A visit to the OB/GYN often requires a Pap smear—at least once every three years—to check for cervical cancer. That’s a good thing. The Pap smear, one of the most important women’s health discoveries of the last century, can detect precancerous cells on the cervix, and thus, help prevent cervical cancer. In the U.S., 69 percent of women aged 18 and over reported having a Pap test within the past three years, according to the latest available data from the Centers for Disease Control and Prevention.
The value of the Pap test in saving lives is clear. For example, in one 2012 study of 1,230 women in Sweden diagnosed with cervical cancer, researchers found cervical cancers detected by a Pap test had a 92 percent cure rate compared to a 66 percent cure rate among women who were diagnosed because of symptoms. The finding was published in the British Medical Journal.
Despite its promising role in cancer prevention, some women scheduled to have a Pap smear may be riddled with nerves, concerned about feeling awkward, uncomfortable, or possibly in pain during the test. However, while you might feel a little discomfort, Pap smears generally aren’t painful.
“Pap smears shouldn’t hurt,” says Damian P. Alagia, MD, OB/GYN and senior medical director of women’s health for Quest Diagnostics in Washington, D.C. “Acute pain associated with a Pap smear can be an indication that something else is wrong.” She recommends that you speak up if you feel a lot of pain during the test.
Read on down below for our expert tips on how to make your next Pap smear appointment more comfortable and pain-free.
Talk to your doctor
If you’ve had a Pap smear in the past and it was uncomfortable for you, talk to your doctor. Your doctor needs to know about your past issues, so they can make your next time more pleasant. “Let your doctor know if you have had pain with Pap smears in the past,” says Soma Mandal, MD, a New Jersey-based physician and author of Menopause I Do Not Fear You. “Let [him or] her know if you have any conditions that may make a Pap smear uncomfortable for you.” Your doctor will keep your past bad experiences in mind, and may be able to make some adjustments to make it more comfortable this time around.
Check for conditions that might make your Pap more uncomfortable
“Conditions which can make Paps uncomfortable include the presence of a vaginal, urethral or bladder infection, vaginal dryness from lack of estrogen, or having pelvic inflammatory disease,” says Nina Carroll, MD, OB/GYN, with Your Doctors Online in Brookline, Massachusetts. For example, the swelling and tenderness that come with infections can make inserting something into the vagina painful, adds Dr. Carroll. Also, for some women, vaginismus, the involuntary tightening of the vaginal muscles, can happen during a Pap test, according to the Cleveland Clinic.
Request a smaller speculum
One size doesn’t always fit all, and your doctor may be able to use a smaller speculum—the duck-bill shaped tool that OB/GYNs use to open the vagina so they can visualize and screen your cervix—that will be more comfortable for you. “Women’s bodies are not all the same shape and size and either are speculums,” Dr. Alagia says. “Choosing a smaller speculum may help your physician navigate a smaller vagina or tipped cervix.”
Take your mind off of the Pap smear with your smartphone, tablet, or a good book. “Bring anything—a podcast, music, a meditation app—that can help you relax before and during the procedure,” says Dr. Mandal. A good tip is to do some yoga before your OB/GYN appointment to alleviate any feelings of stress or anxiety. A 2018 study in the International Journal of Clinical Medicine found practicing yoga three times a week for 60 to 70 minutes each with a specialist has an effective role in reducing stress, anxiety, and depression in a small group of women with a mean age of 34.
Try a different position
It isn’t quite as common here, but you can try getting into a different position for the cancer screening—and you will still get the same results. “Some women can have less pain with different positioning,” Dr. Mandal says. “The ‘no stirrups method’ has been used in the U.K., Australia, and New Zealand. Research has shown women undergoing routine cervical cancer screening did not find any significant difference in the quality of the Pap smears.”
Hit the bathroom before the Pap smear
A full bladder is not helpful, especially when you’re about to go in for a Pap smear. “Relieving your bladder before a Pap smear can reduce pressure in your pelvic area,” Dr. Alagia says. A good tip is to let the appropriate personnel know you want to use the bathroom so that in the event that urine samples are needed, you can collect one at that time. Using the bathroom ahead of time will help reduce pressure on your bladder, which can equal more comfort for you and leave you at ease during and after the test.
Use topical estrogen
For some women in menopause, the use of a topical cream may help when taken prior to a Pap smear. Using topical estrogen can improve the dryness and sensitivity that often comes with menopause. “If your doctor has recommended the use of topical estrogen, make sure to use it consistently two weeks before your Pap smear to help with vaginal dryness and thin tissue in the area,” says Dr. Mandal.
Try some breathing and visualization
Dr. Carroll advises against pain relievers to numb the area, and advocates for more zen approaches to reducing discomfort. “The actual duration of having a Pap smear is so brief that taking pain killers beforehand is not recommended. Deep breathing or other relaxation techniques in the minutes before having the Pap is better.” And remember that you only have to have this test once every three years.