‘I’m so sorry, I haven’t shaved my legs’.
‘I’m really embarrassed, I should have worn better underwear’.
These are things I often hear from patients when they come in for their smear tests. And every time I reply by saying that I really hadn’t noticed.
Because it’s the truth.
All I care about when carrying out your cervical screenings is that you’ve taken the time to come in and see me.
Smear tests are so important. They’re not designed primarily to detect cancer, but instead help to prevent it by identifying irregular cells and treating them before they turn into cancer.
According to Jo’s Trust, cervical screening uptake is at its lowest in decades, with around one in three people not attending when they’re invited.
Attending a smear test is your choice, and I understand why some people can feel a little apprehensive. But the test is quick and easy – usually around five to 10 minutes long – and there’s certainly nothing to be embarrassed about.
All women and people with a cervix are invited for smear tests from the ages of 25 to 65. You may get your first letter around six months before your 25th birthday, so it’s helpful to book your test as soon as it arrives.
Try to book your test around your period, avoiding it and maybe a couple of days either side as it may make the sample harder to analyse.
Cervical cancer symptoms
- Bleeding in between your periods
- Bleeding during or after sex
- Unusual discharge
- Pain in your lower back, pelvis or lower tummy area
- Pain while having sex
Find out more about symptoms and cervical cancer on the NHS website
For your first smear it’s totally normal to feel a little nervous. Don’t worry about doing anything to prepare beforehand, though – it’s not necessary.
Most smear tests are carried out by a female nurse or doctor and you can specifically ask for this, if you wish.
When you see us, after finding out a bit more about you, we’ll ask you to undress from the waist down behind a curtain and to cover yourself with a sheet that will already have been laid out on the examination table.
If you prefer, you can wear a skirt or dress and hitch this up. Or you can wear a long jumper which you can keep on during the exam.
If you’re feeling nervous, then let us know at any point, so that we can put you at ease and explain everything that it is we’re doing.
During the test, we’ll ask you to lie on your back with your knees bent and your feet together.
A speculum, which is a slim tube, will be inserted into your vagina to hold it open, with lots of lubricant. The size of the speculum will vary depending on the size of your body. If you’re feeling particularly nervous, then you can ask for a small speculum, but be aware we may need to use a larger one if we can’t get a good enough view.
As well as taking a small sample of cells with a swab, I will inspect the cervix, which is the opening to the womb from the vagina, to spot any possible abnormalities. This is a really important part of the exam.
If we can’t get a good enough view, then we may ask you to shift positions or to place your hands under your bottom to lift and tilt your cervix.
Some people find it helpful to do some deep breathing during the exam. This helps you to relax and shift your attention elsewhere. Having relaxed muscles also makes it easier for us to carry out the smear.
You might experience a little bit of bleeding afterwards, and this is totally normal
Once we’ve taken your smear from your cervix, we’ll send the sample for tests. The sample will be checked for certain types of the human papillomavirus (HPV), which can cause changes to the cells.
After your test, you’ll be free to carry on with your day as normal and you will receive your results by letter in a couple of weeks. Your letter will detail whether you need any further tests. If not, your next test will be in another three years’ time. When you reach the age of 49, the test switches to every five years.
You might experience a little bit of bleeding afterwards, and this is totally normal.
The bleeding should only be light and it should stop within a day or two. If you experience any bleeding in between your periods or after sex then it’s important you let us know at the time of your appointment, or speak to your doctor.
Likewise, if you experience any symptoms of cervical cancer in between smear tests then please don’t delay – speak to your doctor as soon as you can.
According to Cancer Research UK, there are around 3,200 new cervical cancer cases diagnosed each year.
At MyHealthcare Clinic in London, where I practice as a gynaecologist and obstetrician, I’ve heard many stories over the years from women about why they might have missed their appointments.
Sometimes it’s as simple as misplacing the reminder letters, or pushing it to the back of their minds.
Some people feel as if they’re too busy, or that they don’t need the test – maybe because they feel too embarrassed going for an intimate exam.
Having a smear test is your choice but please don’t ever let embarrassment put you off. Trust me, I don’t care about your knickers, or pubic hair – I’m just pleased you came to see me.
Smear tests remain one of the best ways to prevent cervical cancer so making the decision to attend your appointment really could save your life.
You can find out more about Dr Shree’s work on her website here or more information on the MyHealthcare Clinic website here.
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