Cliff Booth via Pexels

Getting a Pap Smear When You Have Vaginismus

PUBLISHED February 22, 2021

At the age of twenty-seven and almost three years since my first attempt, I finally had my first successful and completely pain free pap smear.

As women, we understand that pap smears are not fun – nobody ever expected it to be fun. But, I wondered, sitting in that same doctor’s waiting room in January 2017, was it meant to be this fear inducing? 

The night before my appointment, I had barely slept. And, as the nurse began to insert the speculum, the sharp pain I experienced was so unexpected that my knee jerked upwards, nearly catching her chin. Six months later, the same problem occurred again. During one appointment, the intensity of the pain was only directly matched by the nurse’s patience. By the end of the session, she suggested that I be referred for psychosexual therapy. 



The term made me feel more abnormal than I already felt in my own body.

Vaginismus – “the body’s automatic reaction to the fear of some or all types of vaginal penetration… whenever penetration is attempted, your vaginal muscles tighten up on their own” – was detected and diagnosed quickly. In the UK 1 in 500 women will suffer from the condition at some point, and as I began to look back on my life thus far, things began to click into place; tampons had always grossed me out and losing my virginity had been painful. But these feelings had always been echoed by at least another friend or two. Whereas this – this felt different. 

In the first session my therapist asked me what I was so scared of, to which I replied:

“I think I’m afraid it will cut me inside or cause damage that I can’t see and then what if I just like, die or something?”

Employing cognitive behavioral therapy techniques (a practice that focuses on the mind/body connection with a concentration on the present, thereby breaking negative thought cycles) meant that she didn’t dwell much on my past. But she did briefly suggest that my anxiety could have arisen from family members’ bouts with ill health during my childhood, contributing to a mistrust of doctors and medical settings. 

By session two, my sense of entrapment had not alleviated, and I was growing impatient.

She asked that I practice meditation daily whilst visualizing myself experiencing a successful pap smear. She insisted that, through deep breathing, I would begin to feel the tension in my body melting away. She then drew a circle, swirling her pencil around it, mimicking the way false alarm signals would race through my head:

“You know that no harm will come to you. Tell yourself that. Repeatedly.”

Obviously, I thought this was total bollocks – how could breathing exercises fix something that felt so incurable?

Next, she asked me to practice at home, inserting a speculum, removing it whenever I felt any tension, to take a deep breath and repeat – all the while visualizing a successful outcome.

At first, I had little success. 

But as I pushed past my frustration and breathed into the fear, the pain, little by little, began to reduce. Over the next two months, as I pictured the process working and repeated her mantra that all would be well, for the first time, I began to feel safe.

By the end of our six sessions, I was able to fully insert a speculum myself. And I couldn’t quite believe it – to me, it still felt as though, at the crux of it, all we had really done was talk. 

At my last appointment, she said that, as women, we are not encouraged to speak up when we are in pain or fearful, it being something – from periods, to losing your virginity, to childbirth – we merely expect in the natural course of our lives. She added that I should never be intimidated by a white coat and stethoscope, and that asking for something to stop was always, always an option.

During my next pap smear, with the “I’ll Be There For You” theme song tinkling in the background (the nurse had asked me what I found relaxing and, as though I were fourteen again, I had said: Friends), the procedure took only twenty seconds. 

At first, I said I didn’t believe her – I really hadn’t felt a thing. But, as she drew back the curtain surrounding the bed, she confirmed the good news, adding: “and it’s a beautiful cervix too.”

When I received the letter a few weeks later confirming that my beautiful cervix was also cancer cell free I realized just how close I had come to missing this life saving procedure. Like many women, instead of being patient with my body, I had actually been punishing it – scolding it for not being better, faster, stronger. 

And there are so many different ways that women can truly care for themselves – one size does not fit all. In my case, my body only began to thrive when I took the time to understand and nurture it with compassion– to finally trust it. 

My therapy finally taught me to have complete faith in myself because after all, is there anything stronger than a vagina?  

Content text