It’s not uncommon for women to fear a pap smear. Seriously though, the speculum is cold and metal so there’s no wonder it can be scary. However, for some women having a pap smear can also be a painful experience. Therefore, I have provided some tips you can use at your next pap smear to reduce your pain and anxiety. 

Ask these questions to your gynecologist: 

  • Lower the top bed sheet: Being able to see your doctor can help decrease your pain perception. You have five senses (touch, taste, sight, smell, and hearing) and when one is taken away, the other four senses can increase in sensitivity.

  • Warm the speculum: Having a cold, metal speculum in your vagina can feel uncomfortable. Warming the speculum to match your tissue temperature can be less shocking to the nervous system and a more pleasant experience.

  • Explain every step: Having the doctor explain every step before she/he performs it can help you and your nervous system feel more comfortable and at ease, preventing your nervous system from going into fight or flight. 

Example dialogue between a patient and gynecologist:

  • Pt A: Dr. X, I tend to get anxious with pap smear tests, so before we begin would you mind lowering the bed sheet to where I can see you?

  • Dr. X: Of course! Anything that will help make this more comfortable for you.

  • Pt A: Thank you! I was also wondering if you could warm the speculum before you begin?

  • Dr. X: Most definitely. I will also touch it to your thigh to ensure the temperature is warm enough for you.

  • Pt A: Thank you. Before you insert the speculum, can you walk me through every step so I am prepared for what’s next?

  • Dr. X: Of course. Let me know when you’re ready to begin.

  • Pt A: Ready.

During the exam, focus on deep diaphragmatic breathing to help reduce anxiety and relax the pelvic floor:

  • Inhale through the nose expanding your belly, ribcage, and chest.

  • Exhale through your mouth making sure that your exhalation is longer than your inhalation to increase the parasympathetic nervous system’s output to promote relaxation.