The majority of our audience are British women aged between 25 and 34 (or at least that’s what our Instagram analytics tell us), which means that chances are you’ve had, or at least been invited for, your smear test. But the number of women attending their cervical screening has fallen in recent years – and the nurse practitioner who performed mine earlier this week said that numbers had been declining before the pandemic started. She listed fear as the number one reason she believed less women were showing up than ever before.
So what exactly is a smear test? Well, it’s a screening of the health of your cervix, which is done by removing some of the cells. That sample is then tested for certain strains of HPV (human papillomavirus) which can change the cells in your cervix and eventually lead to cancer. It’s called a smear test (a v glamorous name that, let’s be honest here, doesn’t exactly make the procedure seem particularly appealing) because originally the cell sample was smeared across a glass slide, ready to be viewed under microscope.
Currently the criteria to be invited for your smear is the same across the UK (regardless of whether you’re in England, Wales, Scotland or Northern Ireland). Women or anyone with a cervix who is aged between 25 and 49 should have one every three years, whilst those between 50 and 65 will be invited every five years.
This week I had my third test. And, whilst we know, we know, that most of you reading this are likely no stranger to the procedure, we thought we’d shine a light on what happens and how it works, in case it reminds you to go ahead and get yours booked in. Or on the off chance you’re one of our younger readers who haven’t yet experienced one. This is how my screening went…
I received a letter through the post advising me that my next test was due and was asked to ring my GP surgery to book in my appointment. I got round to it around a week later and had a two-week wait for the next available slot. So far, so easy.
I managed to convince a friend to look after my kids for half an hour whilst I attended my screening. Having a speculum holding your cervix open isn’t the most relaxing activity in the world, so I thought if I could save having two small kids loitering in the same room, then I absolutely would.
I wore a mask (hello covid times), a pair of semi-respectable pants (and by that I mean they had no holes in), and a dress, because it’s much easier just to hoist it up around your waist whilst the test is carried out then to pull trousers on and off.
An incredibly kind nurse checked a few details with me – my name, my DOB, and my address where my results would be sent – before locking the door and pulling a curtain screen around me and the bed so that I could take my shoes and pants off and get comfortable. I also was given a sheet of paper to have across my lap for extra modesty.
Once I was all set-up, she came to the end of the bed and angled a light so she could better see what she was doing, and then asked me to put the soles of my feet together and to drop my knees so that I was in a bit of a frog position. She then used some gel to slide a speculum into my vagina, and then opened it up to get better access to my cervix, before sweeping a brush inside to gather cells. The speculum is then removed and the test is over and you’re left to get dressed and make your merry way home.
The test itself takes about five minutes – and the main element of discomfort can come from getting the speculum in the right place. I have a tilted cervix which always makes it a bit fiddlier to get right, and each time I’ve ended up having to make my hands into fists and placing them under my bum to make it easier for the nurse to gain access. Admittedly, each of my three tests have had varying levels of pain – ranging from ‘wait – it’s already finished?!’ to ‘aaaaaaand focus on your breathing’. The brush part of the test lasts seconds and you can barely feel it. It’s all over incredibly quickly, and the pain isn’t that intense takes-your-breath-away kind, more just a short-lived discomfort. It’s not unlike having a membrane sweep during pregnancy, or an internal ultrasound or having an STD test.
It’s also possible you’ll feel some sense of having had something in your cervix for the hours that follow. It’s an odd, very subtle sensation to describe. But I guess it’s an area of your body that’s usually left fairly to itself. It’s not painful or even uncomfortable, it’s just… there. My nurse advised that the best time of day to have a smear test is at the end of the day because gravity tends to mean that muscles have relaxed around the cervix and there’s less resistance, so if you’re feeling nervous or afraid, it might be worth booking an end-of-day appointment.
The way I see it is that it’s a short moment of discomfort (in the same ballpark as eyebrow plucking or removing a tampon in a too high an absorbency) to help detect bodily changes that could be huge. Would I rather be having a full body massage on a Caribbean beach? Sure thing. But a smear could save my life.
For more info on cervical screening, visit the NHS website here.