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Question:
I've never had a pap smear before and I would like to have one soon. I've never been examined by a gynecologist before and would like to ask some questions about the exam.
I am not sexually active and I think my vaginal opening is very small and tight. I've tried inserting a tampon multiple times but I can't due to probably the size of my vagina. The only object I can insert is an ear cotton swab. I am worried that because of this I will experience pain and discomfort during the procedure and that the procedure may be difficult to perform. Is this true and what can I do? I am also embarrassed that maybe my sexual status will be obvious.
Another question I have is if I need to shave my pubic hair for the exam. Do women usually shave for pap smears? Is this going to make the exam easier?
Thank you in advance. Your answers will really help me, though they may seem insignificant. I appreciate your service.
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Answer:
by Raven James: (03/30/2008)
Your questions and apprehension over the Pap smear are quite normal and relevant, especially having not yet been sexually active. The discomfort you describe with regard to your vaginal opening may be in part, due to the hymen not being broken. The hymen is a fold of tissue that is usually present at the opening to the vagina from birth and remains intact until penetration of first intercourse. Sometimes, the tissue may be broken by using tampons, or during exercise. The tissue can cause painful first intercourse or penetration of fingers, tampons, etc. In some cases, the tissue is too thick to break easily during intercourse and a medical practitioner may need to make a minor incision. If a woman manually stretches her hymen before intercourse or penetration (which in the case of the pap smear, would be the speculum), she may be able to minimize the discomfort. To do this, you should insert a lubricated finger (using saliva or a water-soluble lubricant, like KY jelly) into the vaginal opening and press dwonward toward the anus until you feel some stretching. After a few seconds, release the pressure and relax. Repeat this several times. Next, you should insert two fingers into the vagina and stretch the sides of the vagina by opening the fingers. Repeat the downward stretching with two fingers as well. This may help to stretch the tissue and minimize some discomfort associated with a pap smear. With the actual procedure, the vaginal walls are held open with a speculum (a plastic or metal device inserted into the vagina, then squeezed open). The practitioner uses a cervical brush or thin swab to remove a few cells from the cervix. As the cervix itself has few nerve endings, there is little discomfort in the actual swabbing procedure. Most women experience discomfort with the speculum being inserted and opened and some discomfort is due to positioning on the exam table and being exposed and vulnerable to the pratitioner. Shaving the pubic hair is not necessary or recommended for a pap smear, as most pubic hair will not impede the exam in any way. If you explain your concerns to the practitioner when you make the appointment, they will also be able to advise you and try to minimize any discomfort as well. If, in the case your hymen is very thick, it may be necessary for an incision to be made to facilitate the exam and any future penetration through intercourse or the use of tampons. As pap smears are recommended no more than 3 years after becoming sexually active, or by age 21, it is important that you are taking steps to take care of your sexual health by making an appointment. The pap smear is a screening test for cervical cancer, and once you have one, the doctor can make recommendations as to how often you should have subsequent tests. Depending on the results, subsequent pap smears can be recommended between every 6 months, to every 2 years, on average. As most of your concerns seemed to center on logistics related to the procedure and pain associated with penetration, I have provided information mainly addressing those concerns. If you have more questions regarding the test, or any other concerns, please feel free to write again. A local Planned Parenthood is an excellent choice of clinic as they are quite experienced with the pap smear and young women's sexual health concerns. Good luck with your exam.Reviewed by: Kathleen VanKirk DHS
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