Everything You Wanted To Know About Smear Tests

Around five million women are invited to attend their cervical screening (also known as a smear test) each year.  You, your mum, your sister, your best female friend, the lady down the shop, your manager, from the age of 25 we’re invited by the NHS to attend to down our underwear and give our vaginas a once over to ensure there are no nasties lurking down below.

Smears have a bit of a bad rap for being lets say, not exactly a walk in the park and it’s that rap which has seen a worrying decline in the number of women attending their screening, particularly those who fall under the 25-29 age group.  Quite concerning considering that at 25 women should be attending their first screening.

“I don’t mind doing smears, they’re all in a days work for me but even I don’t like having them done” admitted my nurse right before she asked me to pop behind the screen and remove my underwear.  Less than five minutes later I was popping on my undies and telling myself “that wasn’t so bad!” as she packed me off back into the cold.

Just five minutes & the brief embarrassment of getting my vagina out for a woman who’s seen “hundreds of the things” and I’d made steps towards protecting myself against cervical cancer.

Lets take a look at everything you wanted to know about getting a smear test (but probably didn’t want to ask!)

What causes cervical cancer?

More than 99% of of cervical cancer cases within the UK occur in women who have previously been infected with HPV. But what is HPV? HPV is a group of viruses rather a singular virus and there are more than 100 types. HPV is spread during sexual intercourse and other types of sexual activity (use of sex toys or skin to skin contact with the genital areas and is very common. Approximately 1 in 3 women will develop a HPV infection within two years of having regular sex and 4 in 5 women will develop the infection at some point during their lifetime. In many HPV infections, you won’t have noticeable symptoms and the infection will pass without treatment, some may cause genital warts and around 15 types of HPV are considered high risk for cervical cancer. HPV 16 and HPV 18 are the highest risk and cause approximately 7 out of 10 cervical cancer cases and these high risk HPVs contain genetic material that can be passed into the cells of the cervix and disrupt the normal working which can lead to the growth of a cancerous tumour.

I haven’t been having sex so I don’t need a smear test!

Nuh-uh. Just because the rivers run dry as of late it doesn’t mean you’re not at risk. HPV can lay dormant and go undetected for months or even years due to the lack of symptoms. Even if you’re a certified virgin and your risk of developing cervical cancer is really low, there may still be a risk and it’s better to be safe by booking in once you’ve received your first “invite” than sorry.

I haven’t had any symptoms of cervical cancer so I don’t need to go for my smear test!

Wrong again! As much as there are cervical cancer symptoms (which I’m guilty of Googling before) the majority are extremely difficult to spot and can often lay undetected until a smear is performed. Symptoms such as bleeding after sex can often be attributed to your contraception affecting your period (such as the pill or coil) and another symptom, pain during sex, may just be seen as the norm if you tend to like it rough in the bedroom.

 Do I need to do anything to prepare for my smear test?

To ensure you’re getting accurate results, try to avoid having sex 24 hours before the test as factors such as sperm, lubricant or the chemicals used in barrier or spermicidal contraception can affect the test results. I also ensure I’m “tidy” and clean down there but that was mainly just out of politeness & respect for my nurse and you know, day to day hygiene.

Can I go for my smear test at any time?

Your time of the month will dictate when you can have your smear test as you can’t be tested during your period.  Try to book an appointment for the middle of your menstrual cycle (usually 14 days from the start of your last period) as this ensures a better sample of cells is taken.

A friend of a friend of a friend said that it really hurts..

Granted, you won’t be used to having your legs akimbo for a prolonged amount of time without as much as a tickle let alone an orgasm and it’s not the most pleasant of feelings, but your smear test shouldn’t hurt. It may feel a little bit uncomfortable, very probably a little bit unpleasant but hurt? Nah. If you do find that during the test you begin to feel any kind of pain, you can ask your nurse to stop but this will be explained to you beforehand.

What do they actually DO down there?

You’ll find that on your first smear your nurse will talk you through your smear step by step but let me break it down. Remove your underwear and lay back on the bed, feet together and allow your legs to fall apart. The nurse will insert a speculum (a clear plastic contraption that looks a little bit like a pelican beak) into your vagina. If you’re super nervous your muscles could tense making this experience a little more uncomfortable (think about the first time anxious time you inserted a Tampon) but you’ll find that your nurse will tend to ask make small talk to put you at ease and ensure the muscles of your vagina are relaxed.

The speculum is then “opened up” whilst inside you, which isn’t as bad as it sounds, honestly, because believe it or not, your vagina is pretty flexible.  After all, if it can birth a child’s head, an expanded speculum should be a breeze. Once your cervix is exposed, the nurse will use what looks like a cross between a mascara wand and a toothbrush to lightly “scrape” your cervix and deposit some of those much needed cells in a pot. After removing the speculum she’ll leave you to make yourself decent and off you trot.  EASY.

I bled after my smear, is that bad?

Firstly, I’m right there with you. You wouldn’t believe how quickly I jumped onto Google after finding blood in my knickers but its completely normal to experience a small amount of bleeding. Due to blood cells being close to the surface of the cervix and vagina and how tender both are, the light scraping sensation during a smear can sometimes cause a little spotting or a light pink discharge.  If you’re heavy bleeding or y’know, full on haemorrhaging, then seek professional advice but a little bit isn’t an issue.

How long will it take to get my results?

It usually takes around 2 weeks to receive your cervical screening results and you’ll either receive the results in the post or you will be contacted by your doctors surgery.  If you don’t hear with two weeks, don’t be afraid to give your surgery a call to chase them up and remember, no news is good news.

I have abnormal cells, do I have cervical cancer?

Not necessarily.  Smear tests are performed to detect pre-cancerous cells. If abnormal cells are found during your smear it doesn’t mean that you’ve tested positive for cervical cancer, cells can change back from being “abnormal” or “inadequate” to “normal” or “adequate” following treatment to prevent cancer from developing and can even change once left to their own devices. If your smear does come back as abnormal you’ll likely be invited back for further diagnostic tests which involving taking tissue samples to ascertain if cervical cancer is present. More than nine out of ten screening results are negative [1] and around one in 20 show low grade changes. For most women with low grade changes, the cells will go back to normal without treatment.

Will I have to have one every year now?

Nope. The frequency of your smears is assessed on an individual basis. For the majority of women, come the ripe old age of 25 you’ll be handed a pot of anti aging cream and a reminder to book in for your first smear test. Based on your results being “normal”, you should seek to attend every three years, if you need more regular visits you’ll be advised by your health professional.