Pap Under Sedation – Unique Vaginismus

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    I know you are all probably reading that title like “wtf” but bear with me. This is a long one.

    At the age of 14 I had 6 mo of lower back pain and was back & forth to the Dr who did scans and didn’t see anything. They didn’t even think to ask if I had started my period (I hadn’t). One day I was shopping with girlfriends when I felt something run down my leg, we went up to the washroom and it was blood. There was so much that the b-room was closed off and an ambulance called. Paramedics arrived & asked if I was sexually active as they thought I had miscarried, I wasn’t. At the hospital they said that can happen sometimes and didn’t say much more.

    Flash forward to being 16 and in my first serious relationship. We tried to have sex but couldn’t. It felt like he was hitting a brick wall, my muscles would spasm, my bum lifted up and was v. painful for me. I went to a Dr who tried to perform a pelvic exam and couldn’t but her conclusion was it was all in my head and off I go. That deflated me. A few years later at 21, I went to a Dr and explained my situ and it turned out I had an imperforate hymen ( which would explain why my period built up and I couldn’t have intercourse. I had that taken care of.

    I am now 25 and in a stable long-term relationship. We have sex and although difficult in the beginning it is fine now. BUT when I try to go for a pelvic exam, my muscles spasm, bum scoots up and it is like hitting a brick wall (the symptoms from before my hymen was fixed). My Dr has said I have vaginismus but I am unique as I can have sex. My current Dr is the one I feel has only really listened to my case and we have tried different routes for the exam:
    * smaller speculum * breathing exercises * ativan prescription

    At my first appt with her she said we could try though as many times as I want, and if the worst comes to the worst, then she can refer me to the women’s clinic at the hospital and they can do it under sedation/anesthesia. So none of the above worked. I had my appointment today with the gynecologist at the hosp and she was wonderful. She gave me a name for a pelvic floor Dr and we spoke in depth about my problem and said I am not the first person with it or the last. She was so understanding and she could do it sedated first, to get it out of the way, and then I can focus on working towards it normally without worrying. So she booked me in for next week. There will be an anesthesiologist and herself. Obviously, it isn’t a surgery so she said it will be over in a few mins. I am having my SO take me but I am so nervous… I am worried about the risks even though it isn’t a long procedure, and the gyne said it would be the best way right now. I want to get it done, as I am sexually active, so I am due a pap and I am scared because I am not able to get one. Anyone else had this for an outpatient procedure? I should also add that I am talking with a psychologist about my problem which has been ongoing for 9 years so this isn’t a rash decision.


    Think its a very good idea to get a pap smear now that you are sexually active. The pap will screen for HPV and other cervical abnormalities. How wonderful that you found a physician who understands vaginismus. I feel that your physician is willing to go the extra mile by offering you sedation for your first pap smear.
    I am a true believer in the role of Pelvic Floor Physical Therapy in my patients with vaginismus. It really does work quite well. I am hopeful that after being seen and treated in Pelvic Floor PT this will be your last pap smear that involves sedation.
    Best of luck to you!!


    Hello! I know it’s been several months, but I wanted to share with you that exactly one week ago I had a pap under sedation. It was still a terrifying experience since it happened with less than two weeks notice.

    For about two years, I have been seeing a gynecologist for painful breasts. She of course asked me the date of my last pap, and I immediately broke into tears (I have not been treated kindly by doctors when I have admitted I am 29 years old and never had a pap smear or a pelvic exam…and I thought a gynecologist would be the meanest of them all since that is their specialty, but that couldn’t have been farther from the truth!) She was kind and gentle with me and said that was okay. I told her I had vaginismus and sexual abuse in my past and she was very understanding and said we didn’t need to worry about the exams right now. She also mentioned that if I had surgery in the future, I could have a pap smear under sedation.

    After trying a few things that unfortunately didn’t work, she referred me to general surgery where I met a wonderful surgeon. She said she would like to do a biopsy…under anesthesia. I mentioned my visit with my gyno and about possibly getting a pap at the same time, and she kindly agreed as long as I coordinated with the women’s health clinic as she didn’t perform those exams herself (no problem).

    The surgery was scheduled 9 days later! I was so nervous because I went from not having a pap on my mind, to having one done in less than two weeks.

    It was honestly a horrible ordeal, through no fault of my doctors. I don’t think I was fully mentally prepared even though I was asleep. The only doctor (at the time) they could find was a male and I was extremely uncomfortable with that. After meeting him for the first time on the day of surgery, I broke down and started hyperventilating when he asked why I needed it to be done under anesthesia. I started saying I didn’t want to do the pap anymore. He asked if he could find a female doctor if that would be okay, and I said yes. So off to surgery I went, not knowing if the pap would happen while I was asleep.

    When I woke up, I immediately felt uncomfortable and very “wet” down there. I started crying. The nurse asked why I was crying and I told her I hurt “down there”. She said they found a female doctor and I did have a pap while asleep. I didn’t know her name or what exactly happened. I cried a lot, feeling very confused and like everything happened too fast.

    The wetness wouldn’t go away and it felt like I had urinated in my sleep. So I looked and immediately started crying and paged the nurse. I had so much blood on my legs and vulva it looked like I started my period! They said that was normal…I wasn’t told to expect blood so I was shocked. Over the next few days I cried a lot. The spotting wouldn’t stop and it immediately turned into my period (it was due anyway) so I haven’t stopped bleeding since the pap smear. I hope my emotional state gets better once my period is over. I think if I could meet the doctor and talk to her I will feel better. I think it just happened so fast I didn’t have time to process everything so I’m having a hard time with it. All my doctors and nurses have been wonderful and supportive though.

    I apologize for the novel…but if you have any questions, please feel free to ask! You are not alone!


    Hi jsmith13. Thank you for sharing your story. Please know I’m thinking of you and you have my full support. Sending you big hugs.



    Sounds like such a difficult experience, but YOU GOT THROUGH IT! I’m glad that you worked with mostly understanding doctors/nurses and it seems that you were treated with respect and care. I hope that the pap results come back helpful, and I am confident that next time will be even easier for you. 🙂

    “Firsts” – no matter how difficult they are – are always a huge sign of progress, and you should feel proud of yourself!

    Thinking of you and sending support!


    Thank you very much for your kind words and hugs, Heather34 and Sks823! As more time passes I am feeling more comfortable with everything, and so very grateful to have had understanding doctors.


    Hi Jsmith13 – I’m so sorry you had to go through this ordeal! I’ve also had a pap smear under anesthesia twice – once when I was younger, before I dealt with my vaginismus, and again while I was “under” for my botox procedure at the Maze Clinic. I’m really glad the option exists for those of us who have issues with receiving exams, but it sucks that yours was such a complicated and scary affair! I especially identify with the anxiety you felt when the male doctor who was less sympathetic to your vaginismus – some of my most triggering moments with vaginismus have involved feeling misunderstood by doctors, the people who are supposed to best understand their patients’ issues and to help overcome them. I’m so impressed with your bravery and hope you understand what a big deal it was to be able to do this!


    Hi jsmith13. I’m so, so glad you are feeling better with everything and am so glad you had good and understanding doctors. You have my support 100%! I had very bad experiences like so many women who have had or currently have vaginismus with doctors who did not get the condition at all. Thank God there are good doctors out there like the ones you had,Dr. Pacik who I had and the Maze team in NY. Again, sending you big hugs and my support.


    Hello jsmith13,

    Thanks again for sharing your story, and writing about the need to “process” the experience. Processing is such a very important piece, and is so often overlooked.
    Take good care,


    HI. I never had a problem with sex, untill now, after menopause. The pain is unbearable and havent had sex in 2 years now.


    Hi Sukemi – welcome to the forums! Vaginismus is absolutely something that can occur at menopause – it happens for a number of reasons and after a number of affecting events in a woman’s life including sexual trauma, childbirth, and menopause. Have you spoken to a doctor about this problem yet? I recommend browsing around these forums to learn more about vaginismus if you don’t know much already, and I would also encourage you to give the Maze Clinic a call – they offer free consultations over the phone that may help you figure out what you want to do to begin treating this issue. Those of us who have dealt with vaginismus in the past as well as the clinical staff at Maze are active on the forums and always happy to answer any questions you may have!


    Hi Sukemi – welcome to the forum.

    I would love for you to give me a call to discuss post menopausal treatment options for painful sex.

    After menopause the vaginal and vulvar tissue become less lubricanted, less elastic, and the vaginal opening often shrinks, making penetration very difficult.

    Often a combination of topical hormonal creams and dilation can be extremely helpful to restore the vaginal tissue, and stretch the vaginal opening to allow for pain free intercourse.

    Give us a call for a free 10 min phone consultation.



    Thank you so much recessivegenequeen, Heather34, and Nicole Tammelleo. Your supportive words and encouragement means so much to me! I have often been made to feel so ashamed of my fear of pelvic exams and it is so healing to hear kindnesses. My most recent PCM told me I was going to wake up in a pool of blood and at that point it would be too late to help me. I know she was only trying to get me to agree to a pap smear, but scare tactics are just that…terrifying! And being “scared” into a pap smear seems traumatizing and not at all mentally healthy. I immediately switched doctors but have only seen the new one once because I’m not sure if I can trust her.

    The female doctor that performed the pap smear called me…after much hoop jumping, detective work, and trying to figure out who performed the exam. She was very kind and that made me feel better. She even apologized for the way everything went down, she said it was definitely not ideal and she would have preferred to meet me before I was asleep but I guess they were in a rush to put me under. She answered all of my questions and did not rush me off the phone or make me feel like a bother or inconvenience. The bad news was my results were obscured by the blood, so the pap smear was really for nothing…it said the results were not adequate for testing, and that I should retest in 3 to 4 months. The doctor mentioned I had a friable cervix, so I am more terrified now that the issue will just happen again and I don’t know if I can work up the courage to do the pap smear while I’m awake.

    Sukemi – I am so sorry for the pain you are experiencing, no one should have to deal with that! I hope you can find a treatment that works great for you and you can enjoy painless sex again. Much love and hugs!


    Jsmith13, we’re always glad to help, and we applaud your bravery! I’m glad your doctor was helpful after the fact, even though the day of the appointment was stressful and confusing. I’m so sorry the results of your test were inconclusive, that just makes it even more of a headache. If you don’t want to get a pap smear while you’re awake, I hope you are able to get another one under anesthesia. Being able to know what’s going on with your body should give you a lot of peace of mind. Good luck and keep going – we’re all in this together!


    Wow. I know how you feel. I actually went to the doctor today and she tried to perform a pap smear and it didn’t go well. I broke down and started crying because it hurt soooo bad. Everytime they try to put that inside of me, it is unbearable!! They need to come up with something else to check for cervical cancer because I just can’t do it. I was just looking up how i can do a pap smear under sedation or something. I’m so glad I happened to come across your story! That would be a LIFESAVER for me. Everyone says its just uncomfortable, but it’s seriously not. It hurts sooo bad. The doctor suggested that I try to put it in myself and I tried.It just wouldn’t go in!! When she tried to put it in, I kept moving my legs and everything.Then the doctor was like stop saying your sorry just do it, like cmon I’m seriously trying here. I’m not trying to make you mad, but it hurts too much. I was screaming it hurt so bad. I’m kinda wondering why she just didn’t get the cells off my cervix if she saw that my cervix was bleeding like I went through all that for nothing today. After I felt so bad, embarrassed, confused and hurt. I felt like a big baby because I couldn’t do the damn “simple” exam.I must have a condition or something because that shit hurt. Why would I want to go back and go through that again?!!! She told me to come back in a year and gave me a speculumm so I could practice. I felt so disapointed in myself too, I almost was able to get it done with and I didn’t…It was so stressful. Can you please let me know what do I have to do to find someone that will do my pap under sedation??

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