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Earlier this summer, we teamed up with Dr Nighat Arif – NHS GP and Wellbeing of Women Ambassador – to host a special Instagram Live on cervical screening. Missed out? Here’s a summary of what we talked about…
Dr Nighat: A cervical screening is the same as a smear test, or a ‘pap test’ in America – it’s a short procedure designed to look at the health of your cervix. Anyone who has a cervix will be invited for the first time at the age of 25.
The reason it’s traditionally been called a ‘smear test’ is because of the apparatus we use. In the olden days, we’d use a stick that we’d then smear onto a plate before sending the plate off to a lab. Nowadays we use a brush – but the name has stuck! The point of the screening is to take a few cells from your cervix that we can look at these in more detail at the lab.
What we’re actually looking for is very early cell changes – the test doesn’t look for cancer but instead what comes before cancer. We’re searching for precancerous cells and something called HPV: human papillomavirus.
The test is simple and takes around five minutes. To begin with, you’ll be asked if you’re comfortable and if you have any questions – and remember, no question is silly! If you want to take a friend or a partner along with you, you can.
Next, you’ll be shown to a private area and asked to take off your trousers or skirt and undergarments. I went in a skirt, which I found easier. You’ll be asked to lie back on the couch and put your legs together. Then, you’ll bring your knees up to your bottom and allow your legs to flop open. We want you to be as relaxed as possible, so that we can insert the speculum. We go through the vagina and then open up the speculum to visualise the cervix. A brush is passed in through the speculum to the cervix where we collect a few cells. Then we remove the speculum, get you to put your legs together and that’s it! Test done.
You might get a little bit of bleeding afterwards, which is totally normal. Please feel free to take a pad with you.
The test can be painful for some, especially if you have a history of trauma. If you are in the menopausal or perimenopausal stages, you can get something called genitourinary syndrome of menopause (GSM), otherwise known as vaginal atrophy, and you should be supported. Your healthcare professional can prescribe topical vaginal oestrogen as a pessary or a cream at least three weeks prior to the smear test. This is then stopped two days before the test.
Other things like vaginal dryness, vaginismus or lichen sclerosus may also make your procedure difficult. Remember, if it hurts, there’s a reason why – and the clinician should be finding out why and helping you. Let whoever’s doing your procedure know that you’re in pain, or worried about pain. Don’t be scared – they’re used to this and can guide you through it. There are different sizes of speculum available, too, to make things more comfortable.
I always use a water-based vaginal gel that is applied to the sides of the speculum. Technology is so much better at picking up cells than it used to be, therefore using a water-based lubricant doesn’t affect the sample or results as it did in the past. You’re within your rights to leave a test if lubricant isn’t used and you’d like it to be. Better yet, take your own!
The general guidance is try not to go for screening while you’re on your period – if you do come on your period unexpectedly, you can always rebook. This is partly for your own comfort, but also because red blood cells can sometimes disrupt the screening sample, making it hard to pick up on subtle changes in the cells.
Yes, you can! We will assess the risks when you come in to see us. If we can’t identify any reasons to hold off, we’ll go straight ahead with your screening. Some pregnant women delay their smear, and we actually don’t recommend that – wherever possible, try to stick to the screening window you had originally.
I feel anxious about my cervical screening – what can I do?
I recommend to speak to friends and family members who you know have been for screening themselves. Sharing experiences is good – you often hear about bad smears but rarely the good ones!
One thing I’d like to say is: don’t be scared of HPV. It’s very common, and your immune system should actually get rid of it in time. What’s important is that you keep coming for your cervical screening so that we can monitor any potential cell changes.
Watch the full video below:
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Categories: cervical screening; Q&A; Wellbeing of Women