The pain of a smear in vaginismus

Vaginismus can make procedures such as swabbing uncomfortable and stressful

Getting a smear test is easy for most women over 25; Nerve-wracking at first, but ultimately okay.

But for women like Eleanor *, 29, who suffers from vaginismus, that’s a completely different story.

“I know they are necessary, but swab tests are so painful for me that I literally sob in pain,” she told

Vaginismus is a psychosomatic disorder in which the vaginal muscles automatically contract when attempting penetration, making any type of penetration uncomfortable, painful, or even impossible.

“Most of the nurses are unsympathetic,” she adds. “Honestly, I’m tired of hearing that it doesn’t hurt and it’s uncomfortable for everyone.”

“A smear is done by collecting cells from the opening of the cervix to check for abnormalities,” explains Dr. Laura Vowels, senior researcher and sex therapist at Blueheart.

A speculum is used to open the vaginal walls and reveal the cervix.

“While this is usually a painless procedure, it can cause excruciating pain in people with vaginismus,” adds Dr. Vowels added.

Unfortunately, this is sometimes lost with general practitioners and gynecologists.

Although it is estimated that around 5% of people with a vagina are affected, many people feel in the dark when it comes to the condition, which can have profound psychological effects on those affected.

Depending on the severity of the condition, getting a smear test can vary from patient to patient, ranging from uncomfortable to completely impossible.

Lisa *, 30, was diagnosed with vaginismus at the age of 19 during a gynecology appointment on a different subject.

For the past 10 years she has had smears very regularly due to a complex gynecological history.

During this time she has had countless negative experiences.

“I was told to grow up,” says Lisa. “I’ve been told that” any other woman can do this without a fuss “and that there is no way it can hurt.

“I was forced to use speculum a couple of times, which caused a lot of pain, trauma and even made the problem worse.”

Lisa recalls an appointment when two nurses and a doctor, even though she was aware of her condition, repeatedly tried to insert the speculum.

“That day I left the family doctor’s practice in such a way that another patient brought me home in her car,” she tells us.

“I even had a doctor who said he felt sorry for my husband and that I should force myself to try more” for his sake – I’m a lesbian. ”

Gynecologist with vaginal speculum

A smear test involves collecting cells from the opening of the cervix to check for abnormalities

Such experiences can turn smears, which are extremely important in determining whether a woman has cervical cancer, into traumatizing experiences.

“Gynecological treatment can often make women feel uncomfortable and vulnerable, regardless of any additional illnesses,” says Dr. Vowels.

“This is why people with vaginismus are more likely to feel uncomfortable during gynecological exams, and this condition can make the experience even more distressing.”

It is important to note that while additional tension and fear of the situation can increase the strength and duration of muscle spasms, this muscle response is not just psychologically controlled.

“Vaginismus is much more complex than the inability to ‘relax’ during penetration, so doctors need to be patient, understanding, and reassuring when performing these medical exams,” she adds.

Fortunately, Lisa’s experience with a smear wasn’t all bad.

“Two general practitioners and two gynecologists were extremely personable,” she tells us. “What made the biggest difference was kindness, understanding of the cause, and control during the investigation.”

During her last smear, Lisa’s family doctor blocked an hour from her appointment, went at Lisa’s pace and reminded her that she could stop at any time.

She also showed her how to do breathing exercises to relax her muscles, constantly reminding her that she would do her best not to hurt or cause Lisa any pain.

“Because I felt safe with the general practitioner and the nurse and had more control over the surroundings, I was actually able to complete the examination,” says Lisa.

Lisa was also doing better now that she realized she could be prescribed diazepam to help with the appointment.

“I found out that I could get diazepam after the GP took my smear test for me in 2016.

“Here, too, everything was carried out very slowly and patient-centered.

“Afterward, she told me that in the future they might prescribe diazepam for support and that it seemed unfair to put me through this kind of anxiety and discomfort every three years when they were given medication that would help.

“I was prescribed it for a smear test in 2019 and it made a huge difference as I was much calmer physically and mentally.”

For people with vaginismus, Dr. Vowels important to arrange a longer examination appointment.

“This can relieve both the doctor and the patient of the feeling of pressure to rush into the procedure,” she says.

It is also important for patients to let their GP or gynecologist know about their condition in advance and highlight any concerns or concerns they may have about the procedure.

“This can help doctors fully prepare for the appointment and approach it with sensitivity because they shouldn’t ignore, misdiagnose, or misinform patients about their own pain,” says Dr. Vowels.

“Most importantly, doctors need to understand that the symptoms and effects of vaginismus are different for everyone, so each case must be treated with care before they learn what works best for each person.”

Tips for a smear test for vaginismus

While the exam can be painful and it should be a doctor’s duty to make their patients feel safe and comfortable, there are a few things patients can do to prepare for a smear test.

  • Before an appointment, try various relaxation techniques or mindfulness to calm any nerves about the procedure itself
  • Bring a friend or family member who understands the difficulties of vaginismus – they can either wait in the waiting room or join you to assist with the procedure
  • Request a longer appointment
  • Make sure your GP is aware of your condition and concerns before the appointment
  • Request pain medication

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