I’m 32 years old. I was invited for my first smear test at 25, and again at 28. I didn’t actually go for my second one until I was 29, so three years later, here we are.
I’ve had several pelvic exams in my time, including smears, so at this point I’m not too phased by going. Of course that’s not the case for everyone, and whilst we all rally the cry of how important it is to go for our smear tests I understand that it isn’t as easy for cervix owner on the planet.
Smear tests past and present
I’m grateful that going for a smear test hasn’t ever posed problems for me. Truth be told, other pelvic examinations have been worse. Once I was in so much pain I cried at the hands of a trainee GP. “I’ve never made anyone cry before,” she murmured, slightly horrified. It wasn’t her fault, I was just experiencing severe vaginismus that made the examination about as easy as chewing on a brick.
Hopefully my mournful mewling didn’t put her off too much and she’s gone on to perform internal examinations with the joy and prosperity they deserve.
This time, I booked my smear pretty soon after getting the letter. My GP surgery have recently initiated a frankly infuriating e-consult service, meaning in order to book my appointment I had to navigate aimlessly around their shit website and different consultation options before realising that an ‘administrative query’ was the best way to book an appointment without going through my entire medical history. I requested to book an appointment and someone called me back the next day to book me in with a nurse during the following couple of weeks.
My smear appointment
Thrilling read so far, isn’t it? Obviously I’m choosing to write about this experience for a reason, but we’ll get to that. The day of my smear arrived and I toddled off down the road to my GP surgery. I made a morning appointment, not for any particular reason other than to set the day up nicely by having my vagina cranked open and my cervix prodded. Really gets you in a winning mindset.
I didn’t feel nervous. I knew what to expect and just wanted to get it out of the way so I didn’t have to think about it for another three years. The nurse called my name and in I went, sat down and faced the usual questions. She asked about sexual partners, contraception, that sort of thing. There wasn’t anything that made me feel uncomfortable, but again, everyone is different and some people might find the seemingly run of the mill questions a little intimidating.
Questions and explanations
Before I was examined she explained the process to me, even though I’ve had it before. I think that’s important. Medical practitioners do well to explain what’s happening and what’s going to happen rather than just assume everyone remembers the procedure or knows what on earth is going on. The nurse also offered me a chaperone which would be a female member of staff from the practice, but I declined. I’m not sure what the rules are on taking someone with you, but I think if you let them know beforehand it shouldn’t be a problem. Some people aren’t going to want to go through that without a trusted person by their side and that ought to be respected.
She asked me to get undressed from the waist down, hop on the bed and cover myself with a paper towel. I did this behind the curtain so my dignity remained intact, although if anyone would get stuck in their own trouser leg and fall spectacularly out of privacy and into full view it would certainly be me. Maybe next time. Again, if you don’t feel uncomfortable getting undressed then have someone with you or wear a long dress or skirt that can be pulled up rather than completely removed. Little things can make it easier, and there’s tons of information available about what to expect and what might make it a little more bearable if you’re worried.
The procedure itself
Once I was ready the nurse returned to perform the exam. Although she’d explained the procedure already she was sure to walk me through every step as it happened and let me know how things were likely to feel: cold when the lubricated speculum is first inserted, stretching when it’s opened up. She warned me before performing the actual test, where a small instrument (I know that sounds medieval, I just don’t know what to call it) is inserted into the cervix itself. It’s not something we usually have much to do with, so yes, it is uncomfortable. It’s over very quickly and once it’s removed the discomfort stopped straight away.
It’s not pleasant, of course it’s not. We don’t usually have to engage with our cervices, so having something popped in there, no matter how short the time, is uncomfortable. It’s plastic so you can feel it scraping the tissue away, but be reassured that it is extremely brief and the pain is minimal. I could see a little blood on the instrument as it was removed and put into a sealed tube to send off for testing, but it was only enough to make the once-white tip of whatever had just been rummaging in my cervix appear pink instead.
After the procedure
The nurse warned me that there may be some spotting after the examination but it should be minimal and there shouldn’t be any residual bleeding or pain. When I got my letter inviting me to book my smear it came with a leaflet about the process, but the nurse gave me another one at the appointment. Again, you can’t be too careful and I think reminders of what to expect after the appointment are just as important. There’s no guarantee that patients have kept the leaflets or that they’ll remember what’s being said to them during the appointment, particularly not if it’s been traumatic for them. Being able to digest the ‘what happens next’ at home when you’re comfortable makes for a far more reassuring experience.
The nurse told me where they sent the sample off to and how long it would be before I got my results. About two weeks, she said, but if I’d heard nothing in three weeks then it would be best to ring the surgery and double check. Relieved to be finished I left the surgery and didn’t give it another thought.
Two weeks after the appointment came and went and I heard nothing. Then, the day before exactly three weeks later, I received a letter in the post. From the timing and the heftiness of the envelope I knew what to expect; it was almost dead on three weeks and it felt like there was a leaflet enclosed.
A clear result wouldn’t warrant the inclusion of a leaflet, so I steeled myself to open the letter and find out what it said. The letter informed me that following my smear test the results showed that HPV was present in my sample as well as ‘abnormal’ cells. This meant that I needed another examination just to check on the cells and make sure that they’re not pre cancerous.
The follow up examination is called a colposcopy, and the leaflet enclosed told me a bit more about the process. Basically, it’s similar to a smear but instead of swabbing your cervix they use a colposcope (kind of like a microscope) to examine your cervix further and assess what’s going on. Nothing actually enters you or your cervix, although depending on what they find there could be more invasive follow up procedures.
A few days after this letter I got another one informing me when my appointment was with yet another leaflet enclosed. This one was a bit more detailed about any further procedures that might take place during the appointment; if there are abnormal cells they can often be removed there and then, and there may be a requirement to take a biopsy.
The appointment was a couple of weeks off, so I got on with my life and tried not to think about it too much. Although it’s intimidating, colposcopies are still pretty routine. It doesn’t mean you have, or are necessarily going to have, cancer. It means there have been some changes that need investigating in order to keep your cervix healthy. Even if they find more to investigate there are simple procedures to keep things healthy and regular monitoring to make sure it stays that way.
My smear showed some abnormal cell changes and the presence of HPV, so it made sense that they’d want to have a further look. It’s important to remember that sometimes an abnormal smear doesn’t mean anything at all; you could have a colposcopy that shows nothing out of the ordinary.
With this in mind I wasn’t hugely worried, but I’d be lying if I said I was looking forward to another internal examination. Despite protestations from NHS websites that a colposcopy is no more uncomfortable than a smear I’m here to tell you that in my case, that’s not true. It lasts longer. There is a degree of prodding and poking that is definitely more uncomfortable. Having a speculum lodged in you for a more extended period of time is going to be slightly painful.
I’ll briefly describe how the whole thing went down; it’s not too graphic so don’t worry, but it couldn’t hurt to know what to expect. I arrived (early, and accompanied by my friend and her seven month old baby). We waited for a bit until my name was called and off I went. The nurse led me to a room where the consultant sat me down and described the process.
She said that she’d examine me and take a biopsy if necessary. She told me what she was looking for (changes to cells, essentially) and that an iodine dye would be applied to my cervix to show the cells better. We went through my medical history briefly, but it was all very routine and I felt clear on what was going to happen. I was invited to change in a separate room and put a very attractive hospital gown on, which I did with absolute gusto.
Then, of course, the consultant needed the toilet so I was sitting in a chair half naked until she came back and stirruped me up. Putting your legs in stirrups is a pretty undignified thing and I’ve never had to do it for a smear test, but it’s not painful or anything. The doctor raised the chair up quite high so she was eye level with my business parts, and off we went.
So what actually happens?
Insert speculum: fine, but cold and uncomfortable when cranked open. Following said cranking was probably about five minutes of poking around but I can assure you it felt longer. She had a look for a while, then added the iodine dye. Then she said she wanted to take a biopsy as there was one area of cells that looked ‘a bit worse’ than the rest.
In order to take the biopsy I needed to have a local anaesthetic applied to my cervix. Oh, good. This resulted in more waiting around with my legs akimbo, but thankfully when she actually injected me I couldn’t feel it. I can’t imagine that a noticeable needle prick to the cervix is a pleasant experience. It might be because the discomfort from the speculum distracted me or she had a gentle hand, but I was relieved not to notice.
The anaesthetic is very fast acting so she could get on with the biopsy straight away. Now, whilst it felt uncomfortable being prodded and moved around, I am extremely glad I couldn’t feel the biopsy being taken. I saw what she used to take it, and frankly it looked like something you’d perhaps use to remove errant nails from bits of wood. It was grim. It’s called a punch biopsy, and essentially takes a small pinhead of flesh and… yeah. No need to know what’s going on there, thanks.
After the biopsy the nurse mentioned that they’d only got one sample, which the consultant said was fine. In my head, however, I immediately created a narrative where one sample was not fine and I’d need to go back for another. That’s just typical me jumping to worst case scenario, and it wasn’t actually anything to be concerned about.
After the procedure
Finally I was finished. The consultant explained that there may be some bleeding after the biopsy, and pleasingly, the occurrence of what was described as “gritty” discharge following the iodine application. I was invited to get dressed again and make use of the hospital-grade sanitary towels they had that was essentially like sticking a packet of pocket tissues to my knickers.
Once dressed, the consultant explained that the biopsy results can take up to two months to come back, so I just needed to crack on and wait for that. Depending on the results I may need to return for another procedure to remove any cells that were high grade abnormal, but that this procedure wouldn’t be much more than what I’d been through that day. She printed me off a letter summarising what had happened and what may happen next, and off I went.
Post-appointment I was a little uncomfortable for the rest of the day, and could feel aforementioned gritty discharge doing its thing. I was warned this could lurk around for a couple of days or even weeks, but thankfully after three or four days it was gone. Overall, whilst it wasn’t the most fun morning of my life it was relatively straightforward and yes, it was uncomfortable and a little painful but it’s done now and I’d rather have gone and got it over with than put it off.
The time frame
I’m impressed by how quickly it was all turned around, even though I’d been braced to wait months for the biopsy results. I went for my colposcopy at the beginning of March and actually received the biopsy results about three weeks later which I’m pleased to say showed the mildest grade of abnormality and required no further intervention. I’m due to go for another smear at the start of next year just to check up, and if that’s clear I’ll be back to three-yearly appointments.
It’s taken me since my smear in January to write the post because I wanted to be able to give a full update of the smear, colposcopy and the results. It’s worked out fine for me but to say it didn’t make me anxious would be a lie. My mind immediately jumped to the worst case scenario, even though all the information you get drills it into you how unlikely it is that you have or are going to have cancer.
Uncomfortable but important
The whole procedure is done to stop abnormal cells developing into anything worse, so the chances of anything being cancerous are miniscule. That’s not to say it doesn’t happen. It does. We know it does. That’s why they do smears and follow ups, and my advice would be to go as regularly as you can in order to get checked.
I’m lucky in that I have no trauma relating to anything in that area other than past painful medical experiences and vaginismus. It’s not enough to put me off going. There are far worse traumas and I completely understand why people wouldn’t want to go. I’d suggest phoning up your GP practice if you’re due a smear and asking what can be done to make it more comfortable for you.
Nobody enjoys it, and the level of discomfort at a smear varies for everyone. I found it to be fine, but I know from past personal experience that isn’t always the case. It can be nigh on excruciating never mind the mental anguish it can put you through. My wonderful friend Anneli has written about having a smear as a survivor of sexual abuse and I’d recommend you give that a read.
Why write about it?
This experience, whilst unpleasant, is important for me to write about. I don’t know anyone who’s had to go for a colposcopy so I was intimidated. My anxious brain finds a way to run off with things and plant dark thoughts at the back of my mind. I went to my smear alone but I’m really glad I took a friend to my colposcopy. I was ok afterwards and having a distraction for the rest of the day was great.
When I got home I curled up on the sofa and cried a bit just from the heavy experience and the potential weight of what was to come. I’d have liked it to have been over after the colposcopy – and sometimes it is – but I didn’t have to wait much longer for my reassurance in the end.
I know this is a little off topic for me, dedicated as I am to writing about my ridiculous brain. It’s important, though, and I wanted to put my experience out there as a reassurance that it’s survivable and that hey, now you know someone who’s been through it. Anyone who has any questions can get in touch with me any time and I’m happy to try to help. Cervical screening is important and it saves lives. Yes, it sucks, it hurts and it’s weird and scary. I’d rather go through that discomfort than the alternative.
Be safe out there. Keep yourselves well and do what you have to do.