Why mammography and pap smear machines need to be redesigned

My boss Pamella Sittoni shared an informative conversation with me on X (previously on Twitter) about mammography. One woman told how she had recently undergone the procedure and felt lucky to have been informed about what to expect, otherwise she would have been embarrassed. Her final comment was: “Please, medical devices for women, made by women, should be their own category.”

Her comment stemmed from another user, X, who described sharing a graphic representation of her mammogram experience with her colleagues. Their stunned reactions and subsequent Google searches for this “torture instrument” highlighted the stark disconnect between women’s lived experiences and the largely male-dominated design of such medical equipment.

The anecdotes shared by the women in this conversation are a sobering reminder of the physical and emotional toll that mammography takes, a procedure intended to ensure their well-being while often leaving them feeling violated and traumatized.

As women, we are always reminded of the importance of regular screening tests such as smears and mammograms to detect cervical cancer, breast cancer and other potentially life-threatening conditions. While these procedures have undoubtedly saved the lives of countless women, the experiences associated with them can be uncomfortable, undignified, and even traumatic for many women.

My first Pap smear experience was terrible, but a story for another day. I believe that these procedures only discourage proactive screening by calling for the elephant in the examination room to be addressed. It’s time for an open conversation about making these necessary but invasive tests more bearable.

One of the biggest problems is the discomfort and pain associated with them. During the smear test, the woman must lie in an exposed position while the doctor inserts a speculum – a cold, sometimes metallic, unforgiving instrument – into the vagina to collect cervical cells. The feeling can only be described as pressure, pinching and sometimes sharp pain. For many women, the humiliation is deepened by the fact that the person performing the examination may be a young doctor, potentially their son’s age.

Mammograms also cause physical pain in order to provide accurate imaging. Compressing the breasts between two plates, although necessary, can be terrifying for many women. The irony is that procedures intended to protect a woman’s health often cause discomfort in the part of the body they are intended to examine.

In addition to physical discomfort, there are emotional and psychological challenges. The sensitivity of these positions is extremely uncomfortable. While testing is crucial, it can be invasive and uncomfortable procedures that violate women’s privacy and bodily autonomy. These tests often involve exposure of private parts of the body and can be physically and emotionally taxing.

The equipment currently in use is designed primarily by men, without adequate input from women who have first-hand experience with the discomfort and humiliation that can accompany such tests. Because devices lack adequate support from women, they may lack sensitivity and consideration of their needs, which may discourage some people from undergoing important screening tests.

Women’s involvement in the innovation and design of this equipment is critical to protecting women’s rights to dignity, bodily integrity and access to equitable health care services. They have a unique understanding of the physical and emotional aspects of these tests. Their input could lead to the development of more comfortable and less invasive devices.

Their involvement could also help develop a deeper understanding of the specific concerns women may have about this research. This could then help develop educational materials, support systems and improved communication strategies, ultimately encouraging more women to prioritize regular screening without fear of going through an overly traumatic experience.

In the meantime, health care facilities can take steps to improve the current experience by offering more female providers and implementing better privacy protections.

In an era in which we advocate for bodily autonomy and consent, it is imperative that we extend the same attention to the health care environment. Women deserve to feel empowered, respected and cared for – not only physically, but also emotionally and psychologically. This is a matter of basic human dignity and is long overdue.

Pamella promised to share her mammography experience. I look forward to hearing her insights, as they may become a catalyst for broader dialogue.