Smear Pain (& Previous Vaginal Pain)

Tests and investigations
1

Hi all,

So I've been putting it off but today I went for my - technically - first smear.

I'm 27 (Coming up 28) and I'd been ignoring those letters that start arriving when you turn 25. I know, it's silly. The reason I saytechnically is because some years ago I did go in for an internal examination at the docs in which they did use the speculum then too etc.. It wasn't specifically for a smear though, it was to check me as I had been suffering with pain inside, with sex or anything really. I did a Chlamydia test and it was even painful to put the cotton bud thingy in to get a sample! I do remember I did find it quite painful when they used the speculum back then. I also suffered at home afterwards with a pain in my lower abdomen for a few hours, It kinda felt like I'd been nicked inside or something. So that's why I've been putting off my smear.

The doc said everything looked fine and sent me to hospital for an internal ultrasound to check everything was ok. There was also nothing found.

So then I didn't have a clue why I had pain - like a rawness/soreness, I thought maybe it could just be me tensing up. I tried to relax with intimate time with my now ex, but it still hurt. I also had/have very low libido - I think partially probably down to the pain putting me off.

So then since me and my ex split I've not really thought about that issue anymore. I put it to the back of my mind but I have on occasion wondered if it's still bad, if it would effect any future relationship etc.. (Been single for 3 years now)

Anyway today was the day of my actual smear test (which I ended up getting booked in as the nurse asked me about if I'd had one on my Pill review checkup last week and when I said no.... she said I really should have it done, so I said ok. (I didn't mention about the previous pain issue)).

I was a little nervous but nothing crazy, got undressed and laid down. She put some lube on the speculum and straight away as she inserted it, ouch! Pain and I was wriggling about a bit. I tried to stay calm but the pain was overpowering that which didn't help and probs made me tense up more and it hurt more. When she then opened it, Oouch - even more pain and it didn't go away. I'd heard it was supposed to just feel like pressure, but it was actually quite painful. I held it together apart from wriggling, felt like crying a little but just shut my eyes tight. 

She said my cervix was slightly tilted so I needed to put my hands under my bum. Then she used the brush, felt it swab round a few times and it was over in a flash. The brush felt like nothing really, that wasn't uncomfortable at all compared to the speculum.

So glad it's over with and I hope the sample is adequate cause I would rather not be going back for another one anytime soon. I didn't mention anything about the pain there and then, I should have, but I just wanted to get out and back home.

I feel ok this evening and not additional pain apart from when I pee it does feel a tad sore/stingy, like theres a miniscule cut or something.

So really, I was just wondering if anyone else has/is suffering from the same kinda thing and really any advice?

Many thanks in advance and sorry if it's all a bit TMI x

2

Oh you poor thing! Sounds like the pain I went through when I had them. I'm  57 and after really suffering the last few times, I discussed it with my practice nurse and doctor and have decided not to have any more as my risk is so low anyway. I didn't have much of a problem when I was younger but after going through the menopause they got more and more painful every time so I put it down to vaginal dryness. This is to be expected at my age but not yours. I do think you should see your doctor as he might be able to give you some hormonal vaginal cream to use regularly and this might make you more supple down there and then hopefully things won't be painful.

Just an extra thought, I also have a tilted womb but I've never thought this was the problem.

Good luck.

3

There is a much easier way, HPV self-testing.

Many women find the speculum unacceptable, older women can find it intolerable/incredibly painful.

Smear tests don't help before age 30, that's why the Finns and Dutch have never tested women under 30. Now the evidence has moved on and we know only about 5% of women aged 30 to 60 have a small chance of benefiting from a 5 yearly smear - those women who test HPV+.

You can test yourself with something like the Delphi Screener, no need for a speculum exam - you can buy HPV self-tests online, they're not recommended before age 30 though.

The Dutch offer 5 HPV tests or HPV self tests at ages 30,35,40,50 and 60 and only the roughly 5% who test HPV+ are offered a 5 yearly pap test. (pap and smear tests are the same thing)

So MOST women are being put through unnecessary smear tests and some end up with false positive results and may have excess biopsies and over-treatment.

I don't test at all, HPV- women cannot benefit.

If you choose to test again, the HPV self-test might be a better option for you, if you're HPV- and no longer sexually active or confidently monogamous, you might choose to forget any further testing. If you start a new relationship, you might choose to self-test again for HPV.

There's no point putting HPV- women through pap/smear testing, or biopsies or treatments. It should be a scandal that so many women have been worried and harmed by this testing and that few actually give informed consent for the test, sometimes there is no consent at all (you need one for the Pill, not true, the Pill has nothing to do with pap testing)

All the best

Elizabeth

4

Pauline, many older women are pressured to have smear tests until they're age 70 (here in Australia) even though they find the test very painful, it might cause bleeding, leave the woman very sore for a day or so, it might even cause a UTI.

It's shocking and so unnecessary, the fact is almost all older women are HPV- and cannot benefit from smear tests, they're not at risk of cc.

No HPV = no cervical cancer

It's just plain callous to put women through speculum exams when they cannot benefit...but they can be harmed, false positives are more likely in older women and that can mean excess biopsies or over-treatment.

Pleased you finally have a smear-test-free future, you were probably never at risk, only 5% of women aged 30 to 60 are HPV+, these are the only women who should be offered a 5 yearly smear test, everyone else should be left alone.

5

Thank you for your reply, it has reinforced my decision to no longer have the tests. Some of my uninformed friends think I am reckless for not having them but I totally agree with your views so thanks again. X

6

Eliz52, I have posted this into a main forum but I'd be keen to hear your thoughts as I feel the same about pap smears having a bad experience, but feeling pressure to go again as I have this tenderness. I have only ever been with my husband and I am his only partner, so we figured the risk would be very low here.

I am female,36, have had 3 children. I have a regular menstral cycle with no pain except in the week or so following my period. I have a bruised like tenderness across the womb area. I can't detect it unless something pushes on there or I feel up inside towards the bladder and it feels tender in there during that time. I also get a sciatica type pain now and then that shifts from side to side. It may or may not be related. I started getting the pelvic tenderness before my daughter, went for a pap-smear (terrible experience) and a precautionary trans-vaginal ultrasound and all was fine. Had my daughter, great healthy pregnancy with some bad back pain at 6 weeks and a couple of weeks after delivery. I didn't notice the tenderness until my periods returned 12 months ago as I breast fed for 2 years prior to this. 

So I am puzzled. I have been seeing an accupuncturist, improved my diet and nutrition, and have been having mayan abdominal massage in an effort to balance hormones and just be healthy in general. I have recently started work on the emotional side of things to try to love myself more as I am a chronic worrier and stress. I get a pain and my mind dives off to the worst case scenario which isnt very kind to myself or my family. Endometriosis has been suggested, but I am unsure and don't want invasive procedures to confirm it. 

7

Hi Bemily

A pap test is for women with NO symptoms, if you're symptomatic, you might need a proper investigation.

If you and your husband have never been with anyone else, that's no sexual activity with another person, then you'll be HPV-...that means you can't be helped by pap testing, you're not at risk of cervix cancer.

Most doctors will recommend you test anyway, concerned you might not know your husband has been unfaithful, I don't agree with that approach, give women all the information they need, make HPV self testing available and leave us to make our own informed decisions.

We know our husbands and it should be our decision - whether we trust them or prefer the reassurance of a HPV- result.

If you wanted to, you can order HPV self-testing online, that would confirm your HPV- status.

HPV testing is only recommended from age 30 to 60, 5 tests in total, the Dutch program is HPV testing or HPV self-testing at 30,35,40,50 and 60. Some women will test just once, those HPV- and no longer sexually active or confidently monogamous.

I hope this information is of some assistance, not sure about the abdominal tenderness, it could be lots of things. (an infection, you can also, get some tenderness before ovulation, etc.) Is the tenderness there all the time? Is it getting worse? Are there any other symptoms?

If you're HPV- then you can forget about cervical cancer. It's a rare cancer as well, women have been trained to worry about it out of all proportion to the risk, and with so many women over-treated after false positive pap tests, many women think it's a huge risk, it's not. The lifetime risk is less than 1% - the ONLY women at risk are those HPV+ and aged 30 to 60, pap testing should only be offered to this group of women, everyone else should be left alone.

I always give my body a chance to recover before going to a doctor, but with persistent and unusual symptoms you might want to have it checked out or if you're worried about it.

8

Hi Eliz, Thanks for your response. The tenderness is only noticeable during that week after my period to ovulation. It is not getting worse. No other symptoms besides occasional sciatica type back pain, that may or may not be related. I am worried about it on and off as that is more my problem that any other health stuff. Its why originally had the pap smears and the transvaginal ultra sound for the tenderness, as a precaution as I was worried. smile

 

9

That was supposed to read that worry and anxiety is my biggest health problem smile

10

Oh, I see...

It sounds like the tenderness I often experienced leading up to ovulation, sometimes it was more than tenderness, quite painful.

I didn't have it investigated because I knew it was a normal part of ovulation, lots of my friends had something similar (and my sisters) - a bit like pain or cramping during your period or just before...

Health anxiety is a real problem, I sometimes despair at the constant scare mongering directed at women, like our bodies are trying to kill us.

I think we need to start trusting our bodies again. I greatly value my healthy body and that's why I've said NO to most screening tests.

If it doesn't pass my risk v benefit test, no deal. I know so many women who've been harmed and worried sick by "simple" screening tests.

11

Really you experience a womb tenderness leading into ovulation also? I havent been able to find any information on this. So I'm freaking out thinking I have cancer. I get what feels like a bruising each month during that time for 3-5 days and its increased towards ovulation then goes, no pain during my period in the region. I track my cycle and have always been overly health conscious getting scans and stuff done for anything abnormal. To my mind this was abnormal as I havent had it my whole life, only since just before my 3rd pregnancy and then the last 12 months. Its been on my mind as I have tried so many things to improve the tenderness but it returns each month.

12

See how you go, it certainly sounds like ovulation discomfort - I found it was worse in my late 30s, not sure why...it also varied in intensity, some months not too bad, other months it was more noticeable.

The fact it's there each month at about the same time makes me think it's something to do with ovulation.

13

Yes I guess our bodies are changing all throughout our life, whats normal 10 years ago, may not be now. Knowing our bodies and not approaching it with fear is prob the kindest route. Thankyou. For interest do you know of where you can get the HPV test kits? The one coming in in May to replace the paps doesnt actually replace them it does paps and HPV and you still have to go through a GP I believe. Ta 

14

You can get the Delphi Screener online, I think you have to nominate a GP now, I think that started when they worked out more women were ordering HPV self-testing kits. They're desperate to keep as many women in the program as possible. 

Under the new program, if women decline the invasive HPV test, they'll have to wait for 6 years before they get a free HPV self-test - and it won't be the Delphi Screener.

They're saying it will be less reliable than a sample taken by a health professional, this is obviously to scare as many women as possible into the invasive HPV test. The Delphi Screener is a very reliable test, it was invented by Dutch gynaecologists, it's being used there and in many other countries now. A few of my friends and colleagues have used it here and in Singapore and Europe.

As more women work out MOST can't benefit from pap testing and that they can self-test for HPV easily and reliably, the program will be in trouble, they'll be forced to put women first and offer evidence based screening and self-testing options.

Our new HPV program is better than the current OVER-screening program, but it's still excessive and we'll still worry and harm our young women. It's all so unnecessary, but when you allow politicians and vested interests to control these programs and keep women in the dark, this is the result.

15

Exactly, right through life, pre-menopause, menopause, post menopause.

I've always viewed the life stages as perfectly normal, not potential disease. Sometimes we need medical assistance, often we don't, I think we know our own bodies best...and if you give women all the information they need to make informed decisions, even better.

I'll PM you a couple of links for HPV self testing kits