No one’s prepared for their first smear test; but it’s going to be fine
By Ella Griffee
All young women have that letter to look forward to when we turn 25. Here's why we don't need to worry - it's not as scary as it seems.
Adolescence is a series of numerical stepping stones. 16 is sex, 17 is driving and 18 is drinking. After these rites of passage, life is a less defined blur of ‘firsts’. First job, first flat, first few weddings...first smear test. This last one is left quietly on the sidelines; rarely discussed. But it’s waiting for all young women when we hit the big 2-5. And it turns out, it isn’t as bad as I thought it would be.
I received a letter from the NHS at my 24-and-a-half-mark, inviting me for a cervical screening.
It sparked mixed emotions. Initially, I had a sense of pride - I’d qualified, I was part of a club; the club of women-over-the-age-of-24-and-a-half. Get me! Then, there was a realisation that I was getting older. Something, especially as women, we are taught to fear. And now the proof was cruelly typed out in a letter, waiting for me on my doorstep. It also occurred to me that this was probably going to be a pretty unpleasant physical experience. I tried to block out thoughts of my cervix being scraped out. But my minutes of overthinking followed with a prolonged, childish unwillingness to book the actual appointment.
The letter sat staring at me for a week. Eventually, I reluctantly read through it to find the contact number. Surprisingly, it listed the number of my local rural GP surgery and I booked an appointment for the following week. I had already readied myself for a referral to the sexual health clinic – a place full of awkward eye contact, unbearable waiting times and STI posters graphic enough to make you swear yourself over to celibacy.
The fact I could pop down to my familiar GP surgery for a scheduled appointment to be seen by the nice nurse felt like a win.
While booking the appointment was easy, there was of course the difficult realisation that it was time to acquaint myself with a form of cancer I had previously given little thought to: cervical cancer. The idea of having to think about illness was hard to entertain. I generally avoid anything which highlights the impact illness can have on the lives of ordinary people. I know it’s a bit selfish, but I’m just so uncomfortable with the sadness. Any hint that something could turn out to be an emotional rollercoaster and I’m out. I thought The Great British Bake-Off would be safe - but even that caught me off-guard with its celebrity Stand Up to Cancer episode. But I couldn’t shy away from it forever, and more importantly, it was high time I educated myself. After all, a smear test is not a test for cancer - it is a test to help prevent cancer.
My first smear test was also an opportunity to get to grips with my biology. Other than slightly awkward biology lessons and the odd mandatory sex-ed day, like most people, I’d been brought up without any real comprehensive sex education.
To be honest, I don’t even know what my cervix is.
Turns out, this lack of education is something that affects many women and can even stop us seeking medical advice when things go wrong. To quickly summarize most feminist theory books in one sentence, men are raised by society to be proud of their penises, and women are raised to be ashamed of their inferior vaginas. Both raise problems. For men, society places a huge part of masculine identity on male genitalia, to the extent that prostate and testicular cancer can feel like an attack on not just their body, but their very masculinity. Many women on the other hand are too embarrassed altogether by their sexual organs to embrace conversations around the cancers that could affect those organs, fuelled by the taboos around menstruation and slut-shaming and many more things.
We can all be a little oblivious when it comes to taking care of ourselves “down there”.
In the end, I wasn’t worried about the appointment. I was successfully and officially “chilled” about it...until I sat in the empty waiting room. With no people watching to distract me, I tuned in to the unnerving sounds of metal scraping from the nurse’s room. I had visions of her lining up a long row of sharp metallic tools and inserting them one-by-one into my vagina, with a cruel smile. But, moments later, I was called in by a cheery nurse who displayed absolutely no awkwardness at the situation. She acted with the same breezy formality as when I’m printing something off in the office. And, to be fair, this is her day job; so it makes sense. She explained why the cervical screening, originally called a smear test, is important. It comes down to HPV, human papillomavirus, of which there are many different strains. Only a couple of strains of HPV have the potential to cause damage. It’s a very common virus; most people are infected with it at some point in their lives, and it can be passed on through any type of sexual activity. In most cases, your immune system flushes out the virus without you ever knowing you even had it. But sometimes, HPV infections can cause cells in your cervix to become abnormal. These can then potentially develop into cancerous cells.
It sounds scientific and scary, but the nurse explained that cells develop slowly over five years. If you keep up to date with your regular three-year cervical screenings, any abnormal cells can be caught quickly.
The test itself was unbelievably quick. I was, as they say, in and out. I hopped onto the bed, wearing a skirt as advised which I just hitched up, with a sheet over my mid-section to spare any unnecessary embarrassment. I lay on my back on the bed with my knees bent and apart. The nurse told me to relax and inserted a speculum, which I’d love to describe with a brilliantly theatrical, menacing mirth, but I never actually saw the thing. I won’t lie, it felt a little bit uncomfortable, and when she told me to breathe I realised I’d been holding my breath. The patronising advice so often given to women of “just breathe” actually worked on this occasion, and I felt my body immediately relax. The nurse chatted through the procedure, informing me she was now using a little brush to take a sample from the surface of my cervix.
She described the motion as being like a washing machine, which made me laugh.
The whole thing took four minutes (if that) and she told me they’d be in touch. My sample would be sent to a lab to be checked for evidence of abnormal cells.
Painless and preventative, I would advise every woman to take up the offer of a cervical screening. They are not obligatory, but ignoring an opportunity to catch abnormal cells early on is reckless. NHS cervical screening saves up to a staggering 5,000 lives from cervical cancer each year in the UK. It can feel like a bit of chore, but it also feels great taking proactive ownership over your body. And while we’re on the subject, we can also check our own breasts and balls on a regular basis. If we don’t know how, our GP will show us for free. And remember ladies (and men), just breathe.