1. It’s nagging at you
How many NHS letters have you had by now, woman?! If you’re anything like me (from my 25th birthday onwards I managed to deliberately ignore the four letters in rapid succession), then it’s time to suck it up and book. Don’t try to tell me it hasn’t been playing on your mind since that very first letter. Free yourself of that nagging feeling, already.
NB: Remember the appointment has to be mid-cycle, i.e. two weeks after your last period. So make a note of yours beforehand so the receptionist doesn’t have to sit on the other end of the line, waiting as you mutter, “Well, I think I started irrationally crying at Crufts on Friday and I had to ask a stranger for a tampon in the looks at Nando’s Saturday so it must be…”2. It takes 5 minutes
and that’s not even five minutes of doctor-vagina contact. That includes going in the nurse’s room, getting undressed and redressed as well as the speculum up your nunny. The speculum part is about 45 seconds to a minute, max.3. It isn’t painful
Honestly, vagina stuff tends to make me squeamish (as in, I’m a bit nervous of super-super sized tampons and other people’s camel toes make me physically flinch, if only in frontal-wedgie pain empathy), so I hear you. But if you’ve not had it before and are scared – don’t be. You can request the smallest speculum if you are anxious, and remember to breathe deeply. They cover the speculum in lube, so it glides in very easily (a bit chilly, admittedly!) and when it is widened, to allow the swab – you feel it only very slightly. I have had a few now and it’s never been worse than the mildest discomfort, a feeling similar to period pain – and now I’m used to them, it’s a breeze. Also, FYI, taking two paracetamol beforehand really can help.
4. It isn’t embarrassing
People are a bit embarrassed about a doctor seeing their bits. But to a doctor, it’s just another part of the anatomy. Have you ever seen Dr Christian Jessen flinch at vagina? OF COURSE NOT. If he can maintain his steely-yet-affable composure in the face of all those Embarrassing Bodies close-ups of weeping boils and foot mushrooms, then he can look at your flange, too. The same is true of the rest of the medical establishment. And just think – medical professionals are adequately recompensed in the form of a paycheque5.It’s bloody FREE
The NHS is a wondrous thing. Many other places charge quite a lot of dollah to have a virtual stranger insert curiously shaped implements up one’s privates. Add onto this the fact that, if cells are abnormal, they also check for the Human Papilloma Virus, you’re actually getting two for the price of one…free! In countries where cervical screening is not free, it is still a common cause of cancer-related death. We are very lucky.
NB: The Human Papilloma Virus, or HPV for short, is a virus which lives in moist areas of your body – mouth, anus, cervix, throat. There are over 100 types, 40 of which can affect the genitals. Some types can cause abnormal tissue growth (mainly HPV16 and HPV 18), which can lead to cervical cancer, though the body’s immune system tends to sort it out. You can read more about it here.6. If your results are clear, you won’t need another one for three years
NB: The Human Papilloma Virus, or HPV for short, is a virus which lives in moist areas of your body – mouth, anus, cervix, throat. There are over 100 types, 40 of which can affect the genitals. Some types can cause abnormal tissue growth (mainly HPV16 and HPV 18), which can lead to cervical cancer, though the body’s immune system tends to sort it out. You can read more about it here.6. If your results are clear, you won’t need another one for three years
Which means the sooner you get book it, the sooner you’re quite possibly done for ages. And results are clear for 19 out of 20 cases.
7. It’s to help you prevent cervical cancer.
7. It’s to help you prevent cervical cancer.
Seems like a no-brainer but I know that for me, and plenty of other girls, the need for a smear starts your brain racing in scary directions – especially “will I have cancer?” So, for some bizarre reason, we put off the test, or don’t even have it, so that we don’t have to risk hearing that sort of news. But the test is predominantly to help doctors detect pre-cancerous cells, therefore prevent cervical cancer (this Hairpin article explains pre-cancerous cervical cells better than we ever could). So take your head out the sand and book your appointment, pronto.
8. In many cases, the cells go back to normal on their own.
OK, so, like me, you may be one of the 1 in 20 people who have ‘abnormal’ results. For me, they were borderline abnormal, which means I had to have a smear test every 6 months, which I did thrice. I’m waiting on the results of my third one. They have all come back as normal so far, meaning that the cells in my cervix seem to have sorted themselves out, but it’s important (not to mention comforting) that they keep checking.
9. You may need treatment, but it is almost always 100% successful.
9. You may need treatment, but it is almost always 100% successful.
Two of my friends have needed a colposcopy after irregular results (see this post on my own Vagina Panic here- Ed). This is where the doctor makes a more lengthy examination of your cervix, and may take a biopsy, and maybe even treat the cells there and then. There are loads of ways they may do this – one of my friends has had LLETZ (a heated loop of wire removes abnormal cells) and one has had laser, but you can check out the NHS website for a detailed account of all the treatments available. I’m being honestly here – neither girl enjoyed the procedure, but said it wasn’t awful, it was over quickly, and it meant they were free of the abnormal cells. The worst part was probably no sex for a month.
10. You’re a feminist
And therefore you believe us women should be helping one another, especially by TALKING ABOUT THIS SHIT. And this starts with helping yourself, so be strong and wise and book your smear test, like, now.
- RP
FYI there are a few link issues in this article. The url of the link that’s supposed to tell you more about HPV is “here.”, and there’s no link at all to the editor’s article on her vagina panic. I hope that I’ve been helpful!
I don’t want to put anyone off but I have to be honest and say that a couple of my tests really did hurt – in fact one hurt so much I had to leave (in tears) before the crucial bit so had to make another appointment. The nurse just kept yelling at me to relax – I think this didn’t help. It is a lot about the person doing it and how relaxed they make you feel as I’ve had other tests where I said, oh, is that it? I have also given birth twice at home – once with gas and air, once without so I can handle a bit of pain but even after childbirth I was dreading my next smear! However I’m happy to report that that was one of the good ones – I think the breathing I’d used in labour helped
The one time I had a smear done it couldn’t be finished – even with the smallest size speculum – because it was unbearably painful. So it’s very much YMMV with saying whether it’ll hurt or not.
one of the best things about the NHS – not a passive organisation but one that forces us to pay attention to our health and the main risks for our gender and age group.
I had an abnormal smear and a biopsy recently, which turned out to be ok, but i was so reassured that if there was any developing problem they were going to catch it before it could do anything. Amazing.
If you’re worried about your smear and nervous of how it’ll feel, a couple of paracetemol will help before. Learn some deep breaths, yoga style, remember how crucial it is to get one, and try and rationalise it – I was so nervous before my first one, but I also did think…”well it’ll be smaller than a willy.”
-RP
Only a month ago I would have completely agreed with everything above without question. Recently I read some Germaine Greer and now I’m chewing this issue over. I disagree with quite a bit of what she writes – her chapter on transwomen ‘imposters’ had me flinging her book against the wall in a fit of rage – but some other stuff is giving me food for thought. I was intrigued by a point she made about how women are herded through the medical system like sheep, how the tiny chances of finding a real problem are massively outweighed by the culture of fear created around constant tests and temporary abnormal results, and how it’s a form of control over women’s lives.
I’m not sure what I think about this yet. At first I thought it was a pretty strange stance for a feminist to take, to be against women’s healthcare procedures. But then, where ARE the letters nagging men to come in every three years to get their testes and prostate checked? Men are left to their own devices, on the assumption they’re responsible enough to make their own decision about whether they ought to book a checkup. The gardasil jab being given only to girls and not to boys is a perfect modern example too.
Is it that the NHS is serving women well and neglecting men’s health? Is this an example of how patriarchy can sometimes hurt men too? Or is it more about a cultural attitude of women needing to be ‘taken care of’ (ie managed, controlled) in a way that men have the unquestioned right to be free from?
I’d be interested to hear thoughts on this from fellow ladybros as it’s kind of bending my mind around at the moment. The good news is, I got my first smear six months ago, so I have another couple of years and more to form a solid opinion on the subject!
I can’t really comment on the feminist curveball that Germaine Greer seems to have thrown at you however, having been having smears since I was 16 (I’m nearly 40) I can honestly say that I do find them reassuring. Three years ago I was told for the first time in 10 years that I could go back to 3 yearly tests rather than annual due to multiple abnormal results. Irrespective of the difference between how the NHS treats men and women, I would recommend every woman has one done within the schedule offered by the NHS. One point though to explain why we have things shoved up our bits to check us out, men’s testicles are outside the body and are easily checked by them as we check our breasts and with regards to their prostates, they get other symptoms with that too. With cervical cell changes, from the minor to full blown cancer women don’t tend to get any other symptoms until it’s too late to save us.
Hi. I think that smears are done partly because they are very successful at picking things up before they have become a problem and also because, once the dodgy cells are known about there is a very effective treatment available that prevents them even turning into cancer. Also as we don’t tend to look at our cervices I would imagine that before smear tests people found out that they had cancer when it had already spread. There is no effective screening test for prostate or testicular cancer yet (but work is being done) and testicular cancer is obviously easier to find – if the men make it to the doctor that is…
I actually don’t think that this is a patriarchy thing at – more matriarchal in some ways as women are very proactive about spreading the word, discussing health issues and putting them on the agenda (of the NHS etc) – the massive amount of money and research into breast cancer shows this. Men (and actually older people too) need more spokespeople and more events like movember to help highlight their health needs.
Check out Margaret McCartney on this topic! http://www.margaretmccartney.com/blog/?p=1696
I think sometimes things really have nothing to do with gender, or gender equality! On a cellular level, the cervix is such an active place anyway, it takes much less to tip the cells into misbehaving than other parts of the body, and young men don’t have an equivalent area of their body, I’m sure if they did, they would be nagged just as much for check ups!
I really feel very strongly that people should go for smears if they can, and if they choose not to go, it should be because they do not agree with screening itself, not because they feel they are only being asked to go because the NHS are a sexist organisation and think women cannot make appointments themselves! Cervical cancer is a massive health burden across the world, and we are so so lucky that here we have the resources to screen for and prevent progression of CIN into cancer, and for free! ( sorry this is ranting but it’s something I’m very interested in and feel strongly about!)
Kate- assuming you are in your 20s too, we are in the high risk group for cervical cancer. The highest risk group for prostate cancer is men over 50. I wouldn’t equate testes with cervixes as they can be self-checked (like boobs). Also both sexes get bowel cancer screening once they’re over the age of 50 (in Scotland). Much as I love GG, I’d be pretty bloody outraged if screening programmes ignored young women like us!
I think the thing with cervical cancer is that it happens at a young age, it has no particular cause that can be attributed to lifestyle (as opposed to lung cancer etc) so it’s quite random, the incidence rate in young women is increasing, and crucially, it is totally curable if caught early. Testicular cancer is remarkably rare considering the publicity behind it (presumably supported by the fact it is quite easily treated). Prostate cancer is a more tricky one as many men have some sort of prostate problem as they get older, and it is also much harder to treat (as I understand). But I imagine the main reason we are nagged to get our smears is that 3-yearly smears and possibly colposcopys etc for the entire female population are vastly cheaper than cancer treatment for an unlucky few thousand.
As for the gardasil jab, yes, ideally we should be giving any available vaccine to the whole population, especially as it prevents a vast majority of genital warts too. However, firstly genital warts are not a major concern in this country, and secondly I’m not sure that HPV affects men, so if all women get vaccinated then there’s no point in doing the guys too? Again I imagine this all comes down to cost, and if you had a son and a daughter and could only vaccinate one, you would probably vaccinate your daughter because you would want her to be protected from other people who didn’t get vaccinated.
Does anybody know if you’re meant to receive a reminder for anything other than the very first test? I got one for my first one, but reading this has just reminded me that that was three years ago so I must be due for another.
Like a few others, I found my first test to be pretty painful. Didn’t help that I was just having a more “dry” day, and I think I tensed up a lot due to nerves. Never had any issues with sex (even the first time), and would have thought that my feminist-awesomeness and rationality would have kept me calm and pleased to be having it, but I was for some reason nervous as hell. Next time I’ll definitely do a better job of reminding myself how important it is and how lucky I am to be getting it for the second time at 23 (based in Scotland).
Something I learned: if the nurse asks if you’ve had your children “yet”, it’s fine to get all angry and say you didn’t realise kids were compulsory, but wait until *after* she’s taken the speculum out…
Oh, and as regards the HPV vaccine and males: my understanding is that men *can* get HPV-cancer in the anus, so offering to vaccinate boys opens a whole can of worms because the only ones in need of the protection are those who are gay – and lots of parents don’t want to think about that.
I am the only person looking forward to a smear? I’m 24 at the moment, been sexually active for a few years (though not had many partners yet) but of course i want to know i’m all healthy down there. If it hurts, it hurts, i’ll get over it i’m a big girl but my health is the most important thing in the world. (Yes I get regular STI checks as well)
Just a heads up in terms of lifestyle factors; smoking doubles your risk of cervical cancer. It disables your immune system so you can’t prevent the HPV altering your cells’ DNA, leading to cancer. Possibly a more compelling reason to quit than the spectre of lung cancer 40 years down the line…
Does anyone know if it’s easy to get a smear test if you’re younger than 25 (I’m 19)? In England, that is.