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Here at SASH, being a sexual health support and advice service, we have a lot of information and even resources on cervical screenings (also known as smear tests or pap smear). We can even offer chaperoning, and you can have a member of the SASH team accompany you to your appointments (as well as other sexual health related appointments), so you have somebody fluent in sexual health to support you and advocate for your sexual health.
We’re joining the #LetsTalkScreening conversation, sharing actual experiences from ours and our partner’s employees about their cervical screening experiences.
My First Cervical Screening
by Áine, an employee at SASH
“My first cervical screening occurred a couple of weeks after I had gotten my IUS inserted. It was a super quick procedure, and I only felt slight discomfort as the nurse positioned the speculum, but no pain at all! The nurse was also super helpful to answer any questions I had, and made sure to be clear about the steps of the procedure. I got a letter in the post a couple of weeks later stating that the results were all clear. Overall, it was a super positive experience."
I'm not sure if this is offered to everybody, but one of my friends stated that during her IUS insertion, the doctor saw on her record that she was a due a cervical screening, and offered to do it during her IUS procedure. This made my friend happy, as it saved her having to book more time off work and minimized the discomfort to one procedure.”
The Importance of the Smear Test
by Anonymous, an employee at Turning Point
I was in my early 20s when my regular smear test showed I needed some preventative treatment. So I learnt, while still quite young, of the importance of smear tests and I’ve taken up every smear test I have been offered since – all of them have come back without issue. Yes, they aren’t nice, I’ve had differing experiences, no two are the same, but I’ve had a normal, happy, healthy life and two wonderful children – it could’ve been very different.
Legs Akimbo in the Air
by Charlotte, an employee at Turning Point
At my first smear test I was asked if a student nurse could do the procedure. It took about ten minutes of being sat legs akimbo in the air while she learnt what to do.
I was therefore very pleasantly surprised at subsequent tests at how quick, easy, and pain free it was! Takes about two minutes. Absolutely nothing to worry or be embarrassed about. They’ve seen it all before!
Into the Unknown of Cervical Screenings
by Anonymous, an employee at SASH
I received my first smear test letter in 2003 whilst I was at university. I had just turned 20 and I felt an immediate dread and fear I remember clearly sat on the stairs of my shared house and feeling panic. Growing up I hadn't had any conversations on what to expect - sex and sexual health were not subjects that were ever discussed, I also never received any reproductive health lessons at school.
I had just gotten my head around booking the appointment when I received another letter to say that I no longer needed to attend - the age had been changed to 25. At the time I felt elated - I didn't appreciate at the time the importance of having a smear. Skip forward a few years to 2008 and I am living in London - my first smear was absolutely fine. I felt pretty relaxed as the nurse did a great job in settling my nerves.
But that was the start of my adventures in the joys of the speculum as my first smear test results showed that I had abnormal cells. This led to a colposcopy discovering grade 3 CIN (cervical intraepithelial neoplasia) and followed by years of different treatments (including LLETZ and cone biopsies) and so many tests and retests. My first "normal" smear test came back in 2013 it was such a relief.
Looking back to that time now I realise how little I understood about what was going on with my body. I was given the same leaflet every time that explained using complicated medical terminology the procedures, but I was never offered information on services that might be able to give me support on an emotional level. This led me to believe at the time that this was just something that I should be able to without complaint or support. Sitting here today I am so glad that I pushed myself to go for my first smear even though I was absolutely bricking it - had I put it off my abnormal cells probably would have progressed to cervical cancer. It has also made me appreciate the importance and benefits that peer support can have for people going through this process. If I had been given the opportunity to speak to someone who had gone through something similar it would have given me the chance to ask questions that I didn't feel that I could ask a medical professional.
What Not to Do
by Leah, an employee at SASH and Young Hounslow Sexual Health
I won’t lie, my first cervical screening was fine, but the aftermath wasn’t fun.
I received my letter for my first one during the COVID-19 pandemic lockdown at 24 years old, for when I turned 25 in May 2022. However due to life events, mental health and genuinely thinking I didn’t need to go, I put it off right up until November 2022. By this time, I was working as the Marketing Coordinator for SASH, so of course I filmed my reaction to getting it done (you can find my reaction on our Tik Tok and Instagram accounts @wearesashlondon).
I’d never had a procedure or test like this done before in this area of my body, the closest thing being a vaginal swab test from the SHL STI kits you can do yourself at home. Plus, being a bigger person, sometimes getting on those examination chairs/tables can be awkward, I have irrational fears that I’m going to break something, or that having thick thighs I’m thinking ‘will the doctor even have enough room?’- clearly I was nervous, even if I didn’t seem it!
You’ll be pleased and relieved to know that of course, nothing broke during the procedure, and obviously the doctor had enough room to perform the test (told you, just my irrational fears!). The procedure itself was fine and overall, the entire thing took around 5 minutes.
I undressed my bottom half as the doctor gave me privacy, climbed onto the chair, covered my lower half with the paper covering, and let the doctor do what was needed.
I wouldn’t say I was uncomfortable, but I also didn’t find it enjoyable, it was just very strange? You’ll see in my reaction that I just stare at the ceiling to ignore the slight pain of the doctor inserting the speculum, to which I was too awkward to request a smaller device. Looking back now, I realise the speculum was too big- I got a really bad UTI (Urinary Tract Infection) a few days after my test.
I’ve had UTI’s in the past for numerous reasons, mainly getting minor UTIs because I constantly forget to drink enough water, yet this was serious enough I was prescribed 5 days of antibiotics. When speaking to my GP, they said that a UTI, whilst uncommon, can occur from cervical screenings since it is a foreign object being inserted to spread and hold open the vaginal walls for the doctor to take their samples.
Now, I know to request a smaller speculum and speak up instead saying nothing. Communication, like with anything, is key.
Regardless, the experience hasn’t put me off getting my next cervical screening done, as they’re incredibly important to monitor your health. Another member of the team who hasn’t reached the age to be invited for their first smear test also agrees with this, saying ‘I have had family members and friends who have had abnormal cells come up on a smear test. So, attending a smear test to me would be really important and I often think I am really fortunate I am in a country where I can access these for free.’
A Negative 1st Screening, and a Positive Prepared 2nd Screening
by Anonymous, an employee at SASH
I've now had two routine cervical screening appointments, one negative, one far better! In all honesty, my first cervical screening experience was painful and uncomfortable. The nurse told me to put my hands into fists and place behind my back (to raise my pelvic floor). This felt quite arresting, and as if I didn't have any bodily autonomy. The speculum that she used was also quite big and made of metal (an outdated version I imagine!) and the swab sample itself felt scratchy. I bled afterwards which can happen sometimes. The whole experience was very invasive and because I felt nervous, it made my body tense, and which caused difficulties for the nurse in reaching my cervix!
However, I had a much more positive experience during the second screening.
For starters, I had to reschedule my appointment as I started my period the day of my screening and the blood can make it difficult for the nurse to take a sample. This is why we recommend having your cervical screening when you're not on your period. This time I came prepared! I brought a pillow to put under my hips, so that I was in the correct position and so that my hands/arms were free and by my sides. I also asked for the nurse to use a smaller plastic speculum which was far more comfortable inserting into the vagina. I was able to control my breathing and keep my body relaxed and this made it easier for the nurse to swab my cervix - it was over in seconds!
Overall, I would always encourage anyone who has a cervix to go for their cervical screening. Even though it may not be the nicest of experiences for some people, it is essential health care. The samples are used to pick up on any "abnormal cells" which if left untreated may evolve into cervical cancer (even if you're had your HPV vaccination). It might be useful to note down in your calendar as a reminder that you should be invited for a screening every 3 years.
When can I get my cervical screening test?
Before your 25th birthday, you’ll be invited by your GP usually via letter to book in your cervical screening. You can find out more on the NHS website
When you'll be invited for cervical screening - NHS - NHS (www.nhs.uk)
Can I get a cervical screening if I’m under 25 years old?
The NHS website states cervical cancer is very rare in the under-25s, and cervical screening hasn’t been shown to reduce cancer cases in this age group, so is no recommended for under 25s.
Can I do the test at home?
Currently cervical screenings are carried out at your GP surgery, hospital or some sexual health clinics by a doctor or nurse (usually female, and you can request a female doctor if given a male staff member).
However a trial study was carried out in 2021 where test-at-home kits were offered to 31000 people to complete their cervical screenings at home. Whilst not currently an available option, the medical world is constantly changing and evolving, so test-at-home cervical screenings could become an option in the future.
Do I have to go alone?
No, if it would help or you need assistance, you can ask if someone can come with you. This can be a friend, family member, partner or someone else. They can be in the waiting room or examination room with you to offer support. They may also be able to speak on your behalf about any worries.
At SASH, we offer chaperoning, meaning a member of the SASH team can come with you for your cervical screening. This means you’ll have somebody fluent in sexual health advocate for your sexual health, and provide you with support.
Cervical screenings are crucial to monitoring and maintaining your cervix health. If you need support going to your screening or want to talk about it in general, SASH is here. You can contact us via our email [email protected] or on our website www.sashlondon.org
Some other organisations who are sharing experiences and raising awareness of cervical screenings you might find informative include:
Jo’s Trust: https://www.jostrust.org.uk/get-involved/campaign/cervical-screening-awareness-week
Primary Care IT: Cervical Screening Awareness Week 2023 - Primary Care IT
Macmillan: Cervical Screening Awareness Week (macmillan.org.uk)
FSRH: Home - Faculty of Sexual and Reproductive Healthcare (fsrh.org)
Cancer Research: Cancer Research UK - Science blog