Fear of smear tests (cervical screening)

A fear of smear tests can make the screening letter sit unopened for months, with your whole body tensing at the thought of lying on the couch.

Many people find that with the right help, they can book their screening, go along feeling calmer and walk out glad it is done.

Use code PHOBIA at checkout for half price: £24.50 instead of £49. Outside the UK? $29.50.

Understanding this fear

Lots of people feel nervous about cervical screening, which is called a smear test in the UK and a Pap test or Pap smear in the US. With a fear of smear tests, the feeling is strong enough to make you delay or skip screening. For some people the fear is pain, for some it is embarrassment or being exposed, and for some it is about feeling out of control. A past test that hurt, or a difficult experience in the past, can make it much harder.

It is closely linked to a fear of doctors, a fear of pain, a fear of being touched and a fear of nudity. It is very common, and nurses who do screening are used to helping people who feel this way.

Common triggers

• Receiving the screening letter
• Undressing in front of someone
• Lying on the couch
• The speculum going in
• A previous test that was painful
• Worrying about the results
• A male or unfamiliar clinician
• Feeling rushed

Where it shows up

• GP surgeries and practice nurse appointments
• Sexual health clinics
• Gynaecology appointments
• Postnatal checks
• Private health screening
• Other intimate examinations

Symptoms

In your body

• Tense muscles that are hard to relax
• Racing heart or short breaths
• Feeling sick or shaky
• Feeling hot, tearful or close to panic
• A strong urge to stop

In your mind

• What if it hurts?
• Feeling embarrassed or exposed
• Worrying about the results
• Remembering a past bad experience
• Feeling out of control

What you might do

• Leaving the letter unopened
• Booking and then cancelling
• Putting screening off for years
• Avoiding other check-ups too
• Not telling anyone how you feel

What causes it

A painful or rushed test, a difficult experience in the past, or stories from friends can be enough to start it. Some people feel anxious about any intimate examination, or about being exposed or touched. Worry about the results can add to it. Once the fear is there, putting screening off brings quick relief, which teaches your mind that the test really was dangerous, so the fear grows.

How it can affect your life

A fear of smear tests can quietly get in the way of your health. People put off screening for months or years, feel guilty every time a reminder arrives, and avoid other check-ups too. Cervical screening exists to spot changes early, so the fear can cost you peace of mind as well as care.

Things that can help day to day

• Tell the nurse when you book and when you arrive that you feel anxious
• Ask for a smaller speculum, a female nurse, a longer appointment or someone to come with you
• Agree a stop signal with the nurse, so you know you are in control
• Wear a skirt or long top so you feel less exposed
• Breathe out slowly, a little longer than you breathe in, and let your shoulders and jaw drop

When to get help

Please keep going for screening. If you have put it off, your GP practice can book you in, and you can talk to them about how you feel first. Getting help with the fear alongside is a good idea.

If you have unusual bleeding, discharge or pain, do not wait for your screening appointment. Please see your GP. If a past experience is behind the fear and it is weighing on you, talking to your GP or someone you trust can help too.

How I can help

If you’re feeling low or on edge most of the time, talking to your GP or someone you trust can help too.

Common questions

Is it normal to be scared of a smear test?

Yes. It is very common, and practice nurses help nervous people every day. You do not need to explain why you feel the way you do. Telling them is enough.

Can I ask for changes at my smear test?

Usually, yes. You can ask for a female nurse, a smaller speculum, someone with you, a longer appointment or to stop at any time. Ask when you book.

What is a Pap test?

In the US, cervical screening is often called a Pap test or Pap smear. In the UK it is called a smear test or cervical screening. The fear and the help are the same.

How do sessions work?

I use hypnotherapy and NLP to change how your mind responds to this fear. Sessions are one to one over Zoom, and you get a recording of the hypnosis to listen to afterwards.

How many sessions will I need?

Many clients notice a real difference after one 90 minute session. If the fear goes back a long way, three sessions gives us room to make the change stick.

Further reading: NHS: What happens at your cervical screening appointment · Royal Wolverhampton NHS Trust: Do you fear your smear? · NHS: Phobias

Ready to start?

A short call is the simplest next step. We’ll talk about your fear, what you’d like to feel instead, and whether I’m the right person to help.

1. Take the free test at the top of this page to see how strong your fear is.
2. Book a 30 minute call. Use code PHOBIA at checkout for half price: £24.50 instead of £49 ($29.50 outside the UK).
3. Start your sessions over Zoom from wherever you live, or face to face in Hertfordshire.

See all session options and prices