I'm 20, have been sexually active since I was 16, and have never had a pap smear. Part of it's my own fault, I've been putting it off way too long because I'm nervous. I have endometriosis that was diagnosed and treated by surgery last May, and before then I had a lot of pain with penetration, especially deep penetration. Most of that issue has gone away, but truthfully, I'm terrified of getting a pap smear. I have my first appointment with my new GP on the 6th, and while she seems great from what I've heard of her, I don't want to get a pap smear from someone who's not experienced with pelvic pain.

My question is twofold: how would I go about finding someone to do a pap smear who's good with people with pelvic pain, and is there any way a doctor could give me a sedative or something beforehand? I know myself, and I know that even if it's not super painful, I'll be super nervous which might make things harder.

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5 Responses to Nervousness about pap smear?

  1. SseNope says:

    Are you worried about pelvic exams in general, or pap smears specifically?

    For the short term, you’re in luck: the American College of Gynecologists has amended their pap recommendation, starting at 21. So you’re not actually way late, and thus have a little longer to work on your general anxiety about the matter.

    As for relieving anxiety over pelvic exams and anything else gynecological, I recommend going to either a doctor you already trust and are comfortable with, or Planned Parenthood. I know they vary widely in terms of bedside manner, but the four pelvic exams I’ve had there have been, in general, my best doctor experiences ever. Take a friend with you to help you advocate for yourself and distract you. Go in with a full stomach and maybe soothing tea, to settle your nerves and help ensure you don’t have butterflies.

    I have generalized anxiety issues, and Cognitive Behavioral Therapy was seriously the best thing I’ve ever done for my brain. It helped give me the tools to talk through scary situations, and my monkey brain is less likely to run amok now. I really do have coping mechanisms thanks to CBT, which I acquired through a local college’s sliding scale teaching clinic. It might be worth looking into even if you don’t think that you have full blown anxiety around doctors.

  2. Hakle says:

    I just want to let you know that I’m 26 and I haven’t gone for a pap smear yet either because of fear. I have an anxiety disorder with panic attacks, and for years, whenever I’ve tried to pluck up the courage to go, I’ve had a panic attack and I’ve just kept putting it off. You’re not the only one who is terrified of getting this done. I think mine is exacerbated by my hypochondria as well, because I am not only terrified of the pain, but of there being something seriously wrong with me down there as well.

    I’ve spoken to a lot of people about their experiences with their first pap smears and a lot of them were really positive. One of them told me that there is no way a pap will hurt as much as losing your virginity did, so that calmed me down a little bit. Another person told me to schedule something fun afterwards that you can look forward to, like a movie you’ve been waiting to see or maybe getting some icecream with a good friend. My goal is to go by March – the hope is to get it over and done with by the end of February. Good luck to you and I hope you’re able to finally get there as well.

  3. EniTuT says:

    What I would suggest is talk to the doctor you are going to see on the 6th. Maybe there’s a way you can talk to the nurse that works with her, or the doctor herself and ask as many questions as you want/can regarding pelvic pain. If there’s no way to do that, I would either: go into the appointment and take the time to talk with her before she does anything, voice your concerns and worries and ask her the questions you have. Or go to Planned Parenthood as knittinggoddess recommended. I’ve never experienced Planned Parenthood though, so I can’t comment on that.

    For my 1st pap smear 6 years ago (I was 18 at the time), I was extremely nervous, I’d only had sex once and it hurt like hell (the sex, not the pap smear). When the doctor walked in and started how I was doing, blah bleh blah, I told her I felt really silly but that I was extremely nervous about the pap smear, how much it would hurt, etc. She took the time to explain step by step what she was going to do, and told me she would be extra careful and gentle with me.

    When she did it, it hurt a bit, but nothing like I had imagined. Mostly it was just uncomfortable. The more nervous I got though, the more it hurt, so I closed my eyes, spread my knees a little more and exhaled slowly. That seemed to help releave the pressure and the pain, for me anyway.

    Then not even 30 seconds later doctor said “Ok we’re done!” Lol It’s not long at all. I bleed a little bit afterwards, but she re-assured me that it’s normal and should stop within the next 24 hours. I’ve been getting my pap smear every year for the past 6 years now and I still bleed every time aftwards, really not a big deal.

    Hope this helps!

  4. Hteall says:

    Amusingly, I just got a pap this morning! (And acknowledged that I was a whiney-pants ’cause I didn’t reaaaaaally wanna have a pap, ’cause they are a tad uncomfortable, but it’d been 3 years so I supposed I should. I think I made the doctor chuckle.)

    I agree with the others — talk with the doctor first and explain about the pelvic pain situation. Get a sense of if this person respects you and would be willing to pause, to try a different angle, or to stop outright, depending on how things go. (It is entirely possible that you won’t have much pain at all, depending on where your endo is/was causing issues, though discomfort is pretty common, if you see the nuance. The speculum is probably 3-4 inches long, but is mostly holding the vaginal entry open, and the walls away from the cervix. The smear itself is essentially a long cotton-swab thing poking around the cervix. I said “ow” a few times today (A: vaginal entry stretching without arousal = ow; B: cervix is not ultra-sensitive, but was annoyed by being prodded), but was mostly chattering about how my kid scared the life out of me a few weeks back.)

    If you don’t think the doctor would respect your decision, then I’d say… get another doctor! Also remember that if you say, “NO! STOP! OW!” and someone doesn’t, your foot is pretty darn close to their chest, and a good, firm shove would probably get the point across without breaking noses. >_> (It’s not likely that you’d need to do that, but for me, at least, reviewing all my options — even the extreme ones! — is empowering.)

    You might well be able to get a sedative, though you’d need someone else to drive, but please contemplate whether it would actually help or if it would have you feeling more out of control of the situation, or unable to vocalize if you had pain.

    Good luck!

  5. 29dWoman says:

    your foot is pretty darn close to their chest,

    YES! Although this almost went horribly for me when the NP said she was going to feel my cervix to check for sensitivity and my automatic reaction was to violently swing my knee and almost knock her to the floor…I obviously am quite squeemish (sp?) about cervixes :p

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