For the under-twenty-fives who haven’t received their letter yet; people with tests booked who are nervous; non-cervix owning curious souls; and folks who are just plain clueless about it all. Don’t you worry, this post is for you.
What is a smear test actually like? Well, it’s kind of like Hogwarts. You know, when you turn eleven, a letter pops through your letterbox inviting you to Hogwarts School of Witchcraft & Wizardry. With a smear test, when you turn twenty-five, you get a magical letter landing on your doormat from the NHS inviting you for a cervical screening. Same difference, no?
Alright, I am very aware that I am exaggerating quite a bit. But I’m just trying to go straight into this discourse with a sense of lightness. So often in discussion of smear tests, it’s approached with hushed tones or via a quick talk in private when in fact, it’s nothing to worry about! Let me tell you why.
The big question – what on earth is a smear test? If we look to the official term for a smear test, a cervical screening, the clue is in the name. A smear test is a check up of the cervix for those people who have one! Your cervix is the bit that goes from the vagina and leads to the womb. The test or screening is to check if you have HPV in the cervix. HPV is a very common group of viruses – so common that around 80% of people will have it in their lifetime! Normally, it is absolutely fine to have HPV and it causes no issues at all. But sometimes, HPV can cause changes to the cells in the cervix which could lead to cancer. So a smear test is essentially a check in with the cervix, a little ‘how you doing bud?’ and ultimately, the best act of prevention against cervical cancer.
So why do so many people hate talking about smear tests? Why do we think it’s ‘awkward’ to share that we’ve booked it? Why aren’t more people talking about smear tests?! Because of outdated social stigma and misinformation, that’s why.
Even now, in the glorious twenty-first century, there’s still a social barrier that goes up when you talk about women* and sex. Even though smear tests are fully health related (not a sexual act at all), because it involves a vagina, that’s ‘too much’ and ‘too inappropriate’ for people to talk about. This stigma is carried on through generations and through families, schooling, and even through medical professionals themselves.
(* Not all women have smear tests and not all people who have smear tests are women! But the stigma started from the way society views women and sex.)
Now, I do not value social stigma as a reason to not discuss smear tests. Ain’t not ‘shh shh shh keep your voice down’ or ‘maybe this isn’t a conversation to have around the boys, hmm?’ will shut me up.
But there are fears and misunderstandings that come with the idea of a smear test that I do understand. Firstly, pulling your pants down around a stranger sounds like the least appealing thing in the world. Unless you are into that, then more power to you – but to most people, that’s a no-no. Secondly, there’s a rumour that we’ve all heard – that your mum’s friends’ cousin’s son’s wife’s smear test was painful, SO painful. Thirdly, (and sorry to get a little bit psychoanalytical) but there’s also the fear of the unknown. This is totally understandable – if you’ve never experienced a smear test before, you don’t know what to expect. But this is where I come in. In true big sister, fun aunt, loud-mouth friend style, let me tell you about my smear test experience, so you know what to expect, how to prepare, and what really happens at a smear test.
My smear test took place at my normal doctor’s surgery. If I timed from when I walked into the nurse’s room to when I left, I reckon my appointment would have taken six minutes overall. Now don’t worry – you don’t walk in and immediately whip your pants down and present yourself for prodding and cell collection. I sat down, introduced myself to the nurse, and we confirmed that I was here for a smear test. Then came the important part – she checked in with me. “Would you like me to explain the procedure and why we are doing this?” I said no, I’ve had a smear before. “So you know what to expect?” Yes, I do. “Excellent. Would you like me to call a chaperone to be in the room whilst I do the screening?” No, I’ll be fine! “Great. Are you okay for us to start?” Absolutely!
She showed me to the medical bed that every medical office has (you know, the one that goes up and down and has the crackling tissue paper) and asked me to lie on the bed once I was undressed – not before handing me a large square modesty tissue. As soon as she had pulled the privacy curtain around, off came the jeans and pants, and my be-socked and half naked body laid down on the crinkly paper. So there I was, a white ceiling above me, a bright light shining on my face, and a blue curtain all around. Cardigan on top, modesty tissue in the middle, hairy legs with odd socks sticking out to the world. I know this is another issue that can freak people out about smear tests. “Do I have to shave?” Simply put, no. There’s no need. The people who do these screenings do these day in, day out. They’ve seen it all before, I promise you.
The people who do these screenings do these day in, day out. They’ve seen it all before, I promise you.
I gave a quick shout to say I was ready, and the blue curtain peeked open to allow the nurse and her trolley in. She checked I was comfortable, asked again if she could begin, and so, we began.
“Alright Rosie. Shuffle your feet back to your bum, so your heels touch your bum. Great, pop those heels together for me. Annnnd keep those heels together and relax the knees down. Great!”
My nurse walked me through every step of the way. As I stared at the ceiling, my hands resting on my chest, she warned me that “this may feel a little chilly” and she popped the speculum in the cervix. Now, this is one of the scarier aspects if you’ve never had a smear test before. In images alone, a speculum looks uninviting, concerning and positively Victorian. But in reality, it’s just a plastic device that is gently popped into the cervix and allows the cervix to be opened just a smidgen more. Both times I have had a smear test, this has not hurt. As in, it didn’t hurt at all. However, it was ruddy cold! Both times I have had a smear, I’ve loudly shouted “OOH it’s cold!” when they’ve used the speculum. But that’s it. Obviously it’s not as comfortable as falling asleep in a king size bed whilst wearing silk pyjamas, but it’s not horrible.
To put the feeling of a speculum being put into the cervix into words, I would say it felt like a reverse period. Yes, I know that sounds weird but let me explain. You know how sometimes you can feel your period start, as it goes down from your womb to the vagina? It’s a very specific feeling. Well, it felt like that but in reverse! And if you haven’t got periods, well – just imagine it feels a little odd.
With the speculum in, it’s time to collect the cells. This is where the nurse pops a long, thin, cotton bud looking brush into the speculum and cervix to take a collection of cells. In all honesty, I was still mid- ‘OOH it’s cold!’ to even notice the brush going in. When the brush collected the cells, I did feel it. But just like with the speculum, it didn’t hurt; it just felt like one of those odd period feelings like a clot or the egg just ~doing~ something. Before my brain had a chance to go “wait, this feels weird”, the brush was out, followed by the speculum, and I was ready to get changed in privacy.
I feel like it is worth mentioning at this point that whilst a smear test should not hurt, all bodies are different. Some people are like me and only feel a bit of discomfort, others say they feel a slight pinch, an ache, or a fleeting moment of pain. But if it hurts, it could be a sign of a condition that needs to be explored such as vaginismus or endometriosis. Any pain at all, make sure to tell the person doing the procedure.
Whilst I was changing, the nurse took the brush and got it ready to be sent off for testing. I didn’t see any of the equipment this time around, but when I went for my first smear test during my PCOS diagnosis journey, I saw it all. And I saw blood on the brush. This is completely normal. It’s just been inside your body, that could be period blood or other bodily junk! Once I was changed, we chatted about what the next steps were. I would receive a letter in the post telling me of my results and if I need to take any further steps, it would all be clearly outlined. And with that, I was out and walking back home.
Out of all the medical procedures, appointments, and check ups I’ve had over the last two years, the smear test has been the easiest and quickest. And this is why I am writing this post – I want to show you that a smear test is nothing to be afraid of, and more people need to talk openly about their experiences to bat away the stigma!
If you are scared about the idea of a smear test, that’s okay. With all of the misinformation that has been spread, coupled with the fear of the unknown, it’s completely understandable to be nervous. Just know that you are fully in control. Tell the doctor or nurse doing the procedure that you are stressed or anxious, and they will support you. Bring a friend or a loved one if you need a hand to hold, or make the most of the chaperone service (COVID permitting, of course). If you feel any major discomfort or any pain, speak up immediately.
“If you are scared about the idea of a smear test, that’s okay. With all of the misinformation that has been spread, coupled with the fear of the unknown, it’s completely understandable to be nervous. Just know that you are fully in control.”
If you are still looking for some more reassurance or information, I would thoroughly suggest watching internet icon Zoe Sugg’s video on getting a smear test! She talks to a nurse before the screening and they go through so many important questions. Then, she actually has the screening in the video! It’s a wonderful resource to find out the realities of a smear test.
Remember, you are doing this for you and your body. The reality should be that it’s ten-minutes of mild-discomfort for what could be a life-saving check up. If you ask me, booking a smear test is one of the biggest acts of self-care you can ever do for yourself. If you are age twenty-five and over and have a cervix, book you smear test now.