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Birth Control/Very Painful Pap Smear


QUESTION: I am 22 years old and a virgin. I am getting married soon and wanted to get get on birth control so I went to the gynecologist today, and she told me since I was over 21 I would have to get a pap smear. I had been worried she would require me to have one so I was looking online to see if they were painful. Almost all of the posts I read were from women saying they were virgins too but there pap smear didn't hurt at all. Even my gynecologist told me that it wouldn't be painful even though she knew I was a virgin. Well it WAS! A lot worse than I was expecting it to be. I consider myself to have a good level of pain tolerance too, but I started crying immediately after she was done. It felt like a stretching, burning sensation. I would say 8/10 on a pain scale. I told her numerous times while she was doing it that it hurt, but she said it was because I was too tense. I tried to relax, but it is hard to do when you are already in a lot of pain! It was impossible for me to relax because it hurt the moment she started. I honestly have been crying on and off for the past 8 hours because I am so traumatized by this experience. I know pap smears are important to get, but I never want to have one again after that. When she inserted her finger for the physical exam, that didn't bother me, so why was the pap smear so painful for me? I have used tampons before and been fine, but this was something else.

ANSWER: As long as your doctor could insert her finger without causing pain, she should have been able to insert a speculum without causing pain.  I would urge you to see a different doctor the next time you need a Pap smear.

As long as a woman uses tampons, the hymen has generally been gradually stretched so that inserting a speculum can be done without much difficulty.

IMHO, it's the doctor's responsibility to make the pelvic exam as easy as possible.  If it's causing pain, it may be better to stop and figure out why and what can be done.  It's almost always possible to do a gentle exam with a speculum such that there is no pain.

It is true that the more you tighten up, the more it will hurt and the more difficult the exam will be.  But it's a matter of you and the doctor working together so that there is no pain and you're able to gradually relax.

I am hopeful that the next time you have an exam, it will be a comfortable and at least somewhat pleasant experience.  I would ask among your friends who has a doctor that is extremely gentle.  Best wishes.

---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your response. Although I've used tampons in the past, I haven't used them in at least 2 years, so nothing has been stretching me out, and I am already very small down there. Should it still be pain-free if this is the case? I know it may sound dramatic, but I am terrified to have one ever again. I heard it is easy to get false positives with these, so I'm freaking out that when I get the results they will say I need more testing and need to have another pap smear. I won't be able to do it. Are there any other tests they can give me that test for cervical cancers that I can do in the future instead? And do I have to have another one next year when I want to renew my birth control, or can I wait a couple of years?

It might be a good idea to start using tampons again.  They can also stretch the hymen so that first intercourse is less painful.

It's not really easy to get false positives on a Pap smear, so I wouldn't worry too much.

As far as cervical cancer, it usually comes from HPV virus, which is transmitted through intercourse.  You don't really have to worry much about getting Pap smears until you start having sex.  Then it requires many years to develop.  The other test used for detecting cervical cancer is an HPV test, but it also requires a vaginal exam.

You don't really need a Pap smear every year.  The most recent guidelines recommend a Pap smear no more often than every 3 years.  Of course, any individual doctor may prefer to do a Pap smear every year, but it's not needed.

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Norman Solberg


I am an OB-GYN physician. I can answer almost any question related to women's health.


35 years in an active OB-GYN practice.

Fellow, American College of Obstetrics and Gynecology

MD OB-GYN specialist

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