About to cancel a smear test.

[jitterbug09]

I ignored the letter for months and GP surgery rang and persuaded me to book one and now I am dreading it!

Since I had my children (in early teens now) the pain has been excruciating. Not just uncomfortable as before, but extremely painful. Felt like I was going to pass out last time. I told her she had to stop and she said that she was almost there. So rather than go through it all again I let her carry on. Felt violated and sore for days. Vowed never to have another.

I'm in my early fifties and find I am very tight down there which I understand is usual after the menopause. I have not been sexually active since my last smear test so do I need to be re-tested?

I have since changed GP surgery. I have no idea what the new nurse will be like. I want to be able to talk to her before hand and explain, but they just seem to want you in and out. I read you can get smaller speculums these days. Can I ask for one? What if she doesn't have one on the day?

I am so close to cancelling. Just the thought is making me feel physically sick.

Wouldn’t it make more sense to just get it over with though? Then it’s out of the way and you don’t have to think about it again for a chunk of years. If you cancel then there’s that build up of anxiety because you know you’ll have to make another one. Rip off that plaster.

Ask for a smaller thing, you can do this.

They do have different sizes.

As someone who lives with the threat of cin4 changes coming back, again, I'd urge you to go. It is uncomfortable, although I've had ones that have been very easy going.

The 2 lots of lletz I have had and the feeling of dread I get if I have irregular bleeding is way more uncomfortable, and terrifying.

The decision is up to you of course - but things that might help:

Take a couple of paracetamol an hour or so before your appointment. I am having daily wound cleanings & dressings at the moment (post-surgery, nothing to do with a smear) which are agony without paracetamol but bearable if I’ve taken it in good time beforehand.

Tell the nurse that your last experience was distressing and painful - most practice nurses will want to do what they can to help.

No I wouldn't avoid it if your struggling with the anxiety over it go see the gp for something that can calm you before appointment, I personally would get it done it's once in a few years and for peace of mind and in case of detection wouldn't you rather just do it? It can save your life

Don't cancel your appointment. Speak with the nurse and explain your worries. It's a lot easier said than done but try to relax. Being tense will make it more uncomfortable. Breathe slowly, count how long it takes you to breath in then out. Concentrate on something other than the smear. It will be over before you know it.

When your kids come home from school today, look at their faces and ask yourself 'could I manage 5 mins of discomfort if it meant the difference between seeing these two grow up, finding partners, having your grandchildren...or possibly not doing all that'? Could you manage 5 minutes of discomfort so that they can have their mother around till her old age? Maybe you would be glad to have that tradeoff.
Then take 2 paracetamol or whatever are your usual headache tablets before you go to the appointment that helps enormously. Bring headphones for your phone and put the radio on loudly in your ears and follow the conversation.

sadie9 - so emotional that tears are welling up.
Wise words all. I know deep down you are right.

I shall take some painkillers as suggested. Have not done that before.

I have quite a high pain barrier (GP was surprised at how little I complained of a recent shoulder impingement - it was bloody painful mind) but the last few smears have been much, much worse.

Maybe, in retrospect I am playing them up? Maybe I should go in with an open mind? Tell myself that this time it will be different.

Yes and please share your fears with the nurse beforehand.

Oh come on, Sadie - that really is shit of you. Women who have had regular smear tests die of cervical cancer. If they have children they have to endure the judgement of people like you who think they just couldn't be bothered - didn't love their kids enough - to have a quick smear test.

OP - if you haven't had a sexual partner since your last smear and that was clear, then many people would argue that you don't need to put yourself through the agony of a smear. However, if you really want one then I'd make an appointment with your GP and ask what they can do to make the procedure less painful. You might be better getting it done at a sexual health clinic (if there is one in your area).

And I would have reported that nurse.

I kind of agree with sadie , that’s what motivates me to go.
There was an advert with a little boy looking sad saying “x’s Mum missed her smear test appointment and now X misses his mum”
Pretty emotive but it certainly means I’ve never missed once since I saw it

My mum had cervical cancer when I was a child. 45 years later, she’s sitting next to me as I write this. Please go, OP.
I have similar problems to you and I always take Night Nurse before I go. It acts as a painkiller but also relaxes me. It really works but you CAN’T drive if you take one so be aware of this.
Do ask for the smallest speculum as this makes a big difference. Also, I find that breathing out as the speculum is inserted forces me to relax my muscles so it’s much less unpleasant. Try it now, it really works!! If you can, visualise something nice or do something to distract yourself. The doctor who did make me told me to get my phone out and look at photos or google something of interest (seriously!) and this made such a difference.
Good luck.

Go and see your GP. Tell them about it and ask about Vagifem.

How cruel was that advert. Why couldn't the NHS give women the facts and let them make an informed choice.

Yes it was very cruel.

OP is unlikely to have cervical cancer. It is not that common. But she probably has issues with vaginal atrophy which are not all rare at all. Taking paracetamol will not help. It is because the tissues have thinned through reduced oestrogen.

OP needs to see her GP and get come topical oestrogen like Vagifem or estriol cream and use this for a few months before going for a smear. Once you have done the initial two week load, you just use it twice a week for life. Even without a sexual partner, it will stave off discomfort in the future and probably clear a few other issues.

Then she needs to talk to the nurse before the smear.

It is a common problem. After menopause, the cervix atrophies and is no longer producing the mucus it was before meno, so it is harder to get cells. The nurse should be fully aware of this and be able to accommodate and also use a smaller speculum instead of the car jack and take time to get it right.

If they want women to continue with their smears after menopause, they need a bit more than paracetamol and earphones.

Ask if you can put the speculum in yourself. I always do this and the nurses don't have a problem with it. Means you can go at your own speed and get exactly the right angle to minimise discomfort.

Thank you all. I feel more supported and that's a comfort.

I am the same; I use estriol cream from GP. I am working on getting "fit" for my smear test.
Recently , there was a post about vaginal atrophy so you could look at that. @pollyperky gives great advice.
You can get lubricants ( YES ) and other aids that can help.

Can't help thinking if men had to do it, medical science would have discovered a far less invasive method!

There are less invasive hpv tests on the distant horizon but they have got to rearrange all the lab services, redo all the supporting software, and collect data on the changes in the pipeline now, before they get anywhere near that. It will have to change, because the vaccinated women are coming into the scheme now and they are unlikely to want to put up with 3 yearly smears when there are other ways to prevent cancer, and the whole scheme will become less cost effective, as they will be testing every one, but for fewer positive results.

The basic pap smear was invented by a man, and quite a long time ago.

I always read these threads and sympathise....

I know the following is not an option for everyone, due to cost, but traditional smear testing at the GPS is not the ONLY way to test for pre-cancerous cells.

You can buy a private HPV test (e.g. from Superdrug online, for about £48). This is just a vaginal swab you can do at home (i.e. it goes no way near as close to your cervix as the traditional smear test so far less painful).

The swab tests for the presence of certain "High risk" HPV types.

The presence of a high risk HPV is suggestive that your cervical cells may have precancerous changes (so you can then go to the doctor's for further investigation.) Conversely, the absence of an HPV type suggests your cervical cells will very likely be normal putting you at low risk of developing cervical cancer over the next three years...

My understanding is these HPV tests are just as accurate as smears (perhaps slightly more so) and they may come to replace smear tests in due course.

The HPV test is a swab, and not a smear, so there's no need for speculum devices, or the presence of a doctor or nurse to do the test, and hence it can be done by you, at home in your bathroom.

That's just an alternative to be considered if you're too scared or uncomfortable at the doctor's.

I had a very high grade CIN, too, several years ago which was treated with the Lletz procedure and I'm very grateful that it was successful.

I've used a mix of smears and HPV swab tests since then. My doctor's surgery have been happy to let me do that. They've recorded those HPV test results on my file and seem to consider them a perfectly acceptable alternative to a smear test.

I don't go for these OP.

www.independent.co.uk/life-style/health-and-families/features/why-im-saying-no-to-a-smear-7577967.html

OP last week I was at a menopause clinic talking to a wonderful nurse.
We got onto the topic of smears.
She was a fierce advocate of women who have vaginas dryness/atrophy having a prescription for vagifem for a couple of weeks before a smear, and further, she was challenging the idea that this should be discontinued after the smear. Her sensible approach was that those problems would still exist and would be an issue with sex too, so why not continue the treatment after the smear?

The smear is your choice. You should never be pressured to proceed if you don't want to. But if you choose to go ahead then please consider a prescription for vagifem for a period beforehand.

Jitterbug
Over the years the equipment has changed, which in my opinion makes a big difference.
They used to use metal (autoclavable) speculum and shaped wooden spatulas.
Nowadays, they use disposable plastic speculum and soft brushes.

Hopefully you won’t find your next smear as uncomfortable

www.womens-health-concern.org/help-and-advice/factsheets/vaginal-dryness/

Fact sheet from the patient arm of the British Menopause Society.

Just to say that I did go in the end and it was a completely different experience than last few times.
I explained everything to the nurse who was so understanding (unlike last one).
She used a small speculum and two tubes of jelly. It was not painful at all - just uncomfortable as it had been previously.
So relieved it's over and that my worst fears had not been realised. Thank you for your support.