I have vaginismus and I can't face the smear test.

[FilamentB]

Be gentle with me please, I do know how important the tests are.

I am 35 and have never had a smear test. I have vaginismus, where my vagina tightens up when I try to insert something into it. I can't use tampons, have never enjoyed (and so don't have) penetrative sex, and even inserting my own fingers is painful and uncomfortable. I am fine with medical or 'scary' things in any other respect: dentist visits, blood tests etc. I have had several operations and spent a lot of time in hospital due to a medical condition and am generally very laid back about medical procedures, so it really isn't just a case of squeamishness. Inserting anything into my vagina is genuinely painful and I can't seem to stop my muscles from tensing up.

I desperately want to have the smear test. I know how important they are and what the potential consequences are of not having them. A friend of a friend recently died from cervical cancer, she was three years younger than me. I did book a test, but when the nurse tried to insert the speculum I tensed up and couldn't let her put it in. We had several tries, and it ended up with me in tears and her saying she felt she couldn't go ahead given how distressed I was getting. She suggested we try again another day but I was so ashamed at wasting NHS time that I haven't been back.

I've tried to talk to my GP about this, asked if I could have some sort of sedative or numbing, but she was very dismissive and basically told me to breathe through it and I'll be ok, that it's normal to be anxious but that it won't be painful. I couldn't get her to understand that I know it will be painful because trying to insert anything into my vagina is and has always been extremely painful.

If anyone has been in my situation and has any advice I would really appreciate it. Thankyou.

I have every sympathy and the same problem. I ended up having to have an internal scan and exam because of gynae problems, with a private consultant, and had to explain to him that I really didn't mean to be difficult but this was probably not going to work well. He was very good, and so was the woman who did the internal scan, and very kind, but yes it hurt and I ended up crying out and everything involuntarily clamped up to the point of his not being able to find my cervix. He did both the gynae procedure and a smear for me (I also had not had one for years) under general anaesthetic, which was absolutely fine.

I would suggest talking to your GP, and seeing whether they can give you anything to take before the appointment that may help?

OP I'm so sorry to read this. I also have vaginismus and could have written this exact post myself 3 years ago.
I was preparing for my first smear and terrified. I very luckily have a very, very understanding husband and we had never had penetrative sex. I wanted to prepare myself for the smear, and as we also wanted to start a family, thought I'd try kill two birds with one stone and prepare for penetrative sex.
We spent months working on it. Due to previous sexual assault my vagina would tighten if anything even went in that direction, and I would go into complete frozen shock. We worked on my husband just touching the area and worked up to inserting one finger and then two. Eventually we managed to have sex (I'm talking 5/6 months after starting this process). It hurt, but it taught me how to breathe through it to cope with the smear test.
When I went for the smear I then asked for a smaller speculum and breathed through it the way I did with my husband. Again, it was uncomfortable, but I got myself into my safe mental space.
Maybe see if there's any way you can practice also? Although I know this is really not easy.
Please don't let this horrific condition stop you in life though. I now have two children and I never thought it could happen!
Good luck OP 💖

Could you do an at home HPV swab yourself? If it is negative, there is no point you going for a smear as they only exam those positive for HPV nowadays.

Speak to a different GP

You can get a HPV test to do at home from Superdrug. This is all the smear tests test for nowadays anyway, so might as well do it in the comfort of your own home.

How is that going to help if the OP can't tolerate tampons or her own fingers?

Op I'm in the same situation. I can't tolerate anything internally. Unfortunately I have endometrial cancer and need regular tests so I have them all under general anaesthetic now. I would speak to your GP and see if they will refer you to have it done either under general or sedation. Good luck!

I was trying to be helpful! I am assuming, but don't know for sure, that the HPV swab is substantially slimmer than needing a speculum inserted, like for a smear. And that possibly, with no time pressure, and with the OP doing it herself at home, that might be something she could build up to.

Talk to your GP about taking a relaxant beforehand. Book the test at your local Sexual Health Clinic.

I have this too so sympathise. I use diazapam (not sure that's the right spelling) prescribed by my GP before my smears and ask for an end of day appt so I have time and am not rushed by waiting patients.

Oh and also ask the surgery to order a small speculum and instiller (again not sure on spelling) gel which is a numbing agent too. X

My sympathies go out to you OP and thank you so much for raising this issue.

I’ve also suffered from the same condition since I was 37 (I’m now 52). I had endometriosis and had been fine with smear tests until 37 and then OMG the pain. I have never been able to have a pain free one since and have not had penetrative sex since then either (very understanding partner).
i recently went for a smear test and although the nurse said I would be fine - again it was awful BUT she did say that it was now possible to do the swab instead. So could you ask for that?

I know that doesn’t solve the vaginisimus problem but at least it would deal with the smear. It frustrates me that doctors don’t take this condition seriously. Mine came out of the blue and I can’t think of any particular trigger apart from that painful smear.

If you've never had penetrative sex and it's unlikely you've had an HPV infection maybe ask for a hpv test which I don't believe involves a speculum as without it you're unlikely to have cervical cancer. Yes there are other ways to get infected but ruling out this common condition could be easier. You could then have the vaccination

This is a good suggestion.

I understand your pain. I can't do it either. The advice I've been given is to insist on a child's size speculum, get them to include lidocaine or some other numbing agent in the lube and ask if you can insert it yourself. I keep meaning to call a clinic and ask if they can agree to this but I keep putting it off. Be really firm if they try to dismiss you.

Find out if your local hospital offer any sort of "difficult smears" clinics.
This is how I finally got mine done, they can give you gas an air and refer you for a general anaesthetic if necessary.

THis is a very unhelpful post. I suggest you educate yourself on vaginismus AND smear tests as you are ignorant about both ("no point going for a smear" indeed. They save lives).

I suggest you educate yourself and then apologise! I am talking factually. Only HPV positive smears are now examined. This is a recent change and was highly publicised! I know this only too well as I had a positive one last year and have spent all year undergoing colposcopies, LLETZ procedures etc for abnormal CIN cells. Google it!

If the HPV swab is negative, they do not test further ie examine the cells.

If you are going to be so rude, at least be correct.

@RaRaRaspoutine as per NHS website the testing regimen has changed
www.nhs.uk/conditions/cervical-screening/

@FilamentB This link onlinedoctor.superdrug.com/hpv-test.html takes you to the HPV test with a photo of the swab which looks about pen size. I agree with pp this home test may be an option if it is small enough.

I suggest you educate yourself and then apologise! I am talking factually. Only HPV positive smears are now examined. This is a recent change and was highly publicised! I know this only too well as I had a positive one last year and have spent all year undergoing colposcopies, LLETZ procedures etc for abnormal CIN cells. Google it

Yes this is true! Smears are pretty much pointless now, you can just as easily get a swab kit this poster is talking about and test yourself for HPV, which is all they look for with your smear sample.

💐 Hi OP, I could’ve written your post myself and just reading it is making me tense up down below (tmi, but there you go!). I’m also celibate out of choice, not just because of this.

I had my first smear around 30, and was absolutely petrified but because I have other gynecological issues (fibroids) I was able to have the “whole” thing done under a general. Now due another one and hoping to have it at the same time as an ablation.

Anything down there- sex/pregnancy/periods grosses me out big time due to the horrendously heavy and painful periods I’ve always suffered (and been ignored by NHS for being “dramatic” etc). Down there for me is a place of pain and suffering- sorry to be dramatic but am currently fighting to get a hysterectomy.

Make sure you tell them how painful it is for you (I find female GPs are best) and take someone with you to fight your corner and ensure that you get the treatment you need under a general.
💐

@FilamentB I am 35 and in the same boat, not for the same reason, I literally can't get over the anxiety of taking my clothes off and someone rooting around 🤦🏻‍♀️ I am currently pregnant with my first baby so will have no choice but to get over that anxiety.
I have spoken with my midwife and they will get me on track with the smears when safe to do so after baby has arrived.
Good luck, I completely sympathise with you 💕

I totally sympathise OP - I don't have vaginismus but I have always hated smears and found them uncomfortable in every sense. From now on I am doing the self HPV test, although I don't dismiss the value of a smear test for those who don't mind them. A visual check of the area by a trained nurse can pick up other issues like polyps, skin problems, STDs, atrophy, etc.

The self swab is WAY smaller than a speculum, btw.

Hi OP

i have the same problem. Never been able to use tampons and sex is not enjoyable. It always hurts. I’ve had two successful smears now. I couldn’t believe she actually managed to do it.

I spoke to my GP who is very understanding, she has done both smears now. Not sure what I will ever do if she leaves my doctors surgery. Could you speak to a different GP who may be more helpful?

Best tips that worked for me

• double appointment so you don’t feel rushed
• ask for the smaller speculum, this is what I’ve had both times
• this is probably not the best tip but I drank enough alcohol to make me feel more relaxed and got my husband to drive me there and back (this probably isn’t sensible but I’m pretty sure it’s what got me through it) you could ask for diazepam as a more sensible option?

please don’t beat yourself up for not going. The shame that is put on women for not attending smears is awful when you have really valid reasons for not attending. And well done for trying to go the first time. There are also always other options, think they have better equipment at hospital to help you have a smear and you could also ask to have it under GA if all other options don’t work x

Fantastic advice