With my 25th birthday approaching I knew what was coming – my first smear test. It’s not really something that I had ever given much thought but in the days leading up to it, I was dreading it. I spoke to my female relatives about what to expect and also did a bit of research and to be honest, I couldn’t believe how much misinformation or just lack of information that was out there. I want all vagina/cervix owning people to feel confident about going for their smear tests (also known as a cervical screening), knowing what it’s for, what to expect and what the results mean so here’s everything you need to know about getting your smear test.
How do I know when it’s time? You will get a letter in the post just before your 25th birthday to let you know to book your smear test. If you forget you will get another letter…and another. My initial appointment got cancelled so my GP practice made sure to send me a few to remind me to rebook. After your first ever test you will be invited back, once again by letter, in 1-5 years, depending on your results.
What are they testing for? The cervical screening test is to check to Human Papillomavirus (HPV) which can cause changes to your cervix. If HPV is not found during your smear test you won’t need any further testing. If it is found you might need further tests to check the changes in cells and possibly remove them before they get the chance to develop into cervical cancer. Did you know that everyone (including men) is likely to get HPV at some point in their life? HPV can affect the mouth, throat and genitals and can be spread through oral, vaginal and anal sex, through sex toys and any skin to skin contact of the genital area. It is very common and usually your body usually fights it off within two years. You may not show any symptoms if you have it but some people may develop genital warts. High risk types of HPV can develop into different type of cancer. There is a vaccine which protects against most types of HPV including the ones that cause genital warts and cancer but it doesn’t protest against all types of HPV – more information about the vaccine is available on the NHS website.
What actually happens at your smear test?
- You will go to your appointment just like any other doctors appointment and wait to be called or for your name to appear on one of those electronic screens.
- I’d recommend wearing a dress or a long top as you feel a bit less exposed.
- Once called in, your nurse (usually a woman) will explain to you what’s going to happen and ask you if you have any questions.
- You will then go behind a curtain and get undressed from the waist down, get on the bed and put the paper blanket over your waist.
- The test usually lasts about 5 minutes and is relatively quick.
- You will light back with your knees bent and feet apart.
- The nurse will then enter a small tube shaped speculum inside your vagina and they may use some lubricant to help.
- They will then open the speculum so that they can see your cervix.
- You may be asked to change position a few times or lift your hips with a pillow if they can’t see your cervix.
- Once they can see your cervix, they will insert a small soft brush to take a sample of cells from your cervix.
- They will then close and remove the speculum.
- You’re all done and free to get dressed.
- Your nurse will make sure your personal information is all correct and may ask some questions and will also let you know what happens next.
What does the test feel like? Most people explain it as a feeling of discomfort. I would agree that it does feel uncomfortable and possibly like a small nipping feeling but it shouldn’t be painful. I had to have the speculum put in and opened and removed 3 times until the nurse could see my cervix so this made it a bit more uncomfortable. If it does feel painful, you can ask the nurse to stop or even to use a smaller speculum. Remember, you don’t need to feel embarrassed or pressured at any point and talk to the nurse if you have an issues or worries. The screening is to protect your health so you have the right to ensure you feel as comfortable as possible.
After the test. You may experience some light bleeding after the test. If you experience any heavy bleeding or bleeding that does not stop after a few hours you should call your GP as soon as possible. I made sure to get myself some nice treats for afterwards and made sure I had nothing planned so that I could just chill out.
When to expect the results. Your nurse will tell you when to expect your results. The waiting time is usually around 14 days but they will let you know if there are any delays in the process. You will receive your results by letter. If you don’t receive your results within the expected time frame, call your GP to see why they have been delayed. Delays do not mean anything bad!
What your results mean. There are a few potential results that you could receive.
- If your letter says ‘inadequate result’ this just means that the results were unclear so you will need to have another screening, usually within 3 months. This doesn’t mean that there was anything wrong.
- ‘Human papillomavirus (HPV) is not found in your sample’ means that you tested negative for HPV and therefore your chances of getting cervical cancer are low and do not require any further testing for abnormal cells. You will be invited for your next test in 3-5 years.
- If HPV is found in your sample with no abnormal cells you will be invited for another screening in 1 year and again in 2 years if you still have HPV. If after 3 years you still have HPV you will be asked to go for a colposcopy.
- If HPV is found in your sample with abnormal cells you will be asked to go for a colposcopy.
- If you are asked to go for a colposcopy they will have another look at your cervix but in a hospital. They will check to confirm whether your cells are abnormal and if they are, they might remove them to reduce your risk of getting cervical cancer. If you’re asked to go for a colposcopy, try not to worry as it doesn’t mean that there’s anything seriously wrong.
Some additional information:
- Help for people with learning disabilities is available. The government have an easy to read guide for people with learning disabilities who need to have a cervical screening and is available here. The charity, Jo’s Trust also have an excellent guide for those with learning disabilities with images and diagrams to help in addition to an easy read booklet.
- If you’re trans or non-binary and not registered as female with your GP you may not be invited for a screening. The Government website has guidance on cervical screening for trans and non-binary people . If you have a cervix and haven’t been invited for your cervical screening, give your GP practice a call as you should be able to book it directly with them and ask them to send you reminders.
- There is a misconception that lesbian women do not require a cervical screening but this is not true and anyone with a cervix should get a smear test. Once again, the government have some information for lesbian and bisexual women.
- If you have any form of vulval pain, such as vaginismus, the Vulval Pain Society have an excellent guide on how to make the smear test work best for you.
- If you have experienced sexual violence and are worried about your cervical screening, have a look at the My Body Back webpage as they specialise in cervical screening, contraceptive care, STI testing and maternity care for people who’ve experienced sexual violence. Jo’s Trust also have some helpful guidance.
If you want further information, I would really recommend checking out the Jo’s Trust website – they are the UK’s leading cervical cancer charity. They have a great deal of information regarding everything to do with smear tests, HPV cervical cancer etc in addition to advice for trans and non-binary people. They also have an excellent support network in the form of forums, helplines and online forms where you can ask the community and medical professionals any questions you may have.