This might feel a bit uncomfortable. A quick pinch, then we’re all done. That wasn’t so bad was it?
These are some of the comments that most people receiving a smear test will have heard at least once.
Everyone with a cervix is invited by the NHS to get their first smear test done aged 25, and then again every three years until the age of 50 and every five years after that, to test for abnormal cells which could be a sign of cervical cancer.
Messaging from the health service about the procedure is usually along the same lines: it’s over quickly, it’s extremely important, if you’ve had penetrative sex before, it’ll be fine.
But this ignores the reality that for significant numbers of women, a smear test can be excruciatingly uncomfortable.
This Cervical Screening Awareness Week, Metro.co.uk speaks to two women who had difficult or painful experiences during their smear tests about how they dealt with them – and what’s changed to make them more comfortable.
Clara* tells Metro that she felt ambushed into having a smear test when she went to the GP for a routine asthma check-up. While there, the nurse mentioned she was due her first smear and suggested she could quickly have it done there and then.
As she’d never had penetrative sex, Clara explained she wasn’t sure she really needed one, but the nurse convinced her to get it done.
Her experience, however,was excruciatingly painful.
‘Cue me screaming because basically she takes my virginity,’ Clara, now aged 33, recalls.
I know it’s a social construct but it bled and bled – maybe because my hymen had been broken. My nurse went to speak to a colleague and brought her in because she didn’t know what to do about it.
‘I remember them saying “almost there” and I couldn’t help but scream with pain. At no point did they tell me to stop yelling, even when I was saying “stop stop stop” – which they didn’t.
‘Whether that was because they’d got where they were and couldn’t stop, or maybe they were so close to finishing, I don’t remember. I just recall getting home and phoning my mum in tears. It was awful.
‘Despite that, it didn’t put me off going for another as I understand the importance of them. It just wasn’t the nicest experience for my first one.
‘Since then, I’ve booked my smears and have felt more prepared. They’re still uncomfortable, but I haven’t bled since – or needed to scream – so they have got easier over the years.
‘I don’t know if it’s because I’ve now had penetrative sex, but I’m also more ready for it.I know it might hurt and feel like the longest few seconds of my life, but I’ve learned to breathe through it.’
Discussing the messaging around getting a smear test done, Clara explains: ‘We all know it’s worth it. And it’s easy for doctors to just say “oh you’re overdue this” – but it’s not as easy to pluck up the courage to pull your pants down and do it.
‘Maybe because of Jade Goody – who died from cervical cancer aged 27 in 2009 after missing several smear tests – there’s more pressure on GPs to make sure women aren’t overdue. But you have a to-do list and the smear is right at the bottom because it’s not the most fun experience.
Cancer charities give advice on preparing for cervical smears
According to Helen Hyndman, an Ask Eve nurse at The Eve Appeal, there are things that you can do to help make your cervical screening easier for you.
‘You can ask for a double appointment if you don’t want to feel rushed,’ she explains.
‘Speculums – a hinged metal or plastic device used to open the vaginal canal so nurses can see your cervix – also come in lots of different sizes, you can ask for a smaller one to be used or ask if you can insert it yourself.
‘You can try different positions, which can be particularly useful with a tilted cervix.
‘A water-based lubricant on the speculum can help to reduce the pain when it is inserted. If your vagina is dry, ask for an oestrogen cream or pessary to use before your screening which can make things less painful.
‘You can do breathing exercises or listen to a podcast or music on your phone.
‘If it would help you, you can ask for a separate appointment to talk things through so you know exactly what will happen before you have your cervical screening appointment.
‘Make sure you tell the nurse or doctor if you have had difficulties with a previous screening so they can help. You are in control and if you find it too painful, you can ask your nurse or doctor to stop. You can also ask to be referred to your local gynaecology service instead.
‘Many women find screening embarrassing and painful, it is nothing you are doing wrong, it is about making sure you have the right information and support available to you.’
Meanwhile, Hannah Tharmalingam, a national clinical advisor at Macmillan Cancer Support, and consultant clinical oncologist in gynaecological and urological cancer, tells Metro: ‘Cervical screening (smear) tests are vitally important for women, trans men and those assigned female at birth – basically anyone with a cervix.
‘We know some can find it uncomfortable however it shouldn’t be a painful process and it is relatively quick – you’ll likely be in and out in a few minutes.
‘If you have had a difficult or painful experience in the past, or are anxious about going for your test, you can speak with your GP practice and share your worries as there are adjustments that can be made to make the process as comfortable for you as possible, for example, using a smaller speculum.
‘If helpful for you, you could book an appointment with a GP or Practice Nurse in advance of your screening test to talk things through at a slower pace. Whatever your fears or concerns, there are often ways to manage them so don’t be worried about speaking up.
‘Cervical screening is absolutely critical in the prevention of cervical cancer, so it is really important that everyone who is eligible attends their cervical screening test.
‘Macmillan offers lots more information about cervical screening tests and what to expect on its website.’
‘Experts on TV say “the speculum is no bigger than the size of a penis” but if you’ve never had penetrative sex it’s probably going to be painful and you’re not going to know what to expect,’ adds Clara.
‘I wish I’d known there are smaller speculums and spoke up for myself more.’
27-year-old Samantha* was terrified of her smear test, having heard horror stories from her mum Maura*, who was in her late 50s when she had her final one before a hysterectomy.
All but Maura’s last smear had been incredibly traumatic for her.
‘My mum absolutely dreaded her smear tests. Every single one had been so painful, she’d often pass out,’ Samantha tells Metro.
‘It wasn’t until her last one that the nurse took a proper look and realised she had a tilted cervix, which was probably what caused the pain before.
‘The nurse told her to make her hands into fists and rest her hips on them, changing the angle, and after that she didn’t have any pain at all.
‘I just remember she was so relieved but also so annoyed that she’d gone through years of painful smear tests for no good reason, as it was such an easy fix to get rid of the pain.’
Knowing Maura had been through so many painful experiences made Samantha absolutely terrified of going for her own smear test. It took her two years from receiving the first letter to pluck up the courage, meaning her first test was at age 27 instead of 25.
‘Every time I called the GP for something else, the receptionist would ask if I was going to book my smear yet, which put a lot of pressure on me,’ Samantha admits.
‘I’d already seen my mum suffer horribly, and it could have been avoided if the nurses doing her tests had just taken a bit more time and care to figure out why it hurt her so much.
‘The NHS is under so much pressure at the moment, I was scared of wasting their time if I showed up and couldn’t go through with the test, and scared I’d end up seeing a nurse who wanted to get me in and out as quickly as possible.
‘Eventually I booked in to get my smear done, but it hurt so much on the first attempt that we had to stop, and I booked another one a month later.
‘I was really nervous waiting for the next appointment – every time I looked at my calendar it reminded me of what was coming.
‘What helped was that in between the appointments the nurse gave me a speculum to practice with at home and try to ease the fear, which definitely made a difference when I went back.
‘Thankfully the second attempt was a success and my cells all came back normal.’
Samantha is due for her next screening in 2025 – and she’s nowhere near as worried as she was for her first.
‘I’m lucky that I don’t have a tilted cervix like my mum, so I know my next smear test won’t be painful as long as I ask for the nurse to use a smaller speculum size,’ she said.
‘There are a lot of different cancers in my family’s medical history, so making sure I’m all clear is really important to me.’
Cervical Screening Awareness Week runs from June 17-23 and you can get support and advice from organisations including Macmillan Cancer Support.
Names and some identifying details have been changed
Get in touch with our news team by emailing us at [email protected].
For more stories like this, check our news page.
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Sarah Carter is a health and wellness expert residing in the UK. With a background in healthcare, she offers evidence-based advice on fitness, nutrition, and mental well-being, promoting healthier living for readers.
