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Friday 28 June 2013

Pap Fear

There's a few things I'm afraid of, including cancer, unemployment & water slides (don't even get me started). The mere prospect of any of these things happening to me (yes, the idea of going to a water park sends me into a frenzy) makes my palms sweaty, knees weak, arms are heavy. There's vomit on his sweater already, mom's spaghetti. Okay, I got a bit carried away there with the Eminem lyrics. But seriously, we have an anxiety response to things we're afraid of. Our heart races, we sweat, we find it harder to breathe and we tense up (and, if you're Eminem, you spew on yourself and crave homemade Italian).

This is the response a lot of women have when they think about getting a pap smear. Coupled with the shear embarassment of getting your bits out for a random, there's a few big reasons why many women don't get their pap smears as regularly as they should.

The NSW Cervical Screening Program recommends all women between the ages of 18 and 70 years and who have ever had sexual intercourse should have a Pap test every two years. I was recently taught how to conduct a pap smear (practicing on a pelvic dummy, ofcourse) which was an amazing experience, so wanted to share some insights with you -


SO WHY DO WE FEAR THE SMEAR?

We don't know what to expect - let's be honest: the speculum (aka the 'duck bill') is a pretty terrifying-looking device. But in reality, it's actually not too bad, and serves a very important purpose. Rather than a sharp pain, most women report more of a firm pushing against the muscles of the vagina and some discomfort. If you're experiencing too much pain or discomfort, tell the person performing the pap smear. Don't be silent!

Some women don't really know what the doctor or nurse is doing down there or what they're testing for. We're never told what actually happens during a pap smear, so, let's lay it out. Pap smears basically check for any abnormal cervical cells which could develop into cancer - so better to get them early. It doesn't check for any other reproductive abnormalities, or sexually transmissible infections, and you will still need them even if you've had the HPV vaccine. The (thoroughly lubed) speculum is inserted into the vagina and is opened slightly, allowing the doctor or nurse to get a sample of cervical cells by gently swabbing a soft brush or similar against the cervix. This is then withdrawn, followed by the speculum. Sometimes they'll do a pelvic examination by inserting their fingers into the vagina and pushing their hand on the outside of your pelvis. Otherwise, that's it! You're done!

We are embarrassed about our own bodies - any time we have to get our clothes off for medical professionals, a lot of us have those circling thoughts - "will they think my vagina is weird?", "I forgot to wax...they'll think I'm gross" or "what if it smells?!". In reality, this is what doctors and nurses are trained to do. They've seen, heard & smelt it all, so don't be embarrassed to get your kit off. If there truly is a physical issue, they are the ones who'll be able to help you address it - so it's a win-win situation!

We think that it will hurt - When we expect pain, our vaginal muscles will tighten, which can make any penetration painful. We prepare ourselves for pain, which actually increases the chances that we will  experience pain. Massive catch 22! The average speculum is approximately 2 - 3cm wide, meaning that it's about as big as two fingers. If you feel comfortable, practice inserting a couple of fingers into your vagina and breathe deeply throughout. This will get you used to the sensation and ways to work through it.

We are scared of the results - Lots of women avoid getting pap smears for the reason we avoid getting other sorts of tests. We don't think we're at risk, or we don't want to know the results if it means bad news. We think that if we don't put ourselves in the situation of getting tested, then we can just put our heads in the sand and stay safe. But the reality is that early diagnosis is much better than late diagnosis, so keep on top of it regularly to make sure you keep yourself healthy.


TIPS TO MAKE THE PAP BEARABLE:


Go somewhere you know they do a lot of pap smears - Family Planning and sexual health centres are your best options. They do a vag-load of pap smears, and will not be shocked by anything. They are usually covered by the healthcare system, so if you have a Medicare card/number, take it along with you.

Relax and breathe deeply  - Learn to focus on your breathing, and make sure it's deep and regular. This will help to calm you both physically and mentally, which will help your vaginal muscles to relax and give the speculum a smooth and painless entrance.

Ask the nurse or doctor to talk you through what they're doing. They will probably do this as part of good practice anyway, but ask them to talk through each step of the process during the test. It will make you more aware of what's going on, able to tune into your body, and not shocked by any unexpected touches or movements.

Pop them pills: Take a few panadol/nurofen an hour or so before you go in. Just like the tactic for anyone's first tattoo, it will make it slightly less uncomfortable and will probably put your mind at ease a little too.

and remember, don't have sex for 24 hours before your pap smear, as it may mean the results are hard to read and you'll have to get a second examination!