What happens when you go for a smear?

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I wanted to write a post about what happens when you go for a smear (Pap) test. A smear test doesn’t test for cancer, it’s a test to prevent cancer.

In 2018/2019 28.1 per cent of eligible women didn’t go for their smear.

I get it, I do understand why women aren’t going for their smear tests. You’re too busy. You can’t get time off work. You forget you need to book it. You’re embarrassed to flash your bits at a stranger. You fear the smear.

Even with the number of people who have looked at, prodded, poked, and swabbed my intimate area, I was scared the first time I went for my smear. I had no idea what to expect but I knew I had to go because I’ve already got something wrong with my bits. I wanted to make sure there wasn’t anything else wrong with them.

The thing is, all of those reasons for not going for your smear test are kind of silly when you think about it. For a couple of minutes of discomfort, you’re getting screened and it could potentially save your life.

Here in the UK, you’re invited to attend a cervical screening appointment once you turn 25 years old. It’s usually done by a nurse or a doctor at your GP practice.

Once you’ve booked your appointment, you can do whatever ablutions you feel are necessary to your nether regions before you go. If you don’t want to do anything to your nether regions, you’re not forced to either. The nurse isn’t going to remember you as the woman with the unkempt bush. At my last smear, the nurse did say I have a lovely cervix. It was nice of her to say and the most random compliment I’ve ever received.

This one thing is a biggie though. DO NOT HAVE SEX FOR 24 HOURS BEFORE YOUR SMEAR!! The chemicals in spermicide, lubricating jelly, and condoms can affect the smear test.

The other biggie is to make sure when you book your smear you won’t be on your period that day. The ideal time for a smear is in the middle of your cycle.

The NHS has some dos and don’ts listed on their website to help you feel more comfortable when you go for your smear.

  • Wear something you can keep on during the test like a skirt or a long top.
  • Bring someone with you for moral support.
  • Use breathing exercises to help you relax.
  • Ask the nurse to use a smaller speculum.
  • Ask the nurse if you can lay in a different position.
  • Bring something to distract you while you’re having your smear such as a book or music.
  • Feel pressure to keep going with the smear. Say something if it’s causing you pain.
  • Don’t be afraid or embarrassed, talk to your nurse and let them know how you feel.

At the appointment itself, you’ll usually get asked a few questions before the smear itself. Usually, the questions are along the lines of:

  • When did you last have a period?
  • When did you last have sex?
  • Is there a chance you could be pregnant?

If you’ve had issues with an internal examination before, it’s worth mentioning it to the nurse at this point. Personally, it hurts if anything is pressed against my cervix and I’ve also had issues where the hospital used a speculum which was too big and it hurt. A lot.

Once you’ve answered those questions, the nurse will tell you to go behind the curtain, remove any clothes from the waist down that you need to, and to lie on the bed. They’ll give you a sheet to cover yourself with.

After you’ve gotten as comfortable as you can, the nurse will then tell you to bring your heels up to your bottom, and open your legs.

The nurse will then get a speculum and apply lubricant to it. Speculums come in different sizes and depending on your Primary Care Trust, they’ll either be made of metal (reusable) or plastic (disposable). Most nurses are kind enough to warm the speculum up before putting it anywhere near you so it won’t be too cold when it goes in.

Metal Speculum
Metal Speculum
Plastic Speculum
Plastic Speculum

Once the speculum has been inserted, the nurse will open up the blades to be able to properly see your cervix. I had no idea they were called blades until I wrote this post. You’d think with them going into such an intimate area, they’d come up with a more friendly name.

At this point, the nurse will get the small, soft brush used to collect the cells from your cervix, pop it up there, collect the cells, and remove the brush.

Soft brush to collect cervical cells
Soft brush to collect cervical cells

Once the nurse has collected the cells, she’ll close the speculum, remove it, and give you some privacy to get dressed.

The nurse will then pop the brush into a pot, label it with your information, and it’ll go for testing at the lab.

The smear test itself takes a couple of minutes to do. I find the getting undressed and dressed again the longest part.

After your smear test, you can go about your day as usual. You may have some light bleeding afterwards. If you have heavy bleeding or severe pain after your smear test, contact your GP.

In my experience, it has always been a female nurse who does my smear test. There aren’t currently any male nurses at my doctors surgery. There is a chance you could get a male nurse or doctor doing your smear. If you’re uncomfortable with that, ask for a female nurse or doctor or ask for a chaperone.

I hope for those of you who haven’t had a smear, this post has given you some insight into what happens. If you’ve been putting off your smear because you’re unsure, please don’t be afraid. 

From this year (2020), all smear tests will also be screening for HPV (Human Papilloma Virus). You may have already had a smear which screens for HPV as they’ve already been rolling it out throughout the country. I’ll be sharing a post about HPV later this week.

Lis x





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