What REALLY happens during a smear test? Every question you’ve ever had, answered!

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  • Smear tests save the lives of more than 4,500 women every year, yet one in three women under the age of 35 are still refusing to go for a test.

    Lots of women find the idea of going for a smear test embarrassing or have heard on the grapevine that it’s going to be painful. With our busy lives it’s easy to put to the back of your mind and not get it in the diary.

    While such feelings are very natural, seeing as it’s not talked about very often, those feelings shouldn’t stop you from going for one to keep yourself safe. Plus you’ll definitely have earnt a treat or two afterwards so just think about that instead…

    So who can have a smear test?

    If you’re aged between 25 and 65 (20 in Scotland), you’ll be invited to have a free smear test on the NHS shortly before your 25th birthday.

    Why am I having one anyway?

    Smear tests are the best way of detecting early changes in the cells in the cervix, which is the lower, narrower part of the uterus that joins to the top end of the vagina. Changes in cells could indicate a chance of developing cervical cancer in the future.

    So it’s a test for cancer? That sounds terrifying…

    The smear test looks for pre-cancerous cells, it is not a test for cancer.

    Do I HAVE to go?

    No one can make you have a smear test, any more than they can make you go to the dentist. However, cervical cancer is like ovarian cancer, it’s a silent killer. Although it can take 10 to 20 years to develop, you’ll never know until you have symptoms and by then it has spread beyond your cervix.

    What should I expect once I’m at the doctors?

    Step 1: A smear only takes about 5 minutes at most and is usually done by a nurse. You’ll be asked to undress from the waist down and lie on your back (with your knees up and apart) on the couch.
    Top tip: If this position is difficult, see if they can do the smear with you lying on your side, knees up in the foetal position.

    Step 2: Once you’re lying down comfortably, a doctor or nurse will insert a speculum (this looks a bit like a duck’s bill) into your vagina so that the nurse can get access to your cervix. The good news is that speculums are often plastic these days – so no more of those nasty, cold, metal ones!

    Step 3: A small brush or spatula is used to gently scrape cells from your cervix. More good news – there’s a new design of brush (a bit like a mascara brush) being introduced that’s much softer and more effective at getting the cells. This might be a little uncomfortable but shouldn’t be painful and takes less than 5 minutes.

    Step 4: The cells are then put on a slide and sealed in a container that’s sent off to the lab, where the cells will be looked at under a microscope.

    Is that going to hurt and will I bleed?

    A smear shouldn’t be painful for most women and you might bleed, but it’s nothing to worry about if you do.

    How long do I have to wait for results?

    The results are usually available after about two weeks, and will be posted to you. If you don’t hear, you should call your GP to chase it up.

    If your test is clear, your next test will be in three years time.

    If the test didn’t collect enough cells you might be invited for another test.

    Should I be worried if they find abnormal cells?

    Finding abnormal cells does not necessarily mean you have cancer, so it’s always best to double check. If the test showed up any abnormal ones you might be invited to attend a specialist clinic.

    What can I do about an inconclusive result?

    Sometimes an inconclusive result just means you need to go back for another test. However, some women get lots of inconclusive results through no fault of their own. You could get an inconclusive result because:
    – there aren’t enough cells present – you have thrush or an infection – you have your period

    What if I’m nervous?

    If you’re nervous, have a chat with your GP or practise nurse who will be happy to talk you through what will happen, to help you feel more relaxed when you go for your test.

    Can I request a female nurse?

    You can request a female nurse to carry out the test if it would make you feel more comfortable.

    When’s the best time to have a smear?

    The best time to have a smear test is 10-20 days after the start of your last period. Avoid having anything in the vagina 24-48 hours before your smear. This includes: semen, spermicides, foams or jellies, vaginal inserts (e.g. pessaries for thrush) or tampons.

    What if I’m on my period?

    You shouldn’t have a smear test during your period as the blood makes it difficult to see the results, although some doctors will do a smear if you have a light period and there are also new, liquid-based smears that can separate the cells from the blood and mucus. If you’re not sure or suddenly start your period, call your surgery to see what they suggest. There’s nothing more annoying than turning up, only to be sent away.

    What if I’m pregnant?

    You can still have a smear test if you’re pregnant.

    How about after birth?

    It’s a good idea to wait a while for a smear test after you’ve had a baby, as Katherine from Wales found out:

    ‘Each time I had a smear after birth (I have 4 children) it came back inconclusive. By the time I was called for a colposcopy, the problem disappeared. Apparently because the smears were taken 6 weeks after each birth, it’s too soon for cells to settle down after birth.’

    Does the test only show cervical cancer?

    Although the smear test is specifically for cervical cancer, it might also show if you have a vaginal infection (e.g. thrush) or an STI (e.g. Chlamydia). You can have a normal test result but also have an infection, so don’t worry.

    Can I have an STI check at the same time?

    Yes, but only for chlamydia and it a good idea to check with your surgery if they offer it.

    Is there an alternative?

    Unfortunately, no. But your risk of getting cervical cancer is cut by 91% if you have a smear every three years.

    Is there any way I can make it easier?

    Julie from Manchester suggests: ‘To help you relax, think about wearing a long skirt that you can hitch up. Or even have your ipod playing so you can keep your mind busy.’

    Other GoodtoKnow users suggested these ways to make the experience better:

    Get a recommendation: ‘Choose your nurse carefully – I always found smears really uncomfortable until a friend recommended a particular nurse at our local practice. For the first time I didn’t experience any discomfort and it was over in a matter of seconds.’

    Don’t put up with it: ‘I once had a nurse who was really scary and told me in a cross voice that I should relax. I couldn’t even go through with it in the end. I’ve since had much kinder nurses who made the whole experience far less traumatic!’

    If all else fails?

    You don’t have to go to your local surgery for a smear. Our GoodtoKnow users suggest some alternatives:

    ‘I had so many inconclusive results that I had to go to a Women’s Clinic. The nurse took two at once to be sure I got a result. If you can’t get a result, find a local Family Planning Centre or Women’s Clinic – they do hundreds of smears every day’ says Amy, from London.

    ‘A friend goes to her local GUM clinic as the nurses are so much better at it as they do it all day. Her nurse even puts music on as she said it was more like a beauty treatment!’ says Jane from Essex

    If you’re worried, or want more information, visit macmillan.org.uk