Smear Fear: What To Expect At Your Cervical Screening

So you’ve had the dreaded letter inviting you to your cervical screening exam? Never fear! Whether it’s been a few years since your last exam, or you’re brand new to this medical encounter, we’re breaking down exactly what you can expect at a cervical screening exam. Let’s get to it!

What is a smear test?

Cervical screening, otherwise known as a smear test, is a short exam which checks the health of your cervix. It’s nothing to worry about, but many women put off going for years due to fear of pain, embarrassment, or because they don’t feel it necessary. It is important that you DO NOT avoid your cervical screening exam for any reason. The test is a preventative measure to catch any signs of cervical cancer as early as possible, and anyone with a cervix in the UK should get regular smear tests from age 25 onwards. 

What are they looking for?

The nurse or doctor conducting your test will have a close look at your cervix and take a small sample of cells from your cervix to check for a virus called human papillomavirus (HPV).

What’s HPV?

HPV is the name for a very common group of viruses. Nearly all cervical cancers are caused by infection from certain types of HPV, so your smear test helps identify if this bug is present or not.

You can get HPV from a sexual partner from any kind of contact with the genital area, not just from penetrative sex, and most people will get some type of HPV during their lives, so don’t worry if you are found to have this.

If you do have HPV present, the cells will be examined under a microscope to check there are no cancerous or precancerous changes caused by this bug.

What happens at the appointment?

Cervical screening exams are usually done by a female nurse or doctor, but if not, remember you can request a female doctor at any time, to make you feel more comfortable. They can answer any questions you have before they begin. If you want to see what happens during a test,this short animation on the NHS website is helpful.

You might be asked a few questions; for example if you are sexually active, where you are in your menstrual cycle, if you are using any contraception or hormone therapies, and if you have any symptoms such as unusual bleeding or pain. You might be offered testing for sexually transmitted infections at this appointment.

Firstly, you’ll be asked to undress from the waist down behind a screen. This may feel a bit awkward, but you'll be given a sheet to put over you.

Next, you’ll lie back on a bed, usually with your legs bent, and your knees apart. In some cases you may be asked to place your legs into stirrups. Being so exposed can feel uncomfortable, but try to remember that your nurse will have seen many, many vaginas before yours!

They will insert a tube-shaped tool called a speculum into your vagina, using a small amount of lubricant to allow it to slide in easily. When they open the speculum, it feels a bit stretchy, as the speculum is wider than a tampon, but shouldn’t be painful. If you do feel pain here, let your nurse or doctor know, they might be able to use a smaller speculum size.

Once the speculum is inserted, the doctor or nurse might need to wiggle it a little to bring your cervix into view. They will take a good look at the cervix, making sure everything looks healthy. A small sample of cells will be taken from your cervix using a soft brush. Though the instrument used is soft to the touch, the very act of anything touching your cervix can feel unpleasant, so you may wish to take some deep breaths during this part, which should only take a few seconds at most.

Remember: You can ask the nurse to stop at any time if you feel uncomfortable or experience any pain, and begin again when you feel more relaxed.

Once the sample of cells have been collected, the speculum is removed and you are free! You will probably be given some tissue to wipe away any remaining lubricant, and then you can re-dress behind the screen.

Some things you may want to do before and during the test to make it easier:

• Wear something long that can be pulled up, such as a skirt or a long top
• Bring along a friend or partner who can put your mind at ease
• Practice some breathing exercises you can use during the test
• Bring something to read or listen to, to take your mind off of what’s going on
• Don’t be afraid to tell the nurse if you feel embarrassed, as they are usually very understanding and will help you through the process

How to prepare for your smear test

A lot of people like to have a shower or bath before their test to help them feel less embarrassed, but don't feel like you need to go mad down there and definitely don't use anything more than water and unscented soap. Wear clothes that are quick and easy to take off and on, especially below the waist (leave the cute jumpsuit for another day). It's recommended to avoid going for a smear test when you're on your period as it can interfere with the results, so if your bleed surprises you, just ask to rearrange. For similar reasons, avoid having penetrative sex for 24 hours before your test if you're using spermicides, barrier contraception like a condom of diaphragm, or any lubricants.

What happens after the test?

The hard part is over! You may experience some gentle cramping and light spotting in the hours after your cervical screening test. This is very normal and nothing to worry about. If the bleeding becomes heavy, speak to your GP to make sure everything is as it should be.

Normally you will receive the results of your test via letter around 2 weeks after your appointment. These can sometimes take longer to get to you, so don’t worry if this happens. If you have any concerns, call your GP.

How often should you get a smear test?

Regularity of appointments depends on your age and where you live. In England, the typical schedule is

• First smear test: around the age of 25, you may be invited up to 6 months before you turn 25
• 25–50: every 3 years
• 5: every 5 years
• 64+: screening by invite, only if one of your last 3 tests was abnormal

You may be asked to attend more often if HPV is found, or if you have required treatment to your cervix in the past. Let’s face it, nobody enjoys a cervical screening test! They can feel embarrassing, invasive, and very uncomfortable, but they are necessary. Your health is important, and the benefits of catching any abnormal cells early far, far outweigh the small inconvenience of a cervical screening exam. 

Even if you feel you have waited too long after being invited to book your screening, know that it’s never too late. If you are in any doubt, call your GP to find out when you should next be seen.

Do you have an upcoming cervical screening exam? Worried about what’s in store? Chat to us in our private Facebook group or drop us a note on Insta @itsyoppie. Don't forget that our personalised period subscription box can get organic tampons, pads, liners (and more) delivered easily and regularly through your letterbox. That's one less thing to get stressed about, at least.

Fact checked by Doctor Samantha Miller.