Cervical Cancer Prevention Week: what’s a smear test like?

Content warning: this post discusses medical procedures performed on vaginas

This week is Cervical Cancer Prevention Week, so let me start by saying if you have a cervix and haven’t had a smear test in the last three years (or you’re over 25 and have never had one), book yours now. Sometimes you won’t always get the reminder letters–this seems to especially be an issue for trans men (GP surgeries often only bother sending the letters out to those marked “female” on their records). So, get your test.

Smear tests, from my own personal experience, are fucking unpleasant. I’ve had three now, and it’s grim, but the worst of it quick. My experience is entirely with GP surgeries, although some sexual health clinics also do smears. It goes a little bit like this:

Booking:  You need to book your smear test for a day you’re not on your period. My surgery likes it two weeks from the first day of your period, although that’s not set in stone. What they want most of all is for you not to be bleeding out of your cervix while they’re trying to swab it.

For me, booking a date isn’t difficult, because my periods are regular as clockwork thanks to the combined pill. If you’re lucky enough not to have periods, then book for whenever the hell you want. If you’re irregular, I would suggest calling up to book your appointment on the first day of your period, so they can schedule it for exactly two weeks’ time, which saves you having to faff about with calendars, apps and ouija boards to work out when’s good.

Preparation: Some people like to make their cunts look nice for their smear tests, by shaving or waxing. This is strictly optional, and unnecessary. Nonetheless, if hair removal is something you like to do, there’s no harm doing it either.

Don’t wash with soap or special fanny soap or apply special fanny perfumes before your smear tests. Not because it will fuck up the test result, but because you don’t need that shit anyway. Your cunt is self-cleaning, and almost certainly smells fine.

Personally, I’ve never bothered with hair removal. Before my last smear test, though, I decided to apply conditioner to my pubes to make them nice and soft–this is something I sometimes do before dates or orgies, too. Unfortunately, on this occasion, the conditioner I used was smoothing conditioner. Do you know what this does to pubes? It straightens them. And so I turned up at my smear test with a bush that looked exactly like Vegeta. The nurse, being a well-trained NHS worker was too polite to comment, and while I cringed, I know she’s probably seen weirder.

Before the test: Before the nurse does the test, they’ll sit down with you and have a quick chat to verify that you definitely need the test, that now’s the right time to do your smear, and to see if you have any symptoms.

They’ll ask you about if you’re sexually active. As healthcare workers, they will be non-judgmental about it. In my experience, they won’t call you a slut (or even side-eye you), but they won’t high-five you either (sadly). It’s OK to be vague if you don’t want to go into exact numbers. Even if you’ve only had sex with other people with vaginas, you need to get your smear test because the HPV virus, that causes most cases of cervical cancer, can be transmitted by sex involving two or more vulvas.

You’ll also be asked about discharge and all sorts of things like that. Be as frank as you like. If something’s worrying you about your downstairs and whether it’s normal, mention it.

When all the small talk is over, it’s time to get behind that curtain and wiggle out of your tights, because it’s time for your smear test.

Assume the position: You lie down on the couch and spread your legs in a different way to the way one would if anything pleasant were to happen to your cunt. For the smear, you put your ankles together, and let your knees drop.

The nurse will probably talk to you throughout, letting you know what they’re going to do. If the nurse doesn’t offer the information, ask them to. You’re well within your rights to.

The speculum: A speculum is a plastic doohickey that looks like a cartoon duck. They should use lube when they put it inside you–if they don’t, ask them for lube. I once had an STI test where a speculum went in without lube and it was the second most horrible cunt experience of my life (here’s the most, not for the faint-hearted).

Even with lube, I’m not going to lie to you. A speculum does not feel very nice at all. As it goes in, it feels like any phallic object penetrating does–so if you have any issues surrounding that feeling, take a lot of time to psychically prepare yourself and do what you need to do. Then after that, the nurse cranks it open, and that feels downright weird: you feel yourself getting a bit bigger on the inside. I imagine it’s how the TARDIS feels when anyone steps into her.

The speculum is not painful, but it is uncomfortable.

However weird it feels, you’re not actually being cranked very far open, just big enough for the nurse to be able to see your cervix and insert a small plastic brush.

At every smear test I’ve ever had, at this point the nurse has exclaimed over what a “beautiful” cervix I have. I do not know if this is a normal part of the procedure, or if I have a particularly aesthetically-pleasing cervix. I’ve never plucked up the courage to ask, and I always forget to bring a hand mirror so I can have a little shufti myself.

The actual smear test bit: Most resources about cervical smears say the procedure is completely painless. For me, at least, that is untrue. I am not going to lie: when they swab my cervix, it hurts a bit. Not much, and not for long, but it hurts.

The little brush they use to take the swab has stiff bristles. The nurse scrubs it around for a second or two on your cervix. It feels exactly like a stiff-bristled brush scrubbing around on your cervix. Have you ever caught the side of your hand with steel wool while washing up? It feels like that, except up your fanny. Oh, and with the added sensation of that weird feeling when something bangs on your cervix.

So yes, it might hurt. But–and I cannot stress this enough–it’s over within seconds. Again, if you have issues with this sort of thing happening to your vagina and cervix, prepare yourself. Have your self-care prepared, try to dissociate through the procedure… whatever will get you through it, because it’s not nice, but it is important you get it done.

Afterwards: The speculum is out of you before you know it, and you’ll be handed a tissue to have a little wipe with. It’s usually just lube, although during my second smear test I bled slightly from vigorous swabbing. The test shouldn’t do any physical damage which will prevent you from getting home immediately (although, once again, if you have any issues surrounding things being done to your vagina, you might want to take a few minutes to be sure you’re OK to go).

For me, I get slight twinges in my cervix for a few hours after a smear: not pain, exactly, but discomfort. This is perfectly normal and happens to some people, although some people feel nothing afterwards.

Results: You’ll get your results within a couple of weeks, usually by post. The letters are quite clear as whether the result was normal, abnormal or inadequate, and what you need to do with that information. Luckily for me so far, I’ve always had normal results.

For a normal result, that means “see you in three year’s time”, and congratulations, you’ve made it through your smear test. If it’s inadequate, bad luck, you’ll have to go in again because they didn’t collect enough cells during your smear. If it’s abnormal, don’t worry yet. My mum and my sister have both had abnormal smears and both are fine–my sister had her first baby recently, and my mum celebrated her 60th birthday! It doesn’t definitely mean you have cancer, and when they catch anything abnormal on your cervix, they can deal with it before you have any problems. It could save your life.

So, to conclude, get your smear test. It is approximately five minutes of awkward conversation, thirty seconds of discomfort and slight pain, and then, potentially, decades added to your life.


11 responses to “Cervical Cancer Prevention Week: what’s a smear test like?

  • Nienna

    I have vaginismus, I can’t do them. I used to have to have a general anaesthetic for one. But last time I found out there’s a new test available which is minimally invasive and can be done at home. It’s in private medicine, and I think the cost was £180. But sorry I don’t have the details to hand.

  • Katie

    This is awesome and comprehensive! I have had several due to gynae issues, and have become more assertive as time has gone on. The most helpful thing I have started to do over time is to tell the nurse that I have experience of sexual trauma and politely insist they use the smallest speculum. I didn’t realise I could ask for this the first time and it didn’t go so well because I just couldn’t relax my muscles. Obviously not all survivors will be comfortable disclosing stuff to random nurses, so I would also totally recommend asking for a smaller speculum based on fictitious experience (I had the usual one last time, didn’t work – whatever) to someone worried about being overly tense due to trauma.

  • Sarah

    This is very helpful! I had some of my cervix removed after a colposcopy revealed pre-cancerous cells. I told the smear nurse I was worried the first one afterwards would hurt and would she be gentle-well, she wasn’t and it hurt a lot. It shouldn’t really hurt at all! For me, it’s only ever been a bit uncomfortable. As I have to have one once a year for ten years, I now pay to go and have them done at Marie Stopes. It’s the best £70 ish I spend. You get time to sit with the doctor or nurse and chat and they are so nice. Obviously, it depends how you feel about paying for medical care. I’m generally against but this is so worth it-and at least money goes back into their work. The only downside (other than the cost) is that religious fucknuts stand outside and upset women going in for abortions. It just means I recruit my mum or dad to come in with me (& sometimes shout back at them)

  • Ren

    Never had my cervix complimented, lol, but otherwise this is very similar to my experience. My GP at least does send out the letters entirely based on the little gender marker, because my flat mate is a trans woman and she gets them – which is obviously not as bad as the reverse situation, but still, it’s such an inadequate system!

    • stavvers

      Yeah, they definitely don’t seem to be related to anatomy. My mum keeps getting them even though she had a radical hysterectomy <10 years ago!

  • Percy

    Other stuff;

    If you have hip or knee trouble, it can be painful to get in the Position. You can request cushions and stuff to prop your legs, and sometimes you can manage it with one leg straight and the other leg folded, if that helps.

    Many (Most, IME) practitioners (and especially doctors) will let you hold the speculum yourself if that makes matters easier, as long as you’re able to take instructions like “Left a bit, right a bit, a bit further in, a bit more open”. They have to swab the cervix themself, to make sure they get the right bit (Plus, they can see it and you probably can’t, unless there’s a well-placed set of mirrors.

    Book a long appointment if you think there might be trouble, and do as much negotiating before you’re lying down as possible, since you’ll usually sound calmer and be able to put together a more cogent argument if you’re in a less stressful and asymmetrical position.

  • Harriet R (@geekyisgood)

    This sounds like my experiences too. I definitely get a weird feeling when things touch my cervix, so that was the unpleasant, but it was so quick.

    I stare fixedly at the ceiling and hope for a chatty nurse to help me through it – a bit like when I get vaccinations. I like a distraction to help me relax because for me the anticipation is the worst bit.

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