Been putting off your first cervical screening test? Here's what mine was like from start to finish
Big sister advice on what to expect from this important but often slightly intimidating appointment. Spoiler: it's not as scary as you think.
Last November, when the NHS reported that five million women weren’t up to date with cervical screening, I was one of them. But, better late than never, last month, I attended my first cervical screening appointment – and it was far less scary than I had expected.
Another reminder you’re officially in your mid-twenties? The NHS letter inviting you to your first cervical screening appointment. Ugh.
The report mentioned above found that the lowest uptake of the procedure was among women aged between 25 and 29 (58%). While alarmingly low, in many ways, it’s understandable. Fear of the unknown can be enough to prevent you from doing something, even if you know deep down how important it is. For many women in this age bracket, it’s their first cervical screening test (usually, if your result is clear, you won’t be invited for another five years) and although you might have heard about it at school – especially if you had the HPV vaccine – it’s still not something we talk about enough.
I was lucky to have my mum and friends for information and advice, but I’m aware not everyone has that. I am also speaking from a further privileged position in that I’m a white, able-bodied cis woman – and I was still very anxious about the whole thing, putting the appointment off for more than six months.
Earlier this year, leading gynae cancers charity, The Eve Appeal, warned of a knowledge gap regarding cervical screenings. The charity – which says the procedure saves 5,000 lives a year in the UK – found:
56% of respondents didn’t know they could ask for their cervical screening test to stop at any point;
77% didn’t realise they could ask for a smaller size speculum;
Only 12% knew they could book a double appointment for their screening test;
Only 11% knew they could ask to try a different position for their cervical screening, like the left lateral position.
What is a cervical screening?
A cervical screening is a test offered to women and people with a cervix aged between 25 and 64 to help prevent cervical cancer. I am not a medical expert, however, so I encourage you to visit sites like The Eve Appeal, Cancer Research UK and the official NHS website for more information and resources.
The cervical screening itself doesn’t detect cancer. Rather, it tests for a virus called human papillomavirus (HPV) – which causes nearly all cervical cancers. High-risk HPV can cause cell changes in the cervix, which could then potentially develop into cancer over time. A cervical screening involves taking a small sample of cells from the cervix to look for HPV and any cell changes which might need to be treated or monitored to prevent them from developing into cervical cancer.
Following your cervical screening, there could be multiple outcomes – all of which the NHS explains here. Likely, you’ll get an HPV-negative result and won’t be invited for another screening for three to five years (my letter said five). If HPV is found in your sample, you might be asked to return for another test in a year. Or, if there are abnormal cell changes detected, you’ll be referred to the hospital for further tests. It may also be that your results were unclear, in which case you’ll be invited to another screening in around three months.
I had reached the ripe old age of 25 without ever having had a medical/gynaecological appointment involving somebody getting up close and personal down there. Once, at university, when I went to the campus GP about heavy periods, I quite literally fled the scene in panic when they said they could do an internal examination there and then. But realistically, what seems like such a big thing isn’t to medical professionals. To them, it’s just another body part. There was nothing special about my cervix. In fact, I didn’t want there to be anything special about my cervix – that’s why I was there. So, just remember that whoever is doing your screening has likely already seen several other cervixes (among other body parts) that day.
Consider booking a double appointment if you’re nervous
I had a double appointment booked, with my screening preceded by a contraceptive review. When the nurse asked which I’d like to do first, I opted for the review (anything to delay whipping off my leopard print trousers and hopping onto that bed), which involved taking my blood pressure. She had to do this several times because it was, unsurprisingly, high – thanks to my nerves. However, I’m glad I did it in this order because it gave me a chance to chat and feel more at ease.
If you’re nervous, definitely ask to book a double appointment – which you are permitted to do – even if it’s just for the screening. Also, I had never had this particular nurse before, and she was lovely. So, if there’s somebody at your surgery who you’ve seen before and feel comfortable with, request them.
The nurse talked through everything before she did it (including a general chat beforehand about what the screening would involve), but it might also help to do some of your own research so 1. You don’t build up a terrifying scenario in your mind and 2. You can think about any questions you might want to ask.
Ask friends about their experiences
It can also help to ask friends about their screenings. All six of my best mates had already had theirs by the time I went for mine, and, for me, it was helpful to hear about their experiences, which were, admittedly, mixed – but generally positive. Even hearing from those whose experiences weren’t as good helped me consider accommodations I might ask for or questions I might have.
Despite somebody unintentionally terrifying me by using the words ‘crank open’ when describing the speculum, this part was way less scary than I thought. The nurse informed me we would be starting with the smaller speculum (the tube-shaped tool used to open the vagina so the cervix is visible) but said a bigger one might be required as she could see I was tall. For some reason, I replied: ‘Yes, I’ve got a very long body.’ Why did I say that? I mean, I do have a long torso, but you know when you just start to blurt out random stuff when you’re nervous? For context, I’m 5’9 and didn’t need the bigger speculum, but I’m sure it would’ve been totally fine if I had.
What should you wear to your cervical screening appointment?
I wore some loose-fitting trousers that I felt comfortable walking there and back home in and were easy to remove and get back into. However, if you’re worried about feeling exposed (which I did slightly when I was ready in position and the nurse decided to squeak the bed up several inches higher), you might be more comfortable in a skirt or dress you can pull up instead, so you don’t physically have to remove any clothes.
The test itself
The nurse found my cervix straight away – announced as casually as if spotting something she had lost down the back of the sofa – and was able to take the sample immediately. She did this using a soft brush (it kind of looked like a small plastic paintbrush), and although this was probably the most uncomfortable part, it didn’t last for very long at all, and I wouldn’t call it painful – just a tad uncomfortable.
It’s age-old advice, but deep breathing – in through the nose, out through the mouth – helped me stay calm and still. Although the nurse said she saw some bleeding while she took the sample, I only experienced a smidge of spotting afterwards. However, I would recommend wearing a panty liner or period pants just in case.
Of course, every experience can be different – and everyone's feelings are valid – but I hope this makes it feel a little less scary. You’ve got this.
Also, when playing around with ChatGPT for headline inspiration, it came up with ‘Legs up, let’s chat’, so I hope that gives you a giggle like it did me.