Pap Smear

[Rosamund]

I’m 29 and suspect that I have vaginismus or a similar problem. At 21 I saw a doctor regarding my depression and set up an appointment for my first pap smear. I was specifically told by the doctor, nurse, or whoever that Iowa law requires that women have a pap smear at 21 regardless of a lack of sexual history. (Years later, I was informed that this law doesn’t by other people.)

I’ve never been sexually active, but I have been groped by a family member. There was no penetration or an attempt to do so. Don’t worry. I’m no longer in danger from him.

I went to my appointment and it was hard for my doctor (a female,) to get the speculum and brush in because I kept clamping up. I’ve never used tampons before and am afraid to do so. I kept being told to relax and tried to do just that. This wasn’t easy considering that I had never had anything up there before. Eventually, all of the tools got in.

The actual smear part of the procedure hurt to a point where I got teary eyed. My results came back normal. I went over 4 years without seeing my doctor. I went because of a health problem going on and on another day I had my physical. There I was told that I was overdue for another pap smear and she did it right then.

Again, there was a struggle to get the tools in. They made it in though and again I got teary eyed from the pain of the actual smear. My doctor put a note in saying that I would only have to do it every 3 years. Also, she informed me that she was leaving the practice.

Within the next 3 years I had other health problems. One of them was urinary. I was referred to a urologist who referred me to a physical therapist to retrain my bladder. The PT poked around the area of my urethra and vagina to see if there was anything abnormal going on related to my difficulties urinating.

I got scared, remembering how my two pap smears hurt. I tried to relax though and get through the pain. She couldn’t get as far as she needed to go, saying that my body was telling her that that was as far as it wanted her to go. I was given some PT exercises and a glass dilator. I was told to use coconut or vegetable oil for lubricant and to slowly insert the dilator at least 3 times a week and keep it in for 5 minutes each time until my next appointment with her. I was told to stop sliding it in if I felt pain.

Doing this was scary for me and I admit that it took me a while to even put it in the right spot. I got it all the way in and kept it in there for about 5 minutes on 2-4 occasions. After a while though, I couldn’t get the dilator in very far. My PT thought that this was weird and said I didn’t need to do it anymore. She still examined that area of my body with the limited length that my body allowed.

A year ago at a physical I was informed that it was time for another pap. This is with a different doctor than I had before. I asked if there was even a point in doing it since I’m still not sexually active. Even now I still haven’t had my first kiss. I’ve only dated one guy and it was a long distance relationship that didn’t last long, so we couldn’t kiss.

I was given a vague answer at my doctor’s office that I didn’t understand. I set up the appointment for it and eventually cancelled it. I wasn’t told that it was strongly recommended to have the pap smear anyway. They said it was time. There was no implication that I could refuse. I’m part of a different discussion forum and was told by the ladies on there that I had the right to not do it. They can’t make me. I’m still nervous calling them to ask. I don’t want another vague response. No cervical problems run in my family. I’ve been researching and haven’t found anything that says that there would be a benefit in me doing it if I’ve never been sexually active and it doesn’t run in my family.

I’m afraid that if I do another pap smear that I won’t be able to even get the tools in, let alone do the actual smear because I’m anticipating the pain. I’m nervous about having intercourse because of the abuse I went through and the expected pain. On top of that, for the past 2 or 3 years in a row at my physical, my breast exams have either hurt or felt bizarre. I keep blocking my breasts with my hands and arms from my doctor. I eventually stop doing that and have to live through the pain. They’ve felt tender, but not frequently over the years. I’m still anticipating being nervous about sex for this reason too as well as breastfeeding.

I’ve been in therapy for years regarding the abuse, my depression, and for other issues. I won’t be having sex until I’m married anyway and who knows when that’ll be?

I don’t have a job right now and have been living with my parents. Mom isn’t sympathetic about my other health problems. She’s been upset with the fact that I’m still taking pills such as antidepressants and confronted me about this. That conversation turned into a fight, me crying, and her asking why I’m getting upset over what she’s saying.

I’ve mentioned going to see the doctor over my problems and specialists. She’s responded that sometimes there’s just no explanation for why we’re not feeling well. Apparently, I’m supposed to not even ask medical professionals for help and just suck it up through whatever I’m going through. When I had a part-time job and had to leave work early because I was feeling so sick, mom was upset with me and said that my doctor wouldn’t know what to do. Yet I saw her and she did help me with it. What’s her deal? She’s fine with my brother and I seeing our doctors when we’ve had bad colds or injuries, but not for anything else.

Mom and I have the same doctor and I don’t know who else I could see for this. My friends are spread throughout the world, so I can’t ask them. I’m limited to who I can see since I’m on Medicaid anyway. So far, my plan is to order Pacik dilators.

[Heliopsis]

Hi Rosamund, I am very sorry to hear that you are feeling so low! It was the same for me that the Pap smears or any vaginal examinations are very painful, by being diagnosed with vaginismus. I burst out into tears and an examination was just not possible – I was so paranoid that I signed off to have no examination for quite a while.
You should definitively talk to your health provider about treating it! Whilst doing the dilator treatment my doctor recommended to not have physical examinations. My therapist always suggested as well to tell the person examining you that you experienced problems in the past. They than try to be very careful and I always agreed with them that they would stop immediately if pain would appear or rather if the pain would be unbearable. I still hate going there but after I was able to enter the last (biggest) dilator I went for another examination, which was not great – but it was bearbale pain wise. And I was proud that I could finally do it. I hope that helps you! Please get the help you need – you will feel much better as well in the future if you decide that you wish to be with a boyfriend! Lots of good wishes!!! I hope you will feel better soon!

[Cathleen Kneidl, RPA-C]

Hi Rosamund,
I’m sorry you had those experiences at your gynecologist office. You might do well to find a gyn that has experience with vaginismus, or is at least more understanding. As far as paps go, you are at extremely low risk for cervical issues, because most cervical cancer is caused by HPV, which is indeed sexually transmitted. It is still advised to have yearly visits for breast exams, blood pressure check, medical history review, etc. But at this point, I would focus on getting treated for what does sound like vaginismus before trying to have another pap smear.
I hope you will continue with your therapist, and never feel bad about seeking treatment for depression or anxiety or feeling sick or whatever is going on in your life.
One last thing, don’t ever feel ‘bullied’ by a provider to have a test or procedure. If you are uncomfortable with something, seek a second opinion.
Hope that helps.

[Rosamund]

Thank you ladies. I’ll schedule an appointment with my doctor then.

[Sks823]

Rosamund,

I’m so so incredibly sorry to hear about your past abuse, your difficult experiences with pap smears, your psychological issues & your mom who just doesn’t seem sympathetic at all. I’m sure this situation is incredibly difficult for you and I’m happy to read that you were able to use a glass dilator with some success, and I’m sooo happy that you found this forum. I just want you to know that it does seem like you have vaginismus (my story/pain with insertion is very similar to yours) and I want to encourage you to buy more dilators and continue to try to use them!

I bought dilators on my own and I wasn’t able to use them at all, actually! I tried also but (similar to you) didn’t know how to use them – the fact that you were able to at some point is GREAT news! I ended up going to Maze Women’s Health in NYC where they helped me learn to use them and I (going at a slow & steady pace) eventually got through all sizes of dilators.

Dilators can be a bit painful, but I think if you buy a set with more/smaller sizes, use lots of lube, and work your way up to bigger ones (at a slow and steady pace – whatever you’re comfortable with), it really may be able to help the physical side of your vaginismus. With time, patience, and determination, I know you’ll be able to overcome your fears of sex.

Besides that, I think it’s great that you’re being treated for your psychological difficulties, and like Cathleen said – you don’t need to focus on pap smears at all right now and you’re able to say no to them if you want until you become more comfortable with insertion! 🙂

Look through some success stories on the forum and you’ll see that a lot of us have been in your shoes and made it to the other side. Please feel free to reach out with any questions throughout your journey and know that we’re all here rooting for you! 🙂

[Rosamund]

Thank you everyone for your support. I ordered the Pakic dilators 3, 4, 5, and 6. At a local store, I bought coconut oil.