For people with a cervix smear tests are a necessary part of looking after your sexual and reproductive health, but we understand they are not typically something that you look forward to.
Today we would like to outline what smear tests are, who they are for and what to expect in an appointment so you may feel as prepared as you can be and feel at ease about attending or booking in your next test.
‘Smear test’ is a bit of an older term for referring to cervical screenings. It comes from the way samples of cells were smeared along a glass slide and sent off to a lab for testing and inspection. Changes in medicine and technology mean that we don’t use this exact process anymore and a more accurate term is simply, ‘cervical screening.’ We will use the term ‘smear test’ throughout this blog as we know most people understand what we are referring to.
A smear test is not a test for cancer. One of the worries around smear testing can be what the results might be. So, it may ease your worries to know that when you have a smear test, the samples are not being checked for cancerous cells. What we are searching for, if detected, can ensure we prevent cancer from forming and make sure we are well prepared to treat any issues that might arise. What we look for is the presence of HPV, the Human Papilloma Virus.
HPV is a common virus that has around 200 variations, the majority of which are very low-risk. Infection with HPV is very common and most sexually active people become infected a few months to years after becoming sexually active. The body however has a wonderful immune system that often deals with it on its own or manages the virus so no symptoms or complications develop.
However, in some cases, mostly associated with the high-risk HPV variants, there can be a risk of developing abnormal cells which, if left unchecked, can develop into cancerous cells over time.
When you have a smear test we check for the presence of high-risk HPV. If no HPV is detected we have no reason to assess your sample any further and you will simply be invited back for your next regular checkup in 3-5 years.
If HPV is present, we look back at the sample to discover whether any of the cells have become abnormal. If we detect no changes, you will be informed of the presence of HPV and invited back for your next smear test sooner than usual, usually after a year, to check the HPV has gone.
If we detect the presence of high-risk HPV and detect cell changes, you will be informed of this and invited to go for a colposcopy, a test that examines the cervix in detail to see how we might proceed moving forward.
Gender: If you have a cervix, regardless of your gender identity, you are entitled to a smear test from the age of 25 onwards. If you wish to have it done under the NHS you will be informed of when you are due so long as you are registered as female with your GP. If you are a transgender man (with a cervix) you will need to make sure you inform your GP that you would like cervical smear tests and will be invited from then on.
Age: Women under 25 aren’t encouraged to have a cervical smear test as it is common for the cells in the cervix to undergo changes up until you are 25 and most of these are going to go away by themselves. Treating these changes unnecessarily has been found to cause complications later on.
So, smear tests, including private smear tests, begin at the age of 25 up to the age of 65. If you are 65 or over you are very unlikely to develop cervical cancer if your last results were normal. However, if you have never had a test before you are still entitled to have one even if you are over the age of 65.
Sex Life: If you have had any form of sexual contact with men or women, even if it was only touching or the use of sex toys, it is important to have a smear test when it is due. HPV is common and prolific enough that even one sexual encounter can pass on the virus, and so it is important to get checked to put your mind at ease.
HPV Vaccine: The HPV vaccine has been a wonderful advancement in female health and ensures that the risk of cervical cancer drops dramatically. The HPV vaccine only covers two of the highest risk variations of HPV and so does not protect against the 200 other variations. It is these high-risk variants of these that you still require screening for and so should still attend your smear test even if you have had the HPV vaccine.
Your smear test appointment will usually last around 10 minutes, but the test itself won’t take more than a minute or two.
Usually, a female doctor or nurse will conduct the test, and with our private smear test you can always check or request whether the doctor or nurse is female.
You will be welcomed into the appointment room and asked to remove the bottom half of your clothing and underwear. If you are wearing a skirt then just your underwear will suffice. You’ll then be asked to lie back on the examination couch with your knees bent and apart. If this is difficult due to mobility reasons then let your nurse know as you should be able to lie on your side instead.
Your nurse or doctor will then use an instrument known as a speculum, (speck-you-lum). The speculum is inserted into the vagina, using lubrication if necessary, and then gently opened to access your vagina so they can see your cervix. They will then take a small soft brush, that can still feel a little sensitive to you, and take cell samples from your cervix which are sent off to the lab for testing.
Some people can find the test uncomfortable, if you do, please inform your doctor or nurse the moment you feel discomfort. Speculums come in different sizes and lubrication can be used to make the entry easier, so if you feel it’s not comfortable for you let your doctor or nurse know so they can make you as comfortable as you need to be. It can really help to relax yourself too, when you are tense all of your muscles contract so if you can relax you will find the test more comfortable. You can take a few deep breaths, try to distract yourself on your phone, or simply chat to your doctor or nurse and the test will be over before you know it.
Do I need to wax or shave? Whilst it matters not one whit to us, we do understand it can feel embarrassing to be examined in intimate areas, and a question that we are sometimes asked is whether you should shave your pubic hair before your examination or not. As healthcare professionals we can outright say we do not care. It does not affect our ability to perform the examination, nor does it change our opinion of you in anyway. Pubic hair plays an important role in personal hygiene, in preventing infections such as UTI’s and yeast infections. If anything, we would say not to shave for your own health, but it is your body and we really aren’t going to make any judgements either way, so please don’t worry about this part of the examination. We are here to support you, not judge you, you can speak to us, be open with us and we will do our best to take care of you and make you feel safe and welcomed whilst under our care.
So, we hope now you feel prepared and informed enough to feel confident and comfortable in attending your next smear test. The benefit of a private smear test with us is that you get to do it on your own time and get to see a healthcare professional who cares, who has time to answer your questions, worries or fears, and you get to see the same doctor or nurse at your next appointment to ensure you can trust us as you build a relationship with your doctor or nurse.
You can book online right here in a few simple steps. Consultations are £75 for 15 minutes if you wish to speak to us first and discuss your options. Alternatively, our routine private smear tests are listed under ‘Nurse Services’ and cost £210. We have other options which include testing for STI’s and a Women’s health assessment at £225 and £310 respectively.
