Various changes that occur in the female body during menopause can make routine health checks like smear tests (cervical screening) painful or uncomfortable. This discomfort can leave some women dreading their smear test appointment, or avoiding it altogether – both of which can be detrimental to their health.

However, the good news is that there’s lots of things you can do to make your smear tests more comfortable.

What are smear tests?

What are smear tests

Smear tests are carried out to check the health of a woman’s cervix – which is the opening of the womb from the vagina. It’s not a test for cancer, but rather a test to help prevent cancer from developing.

Smear tests involve a nurse taking a small sample of cells from a woman’s cervix. These cells are then checked for certain ‘high risk’ types of human papillomavirus (HPV) that can cause changes to cells in the cervix.

If none of these HPV types are found, no further tests will be needed until your next routine smear test appointment. However, if high-risk HPVs are detected, the sample of cervix cells will then be checked for any changes. If necessary, these can then be treated before they get a chance to turn into cervical cancer.

What happens during a smear test appointment?

What happens during a smear test appointment

According to the NHS, all women aged between 25 and 64 should be offered a smear test every three years (or five years if you’re aged over 50).

During smear test appointments, patients are asked to undress in private from the waist down, before lying down on their back with their knees bent and apart.

A nurse will then gently insert a medical instrument called a speculum into the vagina. The speculum holds the vagina open so that the nurse can see the cervix and use a small plastic brush to take a sample of cells from the cervix.

Smear tests typically take less than five minutes and shouldn’t hurt – though they may sometimes feel uncomfortable. It’s also normal to have light vaginal bleeding for a day after your smear test. But, it’s important to let your GP or nurse know if you experience heavy bleeding or bleeding after sex.

Patients will usually receive a letter containing their smear test results within two to four weeks.

For more information, have a watch of the NHS video below, which explains how smear tests are done.

Why might smear tests become harder after menopause?

Why might smear tests become harder after menopause

During menopause, the female sex hormones oestrogen and progesterone are reduced. Aside from their use in the menstrual cycle and pregnancy, these hormones are also responsible for helping to lubricate the vagina and keep the vaginal wall tissue stretchy.

Therefore, as these hormones decrease, the vagina may also become drier and less elastic. This means that inserting something like a speculum (the medical instrument used during smear tests) into the vagina can be uncomfortable – or even painful.

Other symptoms like mood changes and hot flushes caused by menopause can also make cervical screening more difficult. For example, someone who feels anxious or down may find it hard to book or attend a smear test appointment – or they may worry about what to do if a hot flush occurs during their test.

8 tips to make smear tests more comfortable after menopause

tips to make smear tests more comfortable after menopause

Many women find smear tests uncomfortable as it is, but with the added trials of menopause, they can become even more tricky.

However, the positive news is that pain or discomfort during smear tests after menopause is often easy to treat. Below are a few ideas that might help you.

1. Ask your nurse to use a smaller speculum

Many people aren’t aware that speculums come in different sizes. Generally, your nurse will try and choose the right size based on your age, and the length and width of your vagina – but that doesn’t mean they always get it right.

Remember, even if a particular size speculum used to work fine for you, it may not now, and it’s perfectly fine to ask your nurse to try out different sizes to find what works best for you.

2. Ask your nurse to use a water-based lubricant on the speculum

Using a water-based lubricant can help the speculum to enter the vagina more comfortably and without causing unwanted friction.

3. Try using vaginal moisturiser before your appointment

Vaginal moisturisers can be applied regularly to help with vaginal dryness and keep vaginal tissues healthy. A moisturiser is different to a lubricant because it’s placed inside the vagina, rather than onto whatever is being inserted into the vagina.

Vaginal moisturisers are available to buy at most pharmacies without a prescription. However, you can also ask your nurse or GP to prescribe it for you.

For more information on which type of vaginal moisturisers are available, you might want to have a browse of these 10 best vaginal moisturisers from Best Reviews Guide. Amazon also has a range of vaginal moisturisers available to buy on their website.

4. Ask your nurse of GP about prescription hormone replacement therapy (HRT) or vaginal oestrogen

Hormone replacement therapy (HRT) replaces the hormones oestrogen and progesterone, which are no longer made by the body post-menopause. This can help with a lot of menopause symptoms, including vaginal dryness.

HRT can be prescribed in various forms, including a daily tablet or skin patch. Sometimes, it’s also given as a gel or cream, which can be applied to the vagina.

There have been a few news stories about HRT recently, which may have frightened you – but in most cases the benefits of HRT outweigh the risks. That being said, it’s always worth speaking to your nurse or GP who can help you make a decision about whether HRT is right for you, and address any concerns you may have.

You can find more information in our article; Hormone replacement therapy (HRT) explained.

Ask your nurse of GP about prescription hormone replacement therapy (HRT) or vaginal oestrogen

5. Consider lying in a different position during your smear test

While smear tests are usually conducted with the patient lying on their back, if you feel you’d be more comfortable in a different position, you can speak to your nurse about different options.

For example, some women feel more comfortable lying on their side with their legs bent up.

6. Speak to your nurse about how you’re feeling before your appointment

If you’re feeling anxious about your smear test, then letting your nurse know beforehand that you may need some extra assistance can help to take some of your anxiety away.

Opening up to someone – especially if you don’t know them – about sensitive topics can make you feel vulnerable. But it’s important to remember that this is their everyday job – they’ve seen it all before, and they’ll only be able to give you extra support if they know that you need it.

7. Ask your nurse if you’re able to put the speculum in yourself

Some women find that being able to put the speculum into their vagina themselves helps them to feel more comfortable and in control.

8. Remember that you’re in control and can stop the smear test at any time

One of the key things to remember during your smear test is that you’re in control. It’s your body and you’re free at any time to tell your nurse to stop if you feel uncomfortable. They aren’t allowed to do anything without your consent.

General tips that can make smear tests more comfortable

General tips that can make smear tests more comfortable
Aside from things that can help with menopause symptoms and hopefully make your smear test more comfortable, below are some general tips that can improve the overall experience of a smear test appointment.
  • Bring someone with you for support.
  • Bring something to read or listen to that can act as a distraction during your test. Otherwise, if you’re anticipating the speculum being inserted, you may begin to clench your pelvic muscles which can make the test more uncomfortable.
  • Try practising breathing exercises to help you relax.
  • Remember to go to the loo before your test. Needing to urinate can cause you to clench your pelvic muscles and make the test feel more uncomfortable.

  • Wearing a skirt or dress to your appointment. These won’t have to be taken off during your appointment and can help you to feel less exposed.

  • Request a female nurse ahead of your appointment.

  • Remember that your nurse will have performed many smear tests before. There’s no need to feel embarrassed.

I’m struggling with menopause - where can I find further support?

I’m struggling with menopause - where can I find further support

If you’re currently struggling with menopause symptoms, it’s important to remember that you’re not alone and help is available.

Below are a few organisations that offer support and resources for women going through menopause.

  • Menopause and Me. A website with tailored information about all stages of the menopause. Other features include coffee catch ups with other women to discuss symptoms, and interactive body guides to understand what parts of the body menopause can affect.

  • The Menopause Charity. An online community offering information on various areas of menopause and how to manage it.
  • Menopause Support. Offers various resources including menopause symptom checkers, guides, surveys, and videos.

  • Women’s Health Concern. Provides information and guidance about navigating the menopause.

For further help and support, head over to the menopause section of our website. Here you’ll find information on everything from managing menopause symtpoms at work, to understanding the link between menopause and depression.

Alternatively, you could start a conversation with other Rest Less members in the comments below.

Final thoughts…

Various symptoms of menopause, such as vaginal dryness, can make routine screenings like smear tests uncomfortable.

But hopefully, as this article has shown, there are a few options you can try that’ll hopefully make your smear tests quick, easy, and pain-free.