Ladies! Has anyone ever told you "PAP smears don't hurt"?

For the past 35 years I have insisted on female doctors only. It is the best way to insure the proper female care.

I had an excruciating experience with a woman doctor, but that was for a uterine biopsy. She said that wouldn’t hurt too.

All of mine have been on the discomfort level but not pain.

However I do know the feeling. I’ve had doctors give me the you are irrational look millions of times.

It is degrading even when tests or other doctors show them they are crazy.

Of course they can hurt. I don’t understand the point of these stupid lies, unless it is to make the doctor feel better about what he or she is doing.

I’ve done several hundreds of them. I can tell you it’s totally a question of technique. I learned to do them properly, and although they’re always uncomfortable, if you do it right you can avoid most pain. Occasionally I slipped up and I caused some pinching. There are certain tricks to do to avoid excessive discomfort.

@snowberry Anybody who says an endometrial biopsy doesn’t hurt is a liar. They’re pretty easy to do, but you’re sticking a probe through the cervix and sucking out endometrial tissue. Of COURSE it’s going to hurt. I used to give cervical blocks prior to the procedure, but those hurt too, and I finally figured that it’s just better to get it over with. A properly done endometrial biopsy takes about 15 seconds.

I was told there might be a little pinch, but it was never even that as far as I was concerned.

edit. Changed “uterine” to “endometrial” as you can’t actually do a uterine biopsy through the cervix. I’m assuming that’s what you mean.

@Rarebear Probably. My OB/GYN told me it wouldn’t be bad. As soon as she tried to introduce that thing into my cervix I was screaming. It was one of the most excruciating experiences I’ve ever had.

@YARNLADY And this was a woman. I have heard many people tell me to be sure to get a woman doc for ladies’ issues, but I’ve sure met some real duds. Some of the most insensitive people ever.

I never remember anything other than an occasional mild feeling of pressure, and I have had only male Ob/gyns.

I’ve seen 4 OBGYNs, two men and two women, and they never gave me the “it doesn’t hurt” speech. I think the most discomfort comes from that damn speculum stretching me open. I hardly ever feel anything beyond that. I get the speculum way more often than just Pap smears, though, so I’m used to it. Still, my current doctor always says, “I’m sorry this is uncomfortable” or asks if I’m okay in the middle of it.

As for the difference between male and female gynecologists, I’ve seen no systematic difference. My favorites have been my current guy and a female nurse practitioner I used to see. Both were great.

I can see I’ve really been lucky with my female doctors, including my dentist.

@snowberry if you’re interested I can give you my own play by play on how I do it.

@Rarebear I would be interested!

Okay. Tomorrow if I have time.

I have only ever had ladies do it. When they scrape, I feel that and I always bleed.

I was never told it won’t hurt. Sometimes they are more uncomfortable than others, usually it is almost nothing and it only lasts a couple seconds anyway. I’ve had more than one procedure where they have opened my cervix a little to put dye in my uteris and even when that was uncomfortable, the pain was not so bad I would need medication to counteract the pain. The last time a nurse lent her hand when a procedure dragged on a little so I had something to squeeze when I complained the pain was getting uncomfortable. I have also had several times where doctors have put a catheter through my uteris without having to open it and one doctor seemed to have a lot of trouble and I had a lot of cramping for almost 48 hours afterwards. It had to be his technique.

I have had both male and female doctors, I don’t see much of a difference with these types of procedures. I do have some vulva pain, it was much worse years ago, and I literally had objective biopsy results of the tissues being scherotic (less ellastic) and female doctors were better about how they inserted the speculum and my comfort concerning that, although some were just as seemingly uncaring about it as some men. Men seemed to to tend to use a different size speculum I think? I’m not sure, that’s how it feels. But, before I developed the problem the speculum was of no concern to me.

A couple doctors didn’t have stirrups they have the things that you rest your leg in, and that I don’t like at all, unless it is very necessary to stay very still, which is unfortunetaly for the more uncomfortable procedures.

I find that I tend to have a good pain tolerance though I guess? Or, maybe some people just feel more pain, something with the nervous system. Like people who have a very painful experience at the dentist. I think some people must actually be experiencing a lot of pain, I don’t think it is all some psychological thing. A lot of women complain about mammograms being painful. That it is something awful they have to tolerate. Yeah, a little uncomfortable, but I can’t imagine really complaining about it. But, I don’t doubt some women have more sensitive breasts. It’s ironic because some of my doctors comment on my good pain tolerance and some of them tell me I am oversensitive because of the chronic pain I have lived with. Amazing how different doctors and other people’s perception can be.

One other thing, that line about a PAP smear can’t hurt. There seemed to be some sort of belief the cervix doesn’t have pain or pleasure I think. I know there was a big to do several years ago about how hysterectomies that took the cervix decreased a woman’s sexual pleasure. It was like the medical community had no idea removing the cervix would affect how a woman experienced sexual intercourse. I’m pretty sure my favorite sex includes something is inside of me up against my cervix. That’s how I perceive it anyway.

I’ve had a couple that hurt. Most of the time they’re just pinchy and uncomfortable.

I’ve never had a male gynecologist. I’m not opposed per say, but I tend to go to women of reproductive age. When you’re choosing practitioners blindly from a list, you’ve got to have some criteria, right?

Anyway, the only time I’ve ever been hurt was the pre-induction sonogram when I was going to have my son. I had just been transferred to this chick I had never met, about to throw my whole birth plan out the window, and she turns out to be this hulking beast with the biggest hands I’ve ever seen on a female of our species.

Without any warning she just jammed her hand up there. I’m pretty shallow anyway, and was 42 weeks pregnant, so why she thought she had to go elbow deep to check my cervix is beyond me, but sweet Jesus, it hurt.

In fact, every time that woman touched me it was torture. She sutured the tear that her gorilla hands caused, without a topical anesthetic. You know, because I hadn’t been shouting for the last 16 hours that the epidural didn’t work.

Ooh, I hated that bitch.

I don’t recall having anyone tell me they won’t hurt; nor do I recall any hurting beyond the twinge and pressure. I’ve had only male Ob/Gyns. What hurt so bad that I went into mild shock was the insertion of an IUD, but once that initial pain passed it was fine and I basically forgot it was there within a week.

I’ve never had it hurt. Uncomfortable? Yes…very.

It’s never hurt me, guess I’ve been lucky.

BTW, the worst gyno I had was a woman. She actually asked me why I wouldn’t want a hysterectomy. When I switched to a recommended male OB-GYN he solved the problem with a day stay myomectomy.

Okay
Step 1: Meet the woman with her clothes on. It always drive me nuts when the nurses disrobed patients before I had a chance to meet them.

2 Discuss the procedure, and answer any questions

3. Leave the room and have a female nurse go in and help the patient disrobe and get in the gown

4., Lift the head of the bed up so the patient is not staring at the ceiling. It’s important for the patient to be able to see the person performing the procedure and that their eye level is above the level of the doctor or nurse.

5. Use plenty of goop on the speculum. Pick the proper size speculum for the patient.

6. Warn the patient before any touching occurs. Ask for permission to touch.

7. Push down on the posterior vaginal wall as that’s the less sensitive portion. Insert the speculum without touching the anterior wall.

8. Do the pap smear quickly.

9. Upon removal of the speculum, make sure that you don’t snap it closed or pinch it.

10. Have your nurse (who has been with you the whole time) give the patient a towel.

11. Quickly leave the room to allow the woman to clean up.

12. Come back into the room after the woman is dressed to discuss the procedure, any gross findings, and follow up.

@Rarebear I guess I was hoping for details on step 8, rather than about how the clothes are folded. ;)

The real question is – is there a technique to the scraping that causes more pain when some do it, rather than less pain when others do it? Or are we all just on a sensitivity spectrum, and it doesn’t matter what any of you do?

@glacial Well, it’s the folding of the clothes that is important. It will make the difference between an excruciating procedure and one that’s no big deal.

But to do a pap smear, you visualize the cervix, you take a sample with the paddle at the squamocolumnar junction, and put it in the solution. Then you take a sample with the endocervical brush and also put in the the solution. Takes 10 seconds. There are other techniques as well.

@Rarebear “Well, it’s the folding of the clothes that is important. It will make the difference between an excruciating procedure and one that’s no big deal.”

I think 100% of the women on this thread would scoff at that statement. Whether or not I experience pain during the procedure has nothing to do with my state of mind. I’m sorry, but I think this is a little condescending.

@glacial I think Rarebear was just being humorous there, not condescending.

@janbb Let’s hope. But obviously, it’s exactly the sort of attitude that sparked this question in the first place.

@glacial Sheesh! I try to help and I get criticized. I won’t make that mistake again.

Look. I’ve done hundreds of these. The most important part of the pap smear is to make a woman comfortable and feel in control. That markedly decreases the discomfort. In terms of the “clothes are folded” I was using your metaphor. It’s not one I would have chosen.

Signing off this thread now.

@Rarebear This is really not about “making a woman feel in control”. It is about not causing physical pain. You are taking the responsibility for that pain from the person administering the smear, and placing it on the woman. You’re saying it’s not about the doctor’s touch, but that the woman just isn’t relaxed enough. Think about that for a second or two. The OP is describing having different experiences with different doctors, and I have as well. It is extremely likely, in my view, that some doctors are simply more skilled at this than others.

You said in your first post “Occasionally I slipped up and I caused some pinching.” This is what we are discussing, and when you offered to discuss your “techniques”, I assumed you would be elaborating on this point.

I don’t know, if Dr Gorilla Hands had introduced herself, explained what she was planning to do, and asked permission, I probably wouldn’t be so upset about her hurting me during the dilation check.

I’ve had numerous gynecological exams in my time performed by many doctors, only one of them female (and I couldn’t stand her). I’ve never been told it wouldn’t hurt. I’ve experienced discomfort, but I wouldn’t rate it as very considerable. Other diagnostic procedures that I’ve had have been enormously more painful or unpleasant; for example, I once had a colonoscopy without anesthesia.

In all cases, I consider my comfort to be secondary to the aim of the procedure. I want the process done properly, and I want the doctor to get the necessary diagnostic information from it. I can take a little pain.

I do prefer to be told when something will hurt. I also like to know when a longish procedure is halfway done so I know how much longer I have to endure.

I don’t understand the reason for pouncing on @Rarebear. I saw a smile and a wink, not a sneer. I appreciate his detailing the procedure, giving me more information about it than I ever had in an examining room (and I’ve also always been left to stare at the ceiling and try to send my thoughts on a trip).

@glacial, I’d really appreciate not having opinions expressed on my behalf, whether scoffing or otherwise. I wouldn’t presume to speak for you.

As you all can see, this is a more controversial topic than you’d expect at first glance. Thank everyone for contributing (and a special thank you @Rarebear)!

@snowberry (Just popped back on here after all the PMs I got—thanks for those, by the way. Unnecessary but I do appreciate it). Ironically enough for me, and you’ll appreciate this, I was taught this technique by an alternative medicine physician. It was one of the best 45 minute lectures I’ve ever been to and it changed my practice.

And @glacial your statement: “It is extremely likely, in my view, that some doctors are simply more skilled at this than others.” is totally wrong. Technique is everything in performing a pap smear. I’ve seen young resident physicians with terrible technique and have caused the patients marked discomfort. I’ve had to take over for them.

And to answer your question, the paddle doesn’t cause discomfort. The endocervical brush can cause a little bit of cramping. Another technique involves device that kind of looks like a broom, but I didn’t get good results from those so I stopped using them. You have to get endocervical colunnar tissue in order to get a good sample. If you get just squamous tissue, then it’s a useless test. Again, that’s technique. You have to know what you’re doing.