How to Make a Pap Smear More Comfortable: 10 Tips to Help!

by | Jun 29, 2021 | For Women, Uncategorized | 27 comments

10 Tips to Make Pap Smears More Comfortable
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Tired of painful Pap smears? Worried about your upcoming Pap test? Let’s talk about how to make Pap smears more comfortable!

We’re at the end of our pelvic floor series for June, and we’ve been looking at the importance of the pelvic floor, postpartum pain, what causes vaginismus, and more.

But one of the things that people were talking about in the comments this month was that often pelvic exams and pap smears caused trauma, or really hurt, and doctors weren’t helpful when giving them.

A few years ago I wrote a post on how to make Pap smears more comfortable, with help from my followers on Facebook who gave some great advice. I thought the end of the pelvic floor series might be a good time to revisit this, because it is important!

Of course, I don’t want to cause panic where there isn’t any. You may not be nervous about your Pap smears, and you may have an awesome physician and come through with flying colours! Not everyone has terrible Pap smears. But in case you are worried, or if you’ve had bad experiences in the past, here is the combined wisdom of people reading this blog (plus some thoughts of my own) to help with them!

First: What is a Pap Smear?

A pap smear is a medical test where a doctor inserts a speculum (it looks like the picture below) into your vagina, and then uses what looks like a really big Q-tip to take a sample of cells from your cervix. The speculum is kind of like a hair straightener. It gets inserted when it’s closed, and then once it’s in, the doctor opens it up to give some space to insert the Q-tip like thing.

10 Tips to Make Pap Smears Less Painful!

The cells are then analyzed to make sure there’s nothing cancerous or pre-cancerous, because cervical cancer can be a REALLY BAD THING. So you honestly do want to get this done.

Doctors start performing Pap smears after you’re sexually active, or at age 21 in the U.S. and 25 in Canada, even if you haven’t been sexually active.

At the same time as they perform the pap smear they usually do an internal exam, inserting their fingers inside and feeling for polyps or growths on the cervix that aren’t necessarily cancer, or for other abnormalities. My doctor has found polyps that I needed removed that way, so it is necessary to get done.

Seriously, no one likes this. But your health is worth it. So if you have to go through it, how do you make it less UGHHHHH?

1. Know how often you really HAVE to get one done

While a pap smear is necessary, it’s not always necessary every year. People are in different risk categories. If you were a virgin when you were married, for instance, and you married a virgin, your chances of getting cervical cancer are greatly diminished, since most cervical cancers are caused by STDs. If you have been vaccinated against HPV, you’re far less likely to get cervical cancer.

If you haven’t been sexually active and you’re planning on getting married soon, some doctors will want to perform one pre-emptively. It’s okay to ask if it’s really necessary (in many cases it’s not). At the same time, having a thorough exam can help the doctor see if you have a thick hymen which may need to be surgically removed (it’s rare; but I have had commenters who have experienced this). This doesn’t require an internal exam, but it’s good to know that everything’s a-okay!

If you’ve  had Pap smears before and they’ve come back clear, most guidelines now are to wait a few years before a repeat (different countries have different guidelines).

However, one woman gives this warning:

Please don’t ever skip it! I know they say if you have had several good ones in a row you can go every three years…not safe! I had good results since I was 18. When I was 24 I found out I had cervical cancer, which fortunately was removed with surgery and I have been clear since. If I had only been going every three years, I might not be here. It’s a little uncomfortable but better that the multiple surgeries and biopsies I had for years!

Talk to your doctor about whether you’re at higher risk of cervical cancer and how often you should get the tests done, based on your history.

2. Realize that Your Doctor Has Already Looked at 15-20 Vaginas This Week Already

Seriously. It’s okay. All women have them. You don’t need to be shy.

Here’s a joke I’ve heard before that one fan shared:

There is an old joke about a girl doing crafts with her Mom, glue, paper, glitter etc. Mom says “hurry up and go wash up, I have a Dr.’s appointment”. Minutes later the Mom realizes she should probably wash up as well but it’s too late now for a shower so she just hurries to the bathroom and give herself a quick rinse with a wet cloth and off they go. At the Dr’s office she gowns up and lays on the table in the appropriate position. The Dr. comes in and smiles. He says – “Hmm, went the extra mile for us today, didn’t we?” Thinking he noticed her Brazilian wax job she smiled and nervously said, “I do what I can.” All the way home she pondered this, thinking it very strange. On her way into the bathroom to tidy up after her daughter as she was in a hurry before she noticed the wash cloth on the floor, covered in glitter. The same wash cloth she had used on her quick touch up before seeing the doctor. My advice – stay away from the glitter!

3. Wear Warm Socks–That Match!

I laughed at that piece of advice, but it’s probably a good one! You’re allowed to keep your socks on. And warmer feet do make you less nervous!

So does wearing a sweatshirt or bringing a blanket. Those rooms really can get cold, and it’s hard to relax if you’re shivering.

4. Wiggle Your Toes to Help You Relax–Plus Some Other Tips

The doctor will tell you to scooch your bum down the bed to get close, and to let your legs fall sideways while your feet are in the stirrups (rather than having your legs at right angles). Our instinct is to get as far away as possible and to stay tense. But that just makes the procedure hurt more!

One fan said this:

My CNP did mine and she told me to wiggle my toes. I was so focused on wiggling my toes that the pap didn’t hurt. Usually it’s uncomfortable for me, but it wasn’t bad this time. I’m guessing it helped me to relax.

Who knew?

Another relaxation technique:

Find a tile on the ceiling to stare at or close your eyes. Either way, then before it begins, start taking slow, deep breaths and focus on breathing in for 5, out for 5. This will help you relax. I do it for all paps, blood draws, and internal exams while pregnant.

And talking can help, too. It’s easier to relax if you’re focused on something else. So chat away! One woman writes:

And I like to chat with my doctor and the nurse while it’s going on–about anything else, haha. It makes it seem a lot less awkward.

5. Tell the Doctor If You Haven’t Been Sexually Active

Speculums (those scary looking metal tongs) come in different sizes. Ask for the smaller size if you’re a virgin–or even if you haven’t delivered a child yet.

6. Take Some IbuProfen Beforehand

It helps to ward off cramping, which can happen when the cervix gets too much “attention”. And ibuprofen is better for cramping than acetaminophen, too.

7. Pee Beforehand

Great advice! One fan says:

Also, make sure you don’t have to pee!!! I had to pee when I went for my first pap and relaxed muscles do not go along with trying not to pee on the doctor….

8. Give Yourself Something to Look Forward To

One fan recommends:

Also, leave room in your schedule to treat yourself afterwards (Starbucks, cupcake, whatever).

9. Get a New Doctor

If your doctor isn’t delicate, and if you leave the office feeling “used”, then try to get a different doctor. Different physicians have different skill sets, and it could be that your doctor just isn’t good at these. I went to a dentist for the first 18 years of my life and everything hurt like crazy. I thought that’s just what a dentist was. Then I moved to a new town, got a new dentist, and was amazed at how procedures didn’t have to hurt.

If you need some TLC, then find a doctor who will give it to you!

One fan tells this story:

When I was 12 weeks pregnant, I’d had a pap. I asked the doctor to “go slow” and he said, “why do you want it to last longer?”

I replied, “no I don’t want it to hurt.”

DEMAND RESPECT! Don’t ever let a doctor/man treat you this way! It’s inexcusable!

Another fan writes about how a good doctor can make all the difference:

I always had exceptionally uncomfortable paps until i met my doctor.  While she inserted the speculum she told me to bear down a little like i was going to sneeze (this was our first visit-and I made her aware I was really sensitive and it usually very uncomfy to have a pap done). I didn’t feel it go in…or out. She took her time (wow this sounds not right). I thought it a fluke until i had a few tests in that region done and it was uncomfy like before. All of her patients say the same thing. We need to clone her and send her throughout the world.

Communication and letting the doctor know its your 1st time or that you’re really sensitive helps ALOT. And ask what techniques they use to get the job done.

10. Keep thinking … It’s 5 minutes out of your year and could save your life.

Don’t avoid it just because you’re nervous. One woman shares this:

I hate paps but 23 years ago it saved my life. One pap found cancer and it was fixing to spread. I was 27. If I hadn’t went to have a pap done I wouldn’t have known till it was to late. Would have never had the chance to see 5 beautiful grands or the chance to raise my son.

A great reminder!

And I’m going to end with this, because it made me snort my tea all over my computer:

10 Tips for Making a Pap Smear More Comfortable

So there you go! 10 tips to avoid painful pap smears.

10 Tips to Make Pap Smears More Comfortable

What about you? Have any that I missed? Let me know in the comments! Or share your stories about Pap smears. 

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Sheila Wray Gregoire

Sheila Wray Gregoire

Founder of Bare Marriage

Sheila is determined to help Christians find biblical, healthy, evidence-based help for their marriages. And in doing so, she's turning the evangelical world on its head, challenging many of the toxic teachings, especially in her newest book The Great Sex Rescue. She’s an award-winning author of 8 books and a sought-after speaker. With her humorous, no-nonsense approach, Sheila works with her husband Keith and daughter Rebecca to create podcasts and courses to help couples find true intimacy. Plus she knits. All the time. ENTJ, straight 8

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Sheila Wray Gregoire

Author at Bare Marriage

Sheila is determined to help Christians find biblical, healthy, evidence-based help for their marriages. And in doing so, she's turning the evangelical world on its head, challenging many of the toxic teachings, especially in her newest book The Great Sex Rescue. She’s an award-winning author of 8 books and a sought-after speaker. With her humorous, no-nonsense approach, Sheila works with her husband Keith and daughter Rebecca to create podcasts and courses to help couples find true intimacy. Plus she knits. All the time. ENTJ, straight 8

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If we had had these Great Sex Guides before we got married, there would be no Great Sex Rescue. No To Love, Honor and Vacuum blog. No Bare Marriage podcast. Why? Because we wouldn't have had years of pain that we had to untangle from, so I wouldn't have started...

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27 Comments

  1. Anonymous for this one

    From my upbringing of shame, taboo, and secrecy around my female body, to terrible periods with monthly shame from my family (I was supposed to keep them secret, but the massive cramping and heavy bleeding announced it for me and I was shamed for it), to constant reminders that when I marry sex will hurt but must be given, to navigating the fine line of safekeeping while dating, to a rude and inconsiderate Planned Parenthood employee who used a too big speculum on my first gyn exam before marriage and calling me “super virgin” to mock not having had intercourse, yet, to, surprise surprise, painful first time sex, to my new gyn making rude comments and treating me like a bother, to my OB/GYN being a misogynistic lying jerk who did more harm than good and inappropriately examining me, and so many other things that made me feel like I don’t have full agency over my body, myself…..
    I never want to see a doctor again, especially an gynecologist. I never went back to my last 6 week post partum check up. I went to a gynecologist once a couple years after my last son’s birth, and I have never been back. 7 years.
    Between bad experiences and having to pay $$, it has become a non-priority. Maybe if I knew i’d get help, get answers, feel heard, feel like I had control of my body it would feel worth it, but it doesn’t.
    I feel detached from my reproductive anatomy. There’s me and there’s THAT. THAT which makes a week of my life every month a pain in the butt. THAT which I have to give to my husband to keep him from becoming a grump. THAT which bugs me with a libido that needs satiating when I just want to sleep.
    To top it off I get no support from hubby. My reproductive organs are apparently just his plaything and anything beyond that is gross, taboo, and put out of his mind. He has no interest in knowing or dealing with my reproductive health. He won’t go to the doctor with me (though he makes me go with him, but I started refusing). He never went to my prenatal check ups.
    So, why bother? Why pay all that money to feel unheard and uncarex for and violated? Rationally I know it is important for my health, but I still never pick up the phone. I did find the gumption to call one office….and they never bothered to call me back….sooooo…..
    Thank you, Christian patriarchy and a sucky American women’s health system for turning simple medical procedures and normal female biology and anatomy into mountains of shame and fear.
    When I think of male gynecologist I see my OB/GYN violating me and lying to me. When I think of female gynecologists, I hear all the snide remarks.
    Who knows when I will finally go to a doctor again.

    Reply
    • Jane Eyre

      I had a really bad gyn when I was younger. Put me off going again for years. Want once in grad school to the on-campus place, and I learned test there are actually different sized speculums. They used a small, thin one on me, and it was a million times less uncomfortable.
      Still, the original gyn was so bad I didn’t feel the need to go to one until I got pregnant. Thankfully, I found one who is very good: super level headed, very brilliant, calm, and my age. (I found that PCPs can be great at any age, but really do NOT appreciate a lot of the very outdated attitudes from older OB-GYNs. Many of them were actually trained that way.)
      I find your husband’s attitude baffling. He doesn’t get to pick and choose what he likes about the female body: the parts that give him pleasure and brought him children are the same parts that hurt every month, bleed, and need extra attention in bed.

      Reply
    • Elsie

      I’m so sorry to hear about the terrible experiences you have had, both in your family and the health care system. I had some odd experiences with the first two gyns I saw but then found a really great one.
      My best provider was a CNM – certified nurse midwife. CNM is a well trained nurse practitioner level provider who can give gyn care, deliver babies, etc. They have a women centered philosophy so maybe would be a good provider for you. I’ve also found that I’ve gotten great health care at outpatient offices associated with major academic centers, if that’s an option. Or I’ve gotten recommendations from friends or family.
      You deserve to have good health care! Don’t let the bad providers in your past keep you from getting the care you need and deserve. Wishing you healing from all you have been through.

      Reply
    • CB

      I just want to say that your trauma is legitimate and there are lots of other women out there who feel the same way. It is YOUR body and you don’t have to do anything you’re not comfortable with. There’s a very helpful website called womenagainststirrups.pro boards.com which is a safe place to talk about your trauma and where women share information about alternatives for those not comfortable with the modern medicine approach to reproductive health.

      Reply
    • Sheila Wray Gregoire

      Oh, I’m so, so sorry. So sorry. For how your parents treated you; for the abuse from the doctors; for the pain you’ve endured.
      Have you ever seen a trauma therapist to talk about the doctor’s abuse? Or your views on sex? Or a counselor to talk about sex with your husband? I know you’ve heard of The Great Sex Rescue, but I’m so sorry you have so much to unpack, and maybe getting some real help could actually bring some healing.

      Reply
  2. Andrea

    I would like to encourage everyone to make ample use of Google reviews (and any other reviews available), both for finding a sensitive gynecologist and reporting those who are not. If you’ve had a bad experience, write about it in detail, so you can spare other women and cause the doctor to either change or close down the practice for lack of patients.

    Reply
    • Tifffany

      And I’d like to add. If they mock you or harass you or treat you horribly report them to their governing body. I’m in Ontario and there are ways to report doctors for when they make you feel violated etc through the college of physicians and surgeons. This way with enough reports they might get investigated.

      Reply
      • Sheila Wray Gregoire

        Yes, exactly. And again–I have heard horror stories about female gynecologists or GPs as well. Sometimes when women don’t experience problems they have less compassion for other women. I’d love to see stats on whether women gynecologists are more compassionate. I’m sure there are studies out there if anyone knows of any! But I think it’s always individual, and you can’t always be sure they’ll be good just because they’re female.

        Reply
  3. Charis Bombela

    I was lucky enough to get my first one after I was married and had my first baby. Didn’t feel a thing.

    Reply
  4. Anonymous

    Having a tipped uterus makes getting a pap or having my cervix checked painful. I’d love to know if there’s a better part of my cycle or a certain position or use of my muscles that would make this more comfortable.

    Reply
  5. Meredith

    From this article by a British GP:
    https://www.independent.co.uk/life-style/health-and-families/features/why-i-m-saying-no-smear-7577967.html
    “Because {screening tests} aim to find disease you don’t know about, the trade-off between benefits and harms tends to be more nuanced compared with tests done to investigate symptoms. Cervical screening does prevent deaths from cervical cancer. But to get that reduction, you have to follow up and/or treat all the women who have cell changes on their screening test. However, most cervical-cell changes found at screening will not lead to cervical cancer. The problem is we can’t predict which will, so all need further monitoring or treatment. A study from Bristol in 2003 found that 1,000 women have to be screened for 35 years to prevent one death from cervical cancer; and to prevent that death, 80 women have to have further investigation, with 50 women having treatment to their cervices. Four out of five women found at screening to have “high-grade” changes in their cervix did not go on to develop invasive cancer.
    Clearly, there is a benefit – but overall, it’s small. That potential for good has to be weighed against the risks of treatment. It’s known that having a cervical biopsy – which is done to get more information about the degree of abnormality – raises the risk of pre-term birth in later pregnancies. And the worry and anxiety that the results cause shouldn’t be underestimated.”
    I have a lot of trauma related to my pelvic area because of the stillbirth of my twin girls. I also do not trust western medicine when it comes to women’s health– it has a horrible track record: calling women “hysterical, twilight sleep, thalidomide, forced episiotomies, doctors dismissing menstrual problems as “all in your head”, shall I go on?
    So yeah. Factoring that in, with the ridiculously high false negative and false positive rates in pap smear results, and the fact that I am low risk for cervical cancer anyway (husband and I both virgins when we married, no other sexual partners, I don’t smoke, no family history) it’s not worth it to me to risk further trauma or even just the high stress from forcing my body into the extreme vulnerability, the pain, and the potential for uncaring gynecologists. No thanks. Maybe when I’m in my forties.

    Reply
    • CB

      You just said everything I wanted to say. Thank you so much for this comment!

      Reply
    • Hannah

      Yes – here in the UK, we’re much more relaxed about people who have never been sexually active not having smears (no sexual contact at all, not just no piv, as hpv can be passed on by skin, toys, etc.). I’ve discussed my personal risk with several health professionals and agreed each time a smear wasn’t appropriate. Great to know there are things to make it easier if ever I need one.

      Reply
      • Sheila Wray Gregoire

        I think the U.S. does start them younger than Canada, too. It’s interesting how different countries have different regulations!

        Reply
      • Anon

        Not everywhere in the UK – I’ve been told I was selfish, foolish & irresponsible by GPs for refusing a smear test – even though they admitted that it was unnecessary for those who had never had sex because the chances of it picking up anything serious were so small!!! I’ve also been asked if my ‘reluctance’ to have sex is because I’ve been sexually abused as a child and also been offered counselling to help me get over my ‘abnormal attitude’ toward sex. (NB: The ‘reluctance’ and ‘abnormality’ were their descriptions for my choice to save sex for marriage. Since getting married, reluctance has definitely NOT been a problem!) I think the issue is that, because hardly anyone saves sex for marriage now, the assumption by many medical staff is that everyone over 25 MUST have had sex, even if they don’t admit to it.
        When I was in my 20s, the advisory leaflet that came with the invitation to a test stated that ‘women who have never been sexually active should check with their doctor to see if this test is necessary’, but it was dropped after a few years and instead, we were told that ALL women needed it.
        I’m really glad your experience has been different, but in my case, I was left with a huge amount of emotional baggage because of my treatment from GPs etc.

        Reply
    • J.

      Here in the Netherlands, pap smears aren’t a thing until you’re THIRTY! And then they’re only every 5 years I think, unless there are other reasons to have them more often. (There’s actually a funny story I read online of an American woman whose doctor thought she was a sex worker because she’d already had many pap smears/pelvic exams done – ha!!) It’s something to do with the idea of how “necessary” it really is, and the way healthcare works here (NL isn’t so litigious as the US). i.e., NL doesn’t do loads of tests or physicals, or check your vitals at each GP visit.

      Reply
    • Sheila Wray Gregoire

      I hear you, Meredith. I’m in a really low risk group too. My doctor is really good at only doing tests if she thinks they’re necessary. She was the one to tell me I didn’t need them very often at all.
      I’m sorry about your daughters. So very sorry.

      Reply
  6. Alma de Color

    Another piece of advice I’ve used over the years for any time a doc needs to be up in my business… Relax the butt! I discovered that by focusing on releasing the tension in my butt, breathing deeply, and focusing on keeping my butt muscles relaxed, everything else is so much less uncomfortable!

    Reply
  7. Anonymous

    Regarding the HPV vaccine – my partner and I were both virgins when we married, and of course plan to remain faithful to each other. Is there any added value to me getting the HPV vaccine, or is it a moot point because of the low-to-nul likelihood of getting an STD? (Or should I just ask my doctor?)

    Reply
    • Sheila Wray Gregoire

      I’m reluctant to comment specifically because I’m not a doctor, but my impulse would be to say that it’s not necessary. But I’d still ask your doctor!

      Reply
  8. Rebecca

    I was baffled by the joke about hiding the bra at first! But I’m guessing they ask you to undress and put a gown on for the pap? I’m in Australia, I’ve had 3 children and 2 Pap smears, and the only time I’ve worn a gown was for actual surgery. For my Pap she just asked me to remove my bottoms, hop on the bed, and cover myself with a sheet. My less intimidating if you can keep most of your clothes on.🤷‍♀️

    Reply
    • Bethany#2

      I was trying to remember that too! Because my last pp visit, I think (not sure) I got one. I was thinking the reason for the bra off, was a breast check. Which I know that I’ve gotten, I just don’t remember when or how. They check for lumps…which is actually probably a much more likely issue than cervical cancer.( I don’t know actual data, but based on the cases I’ve heard of, breast cancer seems more prevalent?)

      Reply
    • Sheila Wray Gregoire

      Seriously? That sounds so great! Yeah, we always get naked. Of course, my doctor does a breast exam at the same time…

      Reply
      • Rebekah

        😆 I was wondering that about the bra – also from the UK, so no need to remove the bra here either…although I do always hide my underpants haha!
        I have always had a really positive experience with my smear – although I had my first one done after my first child was born, so I was 27 at the time. Over here it’s the nurse who does them rather than the doctor, and my nurse has always been so friendly and chatty, I don’t really think about what’s going on down below! I do think in the UK because our healthcare is free they do focus on what is really necessary, rather than insisting on additional checks when it’s maybe a bit of overkill due to your personal circumstances…it’s the same with childbirth – I couldn’t believe all the examinations the book I got suggested I would have, but I didn’t have anyone poking about down there until I was full term – which was definitely a relief 😆

        Reply
  9. Nan

    After all these comments, I count myself especially graced to have had nothing but good experiences with my OBGYNs. My first was with a local Planned Parenthood (they were all I could afford at the time). She was the kindest doctor I’ve ever had. She was sweet and gentle and told me everything she was about to do before she touched me – and before each step of the way. That helped a lot. My doctor now is a little more abrupt in personality, but still tells me what she’s doing and where she’ll be touching before she does so and it helps. I don’t get startled by a hand on the bum or the cold speculum insertion because I know it’s coming. Asking the doctor to walk you through the process is always worth it. And if they can’t or won’t meet your needs, it’s always fair to look for another doctor!

    Reply
  10. esbee

    i tired to tell the doctor not to use a ditch digger but to use a very small one….did they listen? noooo and yes it hurt like a big dog!!!! j have not had one since

    Reply
  11. T

    Long socks. Like, thigh-highs.

    Reply

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