Last month, I replied to a tweet by @talkhealth asking why more women didn’t take up the offer of free cervical smear tests.
I pointed out that there was a very simple reason why one in five women don’t go for a regular smear.
It’s because smear tests can be immensely painful, especially if you have something like endometriosis. I expect that a lot of women are suffering in silence, or find the very idea so painful (due to past experience), they can’t bring themselves to even go.
Having personal experience of truly agonising smear tests that I’ve wept through, I really can’t blame them.
Smear tests are terribly painful for me and others
When you’re first asked to come in for a internal exam or smear test, the letter might mention that it’s a bit uncomfortable. That description falls far sort of the reality for me. A smear test triggers my endometriosis pain (which includes internal pain, vaginal pain), it causes me to bleed. It means I have to go home and rest for a day or more, and do nothing but lie down, hold my sides and writhe around in agony.
So in short, I can’t do anything other than experiencing serious pain during (and long after) a smear test. I am not alone in this, and it’s not that surprising given where the endometriosis can exist in women. If it’s found in your Pouch of Douglas, you’re likely to have a very hard time with this too.
Whenever I have one (or an internal exam of any kind). I’m normally out of action for a day or more. I hurt really badly. I am certainly no stranger to pain, but I rate a smear tests up there among my most painful experiences.
Why are people making women with endometriosis go through this invasive process without pain relief? Painful sex is a known symptom of this disease, so why is insertion of speculum deemed less painful? In a stressful, clinical setting I’d argue it’s even more painful.
Why don’t doctors and nurses understand this?
I’ve pointed out before my smear test that I have endometriosis and that my examinations can be deeply painful. This should ring alarm bells in the mind of the person undertaking the test. Quite often though I’m asked to simply “relax” or maybe “take an ibuprofen a couple of hours before you come in”. There is little to no appreciation of quite how painful it is.
I’m not even offered routine pain relief, even when I ask for it. It’s a deeply upsetting process, and I am certain it upsets other women too. I know that a lot of women with endometriosis are suffering in silence (like me) when it comes to internal exams and smear tests and this upsets me even more.
It shouldn’t have to be this way
Automatic pain relief should be the default for any woman with the word “endometriosis” in their notes. No wonder one in five women don’t turn up. The very thought of another smear test makes my insides hurt. I have no shame in admitting that I am very tempted not to turn up myself in the future. It’s really starting to not be worth the trauma and agony that it causes me, and I am a huge pelvic pain and women’s health advocate.
How to get more people to have smear tests
I fear this is a massive problem for many, and we’re trapped by the process because so many are unable to talk about it. I’m tired of “putting up” with the pain. I want smear test processes to improve for women with endometriosis, by improving the experience it’ll improve for everybody.
We have a gynecalogical condition. No one understands the importance of smear tests better than we do. However for many women it’s a trade up between an agonising experience that will leave them feeling violated and wretched and having an important women’s health test.
Offer woman pain relief and comfort for this invasive test, don’t rush people through what can be a very painful experience. Offer them a place to rest after it’s over.
Next time you go for a smear test, demand pain relief, explain the pain that it may cause you, point out that you have an endometriosis diagnosis and explain how it pain it feels explicitly to the nurse if you must. Get them to take notice of your pain.
If you’re not happy with the process as your locals doctors surgery, try enquiring as family planning clinic, as they seem to be on the ball when it comes to endometriosis and can offer you numbing anaesthetic and a smaller speculum.
I can’t ask you to tolerate this pain any longer, but I can ask you to find a better way.