Women with vulvodynia will undoubtedly experience painful Pap smear tests, so it is important to inform your practitioner of this condition so that they can help you through it.
Aside from the above, you should not experience painful smear tests. A certain degree of discomfort is normal, but anything more than that indicates that there is some kind of problem. That’s why it’s important to highlight any pain you feel during your smear test, and to consult your healthcare provider to explore further diagnoses if necessary.
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