Excruciating pain during smear test

[Em308]

Putting in AIBU for traffic

My last 2 smears, and an internal exam, have all been unbearably painful. It feels as if the speculum is pinching and cutting inside me. I did tell the nurse / doctor on the last 2 exams what had happened before but they did nothing different. It was so painful I had to tell them to stop, the doctor got extremely annoyed with me! I am heavier than I used to be and carry my weight on my stomach, I am wondering if this is causing extra pressure inside on the speculum and causing this excruciating pain? Has this happened to anyone else, and if so is there a solution? I am having my smear tomorrow and getting very worked up (it really is that painful.) I’m ashamed to say, so much so that I’ve already cancelled this appointment once.
I am 49 and perimenopausal.

I really have no knowledge of what it could be, but I don’t think severe, unbearable pain during a smear is normal. I’ve only had one, and it was uncomfortable but not intense pain in the slightest. Is there a way to book a separate appointment to see a gp to discuss this with them, even if it’s just for peace of mind? I hope things work out for you tomorrow!

Being uncomfortable is normal, but it shouldn't be painful. I always took painkillers an hour before the exam. Good luck.

I could have written this! You need hrt. I had this and the nurse immediately referred me to the doctor for hrt as it is the perimenopause that causes it. HRT really helps this, even if you only have the vaginal cream, which has no risks associated with it at all. You shouldn't have to put up with that!

I have had the same @Em308 . I'm a few years older than you. The last twice I've been given pessaries to use beforehand but I don't think they made much difference. The thing that did make the difference was that the nurse (eventually) used a tiny speculum, the smallest one she could find. It didn't just make it bearable, I hardly felt it.

Ask for a smaller speculum and for them to be aware that you have untreated vaginal dryness. And take pain meds before going. It is excruciating I know but you can make it better with a little time.

I agree to ask for a smaller speculum. The test I had before last was horrendous and I was bleeding afterwards as she cut me. The following one I told the nurse and she used a small speculum and it was uncomfortable but no where near as bad. Reading these replies I'll also take some painkillers beforehand!

That doctor should not be doing smears, what a disgusting response to get annoyed with you.
Are you sexually active, and if so is it painful.I am no medic, and may be way off but could it be vaginal atrophy.
If it is, pessaries to replenish oestrogen are available. These have very recently been allowed to be sold over the counter at chemists. Your GP should have been helping you.
Sadly there is a huge lack of care around this area of women's health, so much so a Comons Select Committee in Parliament has recently been discussing this. I think I am right in saying Carol Voderman was invited to speak. So many women suffer when they should be offered help. I think you would be better seeing a different doctor.

Often is painful for many women. Is for me too.

I always had incredibly painful smear test. my inside are all at odd angles and I felt like I was being torn apart. I changed doctors due to moving house and before the next one spoke to the nurse in charge. she was mortified that this had happened to me and discussed lots of different alternatives we could try to make it more comfortable - different position, cushions, smaller speculum etc. and it worked. still very uncomfortable but bearable. just worth speaking to the practioner beforehand to see what suggestions they can make.

Not unreasonable at all. Sorry to hear about your discomfort. I experienced similar pain during my last smear, I am in my 30s and less than 1 year postpartum. My women's health physio said my pain likely related to my overactive pelvic floor and i also had a series of traumatic examinations during labour - apparently the pelvic floor has a strong muscle memory and will recall the previous trauma.

I find them extremely painful too. Haven’t always so I find it interesting that it could be due to being peri menopausal. I have to book a double appointment and have a doctor do mine. It’s so important to attend but I dread it too and have halfway through said that I don’t want it done anymore. Luckily they persuade me to try a bit more. Think they know that once I leave defeated I will never come back!

I'm 35 and had my latest one a few months ago. Never had an issue, just uncomfortable.

This one was like my insides were being punched! I actually cried out and I have a high pain threshold, and it also took me by surprise.

I wonder if some HCPs are rougher than others? She was lovely and chatty, but did this weird thing when she picked up the speculum where she snapped it open a few times staring at me with a maniacal grin on her face... like toying with scissors.. I guess she was trying to be funny. But she snapped it open in the same way inside me, really fast and forceful.

I was mildly annoyed when I read my notes on the app later and they said "patient very nervous". I absolutely wasn't, we were laughing and joking and I thought it would be a quick and mildly annoying appt but no bother. Maybe she thought I would complain or something after punching me twice with the speculum before using a smaller one, which was better. I didn't and wouldn't.

Oestrogen cream or pessaries to help plump up and restore elasticity to the area. An unfortunately named symptom if peri is vaginal atrophy, or urogenital symptoms of menopause.

They can pinch quite a lot, ask them to change speculum to one that is more appropriately sized. Take a couple of painkillers 1/2 hour before and focus on breathing whilst they are doing it. It's certainly not the same having a smear when you are menopausal, I'm guessing hormonal changes must have an effect.

I've always had some pain during smear tests (bearable to me, but I've got a really high pain threshold and I think some people would find it a lot worse). Last time, the nurse (who is a very experienced practice nurse and has been doing smear tests for decades) put a pillow under my bum to tilt my pelvis a bit and it made a huge difference; virtually painless.

There was also one where I flinched and the nurse on that occasion said 'Did that hurt? Sorry, bear with me a minute and I'll try again with a smaller speculum.' That also helped a lot (although I kind of wondered why they don't just start off with a smaller one anyway).

I have always found them extremely painful and I now have them done at the hospital, where they have the resources to make this less traumatic - please ask your GP to refer you. I promise you it's worth it!!

I was told at the hospital that I have a long vagina (erm, ok!) which causes the pain.

Please please please ask for a referral.

I’m morbidly obese and pre or post birth smear tests have never been that uncomfortable. I think I’ve once felt a pinching or a sharp pain internally - I assumed it was an awkward angle or a wrong sized speculum.

can you cancel and rebook at a sexual health clinic or somewhere more used to doing them?

I had this it was cervical ectropian was terrified though as they where not a 100% certain they put me on the two week cancer referral was terrified xxxx

I had the same thing a couple of months ago. Really painful smear.

47, also overweight. All previous smears were fine (always wondered why people fuss about them).

I was already taking vagifem. Sex is fine, maybe a bit dryer than it used to be but certainly not painful.

Anyway, the results were inconclusive so now I need another one. The nurse said she might have the dr do it. She also said NOT to take vagifem for a couple of days before, since that might mess up results. Ditto lubricant.

When I had an IUD inserted once a long time ago it was also painful and the dr said my cervix was a funny shape (or something).

Exactly this. My smears started hurting suddenly, out of the blue, and this is what it was. I was prescribed vagifem, it definitely helped a lot.

Mine have always been excruciatingly painful and take an age (last one was three different nurses over 35 minutes). I've raised it before and I get met with that's just how it is. So after the last one I refused to have them anymore. A new doctor raised it to me and I explained the position. Just like that she offered up prescription pain meds prior to it. Years of suffering and it took me finally refusing to go back for them to acknowledge there was a problem and offer a solution. I'm not convinced it will actually happen (when I eventually pluck up the courage to go back) because the follow up email I had from a nurse rowed back entirely from the doctor's offer of prescribed pain meds to "let's see how the next one goes". No let's not, let's instead LISTEN to the patient.

I've always found smear tests very painful. Never been able to work out why, as I'm definitely not menopausal or peri and sex is never painful. I just grit my teeth and got on with it last time, even the smallest speculum was agony. You're not alone, it's just a shame I have no idea why.

Thank you for all your input. I am on hrt but the doc reckons my dose needs increased , which is of no help for tomorrow of course! I will ask for a smaller speculum (didn’t know this was an option) and will speak to the nurse about my past experiences. I will also take ibuprofen prior to my appointment, which again I hadn’t considered, although the pain caused last time was so bad I almost fainted on the way home so I’m not sure how much this will help. Thank you for sharing your experiences and I’m sorry others also suffer during this procedure, we really shouldn’t have to.

How did you get on @Em308 ? I hope it wasn't as bad as you feared

I have a friend who always says this. She has Ehlers Danlos Syndrome and says that's what causes the pain in her case.