I have vaginismus, and though I’ve undergone physical therapy for it, pap smears are still unbearably painful — it basically feels like I’m being stabbed. Is there any way to tell my doctor that an Ativan and a Tylenol won’t cut it? Or am I doomed to never get a pelvic exam ever again?

— Molly from N.Y.C.

Short Take

Pap smears should not be painful, and they are most definitely not something to endure. In fact, each painful pelvic exam or Pap smear can further increase your pain, which worsens your underlying condition, never mind causing stress and trauma. There are definitely options to reduce your pain.

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Tell Me More

Pap smears and pelvic exams should not be painful, and I am sorry for your experience. As an OB/GYN and pain medicine physician I cannot say this enough: A painful pelvic exam should be stopped.

For someone who historically has suffered with pain during pelvic exams or who has underlying pelvic pain and is understandably apprehensive about an exam there are several options:

Find someone with expertise in doing pelvic exams for women who have pelvic pain. As a pelvic pain specialist, I see women every day who tell me that my exam was their first pain-free Pap smear. I am so happy to help them, but it also makes me want to cry because it shouldn’t be that way. An experienced provider should allow enough time (feeling rushed helps no one relax) and may be able to coach you in other ways to help you relax your pelvic floor muscles. Some other options that can help reduce pain are applying topical numbing medication to the vaginal opening and using a narrow vaginal speculum that is about the size of a finger. Sometimes, I even have my patient insert the speculum herself.