Are smear tests painful?

Reviewed by our clinical team

A smear test – now better known as a cervical screening – is a routine medical procedure that everyone with a cervix is invited to every few years between the ages of 25 and 64. 

The purpose of a smear test is to check the cervix for warning signs that point to an increased risk of cervical cancer. If these warning signs are spotted, it doesn’t necessarily mean that you’ll develop cancer, but you might need to be monitored more closely or have another procedure. 

Attending your scheduled cervical screenings is really important as it can help prevent cervical cancer. However, lots of women and people with cervixes feel nervous about the process and end up skipping their appointments.  

If you’re holding off booking an appointment, read on. We’ve put together a guide to address some common concerns about screenings, and the steps you can take to make a smear test more comfortable.

What happens during a smear test

A smear test/cervical screening is a really quick procedure only taking a couple of minutes, that is usually done by a female doctor or nurse.

When you arrive you’ll need to undress from the waist down behind a screen, then lie down on a bed with a sheet over your middle section. You’ll be asked to bend your knees and open your legs.

The doctor or nurse will gently insert a tube-shaped device called a speculum into your vagina. They’ll then open the speculum to expand your vagina and insert a soft brush on a long stick, which they’ll use to brush away a few cells from your cervix.

Once this is done they can remove the brush and the speculum and leave you to get dressed behind the screen. 

Pain during a smear test

For most people, a smear test shouldn’t be painful, but it’s normal to find it a bit uncomfortable. Usually the most uncomfortable bit is when the speculum is opened. Having your cervix brushed to remove cells can feel a bit strange, but shouldn’t hurt. 

However, some people will find a smear test painful. If you experience pain and you want to stop, tell the doctor or nurse. There’s no pressure to keep going. 

Is it likely my smear test will hurt?

There are many different physical and psychological reasons why a smear test might hurt or be very uncomfortable.  

You’ll probably find it difficult if you have a condition like vulvodynia or endometriosis, or if you’ve been through the menopause and you’re experiencing vaginal dryness. You might also struggle if you’ve been sexually assaulted or had a traumatic medical experience in the past. 

If you’re concerned that your test will be painful, there are a few things you can do both before and during your appointment – for our tips, skip to the section below titled “How to prepare for your cervical screening”.

What happens after a smear test 

Once you’ve had your screening, you’ll have to wait to get your results. Normally these will be sent to you in the post, but you might be asked to call you GP surgery instead.

The screening looks for high-risk strains of the human papillomavirus (HPV), which cause most cases of cervical cancer. If these strains are found on your cervix, you may need to have another smear test in a year’s time or a procedure called a colposcopy to look at your cervix more closely.

You can find out more about smear test results here. 

Bleeding and pain after a smear test

A little bit of bleeding and cramping after a smear test is fairly common, as the cervix is sensitive and can be irritated during the procedure. However, the bleeding should be very light and should stop within a few hours.

If you’re in a lot of pain, if you bleed more heavily (i.e. you’re soaking through a sanitary pad in one hour) or if the bleeding gets worse, you should contact your GP. 

How to prepare for your smear 

If you’re worried about attending your screening, there are some simple things you can do to make the process easier and more comfortable. 

Before your appointment you can:

• Request a nurse or doctor of a specific gender 
• Ask for a longer appointment so you have more time to talk through your concerns with the doctor or nurse 
• Invite a friend or family member to attend the appointment with you 
• Book an appointment with a specialist clinic like My Body Back, which offers screenings, STI tests and maternity care for people who have experienced sexual violence 
• Wear a skirt or dress that you can easily lift up during the procedure, so you don’t have to worry about getting undressed from the waist down 

During your appointment you can:

• Speak to the doctor or nurse about your concerns, letting them know if you have any relevant conditions or experiences that could make your smear more uncomfortable or painful 
• Ask to lie in a different position that’s more comfortable  
• Ask for a smaller speculum  
• Ask for lubricant  
• Put the speculum in yourself 
• Try breathing exercises to help your body relax

Remember, you can ask to stop at any point if you’re feeling very uncomfortable or nervous, or if you’re in pain. 

References

https://www.nhs.uk/conditions/cervical-screening/
https://www.nhs.uk/conditions/cervical-screening/what-happens-at-your-appointment/
https://www.jostrust.org.uk/information/cervical-screening/what-happens-during-cervical-screening
https://www.jostrust.org.uk/about-us/news-and-blog/blog/sometimes-smear-tests-are-painful
https://www.nhs.uk/conditions/cervical-screening/your-results/
https://www.jostrust.org.uk/about-us/news-and-blog/blog/bleeding-after-smear-test-it-normal-and-why-does-it-happen
https://www.jostrust.org.uk/information/cervical-screening/cervical-screening-tips