This is why some women find smear test more painful than others – and how to ease the discomfort

This week it was revealed millions of women are missing their smear tests out of embarrassment or fear of pain.

But smear tests are the most reliable way to detect cervical cancer, so it's vital you don't miss your recommended check-ups.

While most women don't find the experience particular pleasant, some women find it more painful that others.

There are two main reasons for this.

A condition called cervical ectropion and another referred to as a tilted uterus.

A cervical ectropion, also known as a cervical erosion, is a common condition caused when glandular cells usually found on the inside of the cervix are found on the outside.

The glandular cells, also known as soft cells, are more sensitive and fragile than the cells normally found on the outside of the cervix.

According to Dr Vanessa Mackay, a spokeswoman for the Royal College of Obstetricians and Gynaecologists, women with this condition may experience more bleeding after a smear test than women who don't.

And they may also experience some discomfort.

"Cervical ectropion is when the glandular cells from the inside of the cervical canal form on the vaginal part of your cervix," she told The Sun Online.

"Most people that have it don't know that they've got it, it can cause some discharge and a little bit of unscheduled bleeding.

"But it is not sore as such. There is an increased chance of bleeding after a smear test because the cells are more fragile, but it shouldn't cause too much discomfort.


WHAT THE CELL What happens in a smear test, does it hurt and will it reveal if I have cervical cancer?


The soft cells are usually redder in colour and can be seen by a doctor or nurse doing a cervical screening.

Cervical ectropion can be caused by fluctuations in oestrogen levels, pregnancy and being on the Pill.

But the exact cause of the condition is unknown and for most women the condition doesn't cause any symptoms and often goes away by itself.

Cervical ectropion can also cause spotting in between periods and more vaginal discharge than normal.

That's because soft cells produce more mucus than the squamous cells found on the outside of the cervix, so when there is more of them there is more discharge.

Despite it being a problem commonly detected during a smear test, it is not is not linked to the development of cervical cancer or any other condition that may cause women's cancer.

Another reason women may experience pain or discomfort during a smear test is because they have a tilted uterus.

This is another condition that causes no symptoms, it simply means that your uterus is tilted slightly back towards your back meaning your cervix is tilted more upward than usual.

Because the cervix is tilted slightly forward it can be difficult for a doctor or nurse to reach when they doing a smear test, which can be uncomfortable for the woman on the exam table.

"A retroverted uterus is what we call it, a uterus which is acutely tilted, and that can make finding the cervix a little bit difficult," Vanessa said.

"The GP can put patients into different positions, like sitting on their hands, to make it easier to find the cervix.

"If not finding it can be uncomfortable because there is lots of pushing and moving around the speculum (tool that's used to open the vagina)."

But don't panic if you think you have either of these conditions.

There are several things you can do to make your smear test experience less uncomfortable.

AN IMPORTANT TEST TO SPOT CERVICAL CANCER

Public Health England (PHE) has recently issued a call to all young women to attend their smear tests.

In the UK women are recommended to have cervical screenings, or smear tests, every three years between the ages of 25 and 49 and every five years between the ages of 50 to 64.

The smear test is not a test for cancer, it is a test for abnormal cells that could become cancerous.

Cervical screening tests can be carried out at a GP practice, a well woman clinic or a sexual health clinic.

It's usually done by a nurse and you can ask for a female nurse.

You're asked to remove your clothes from the waist down, and the nurse or doctor inserts a speculum, which holds the vaginal walls open.

Then, a small, gentle brush is used to collect cells from the surface of the cervix – and you will receive your results within two weeks.

The test can be uncomfortable, but for most women it isn't painful.

"The most important thing to do is try and relax, although I know that is easier said than done," Vanessa said.

"If it doesn't work because it is too uncomfortable draw the line under it early rather than persevering and book a time for another day."

Dr Mackay also recommends booking an appointment with a gynaecologist or doctor who is experienced with smear tests so they will be able to accommodate your condition.

And you can even have your cervical ectropion removed using heat or freezing therapies that remove the excess glandular cells.

These need to be performed by a registered gynaecologist who can help you decide what treatment is right for you.


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