This year I turned 25 and as such, I got invited to have my first smear test. I actually - apparently - got invited just before I turned 25 but the letter must have got lost in the post because I never received it. I ended up receiving a second letter a month after my birthday, at the end of July and I quickly went ahead and booked it in. As a midwife, I regularly tell women to make sure to attend their routine smear tests as part of their postnatal checks and I've always felt somewhat guilty telling them to do something, I never had, so I jumped at the opportunity to finally have my first screening.
What is it?
A smear test is short for cervical smear test. From Cancer Research, cervical screening is a way of preventing cancer. The cervix is part of the female reproductive system. It is the lowest part of the womb and is at the top of the vagina. It tests for a virus called high risk human papilloma virus (HPV). High risk HPV can cause cervical cells to become abnormal. Most cases of cervical cancer are linked to high risk HPV. Many younger women now have now had the three vaccine course for HPV. I myself was the first year it was approved for in the UK.
What happens?
A healthcare professional, usually a nurse, takes a sample of cells from the cervix using a small soft brush and then sends the sample to the laboratory. Within 2 weeks time, you'll get another letter in the post informing you of the results. If no high risk HPV is found, you will be invited again in 3 years time. If there is high risk HPV, the laboratory will test for cell changes. If there are, you will be invited for a colposcopy; if there are none, you will be invited for a repeat cervical screening in 1 year.
My Experience: Part 1
I ended up having two smear tests. At my first appointment, I had nurse, the specialist in the practice. I felt relatively calm prior to the appointment, considering I do something similar in my career and I had done my research. I ended up waiting for 40 minutes in the waiting room, getting more and more worked up and of course, nervous. I went to the toilet 3 times! By the time the nurse called me in, I was ready for it to be over. I was also meant to be meeting up with a friend shortly after.
They first ask questions about your demographics, your sexual activity and your medical history. Then you get undressed from the waist down and lie on a couch, with feet together and knees split apart. From there, the test usually takes a few minutes. They put in a speculum and then use a brush to take the sample.
I felt fine but I found the speculum being inserted very uncomfortable. She then switched this to a smaller speculum which worked much better. She said with this one that she could see the cervix and got me to cough multiple times, but as it was so posterior, she couldn't see the opening. She then switched to a third one which was the same size but much longer. I found this one much more uncomfortable and at this point I was of course, panicking a lot more. I started to feel tears welling up in the my eyes and just remember her keep saying "relax, just relax". I tried breathing exercises and tried to relax but at this point it was pretty much over. She said it was all the way in, but I was so tense, that she couldn't open it. Eventually, we both gave up and I got redressed having not been successful. She gave me a card to make another appointment and so I quickly escaped with embarrassment, made an appointment to see the doctor next time, and went to the toilet...
I sobbed for a good ten minutes. I felt like such a failure and I was so disappointed in myself. It hurt a lot during the procedure and it got more and more painful as time went on. Especially the last speculum, it felt like it caught the inside tissue and just clamped on it. Anyway, I cancelled plans with my friend and came straight home, and carried on sobbing for at least an hour. I ended up feeling so sick and just cried myself to sleep. It took a few days for me to get over myself, and it didn't help that I was told, if the next one failed, I'd have to be seen by the hospital and put under anaesthetic.
My Experience: Part 2
About a month later, I had my next appointment. It was the first appointment available pretty much and it was at the end of a busy clinic day. I ended up working 8 - 4pm instead of 9 - 5pm, as the appointment was at 5pm. I had a quick shower at work, and then headed to the appointment, wearing loose leggings. I think it actually worked in my favour that I'd been at work all day because it had kept me occupied and not thinking about what was to come. I also had shaved my legs and arms from the party the previous weekend, which made me feel more comfortable. Plus, I wasn't wearing makeup so I didn't feel claustrophobic in my mask.
The doctor came to get me 5 minutes before my appointment which was actually amazing and made me have even less time to worry about it. She was so lovely, and talked through my previous experience, plus we talked about midwifery stuff as well. Her couch actually had stirrups and I asked if I could use them straight away because I felt last time, that having to support my legs myself made me have more tension. She agreed and happily obliged.
When the speculum first went in, it hurt again. I asked her to go slow and she listened. She said that I have a lot of nerves in the opened so to do some stretches and exercises to try and make it more comfortable. She found the cervix fairly easily, but again it was quite posterior. This time, she took the speculum out and did a digit vaginal examination, walking the cervix forward, not dissimilar to how I would in midwifery. It was interesting to be in the reverse position. Then she stretched the opening on my vagina gently for a minute or so, before putting the speculum in. This time...success!
She put the little soft brush inside and took some samples of cells from the cervix. This was then put into a pot of liquid and sent to the laboratory. It was a strange sensation with the brush. The speculum going in was a little uncomfortable but not painful, once in position and opened, I didn't feel it at all. The sample taking wasn't what I expected at all. I expected it to be a little painful and feel like a scratch. Instead, it just felt like a heaviness. I had a few mini stomach cramps and then it was all done. I was just so happy it was a good experience and that the doctor spoke so softly and really did take her time.
My Results
A couple weeks later, I received my results and it was negative. I was so happy to see the results, and not have to undergo the smear test again just yet, but also felt comfortable if I did. Here's to another 3 years!
My Top Tips
Given both my negative and positive experience, I thought I would quickly share my top tips:
- If you're nervous, book an early appointment or be busy prior
- Shower before so you feel clean
- Although you don't need to shave, if you feel more comfortable, do it!
- Wear loose clothing
- Talk to the healthcare professional. Tell her when to go slow or even stop
- If you find sex painful or anything similar, warn the professional prior
- If you feel that you won't be able to support your legs yourself, ask for stirrups (this is something I will defintely be doing going forward)
Have you had your first smear test? How was your experience? What are your top tips?
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