According to the charity Jo’s Cervical Cancer Trust, attendance for cervical screening (or smear tests) is at a 19-year low in England and a 10-year low in Scotland and Wales. This means that, when they receive their invitation letter, one in four women are not making an appointment to be checked. Things are going on to try and help reverse this shift. For example, the recent Channel 4 documentary about Jade Goody’s life, which includes her journey with cervical cancer, has got a lot of women talking about, and booking, their cervical screening tests. And recently, Zoe Sugg (aka. Zoella) uploaded a video that showed her having a smear test and asking the nurse various questions about the procedure. Over 1.4 million people have watched it so far. And it’s not just these high profile celebrities who are raising awareness of why it’s so vital to go for your cervical screening appointments. You only have to look at Instagram to see hundreds of thousands of pictures discussing the importance of having regular smears.
And don’t get me wrong – this movement of women taking ownership of their health and encouraging others to do so too is fantastic. And for most people, these campaigns are enough to inspire them to book an appointment and get checked themselves. But the thing I struggled most with, was trying to find stories from people for whom having a smear test isn’t as straightforward as most people say it is. In amongst all the amazing posts and media about why it’s so important to have a smear test, I also found a lot of content shaming people for not having one. And that’s why I have decided to write this post. Not to put people off going for their appointments or to scare people off who haven’t been for a test yet. But to reassure others that they’re not alone if they struggle, for whatever reason, to go for their cervical screening. And that that struggle is nothing to be ashamed of.
Like most women, I received an invitation to go for my first smear test just before my 25thbirthday. As someone that has had a huge number of medical tests over the years, I wasn’t too worried about the prospect of another one and so, fairly quickly, booked in with my GP Practice. On the day of my test, although feeling a little apprehensive about something new and different, I went in to see the nurse on my own, as I have done with many tests before. She asked me all the usual questions and told me how the test would be carried out, and then asked me to lay on the bed so she could proceed with the test. And this is where things started to go wrong. I found the test incredibly painful – so much so that I was in tears because of it. It didn’t help that the nurse I saw didn’t seem to be particularly gentle or sympathetic, and made comments about how difficult I was making it. After what felt like ages she finally managed to get the sample and I left feeling completely traumatised.
Thankfully the result came back negative, so I tried to just forget about my experience for the next three years. But when my next invitation letter came three years later, the panic set in. I just couldn’t face going through that experience again. In the end, I went to talk to my GP about it. She told me that it was my choice whether I went to have the cervical screening done and that I didn’t have to get it done if I didn’t want to. But the problem was, I did want to – I knew how important the test was and I wanted to make sure I was doing everything I could to keep myself as healthy as possible. We talked about it quite a lot and in the end, decided that I would give it a try and if things really didn’t work, then we could talk again. She did also recommend asking the nurse to use a smaller speculum.
And so, with a lot of apprehension, I booked in for my second cervical screening test. This time round, I decided to take my Mum into the test with me for some moral support. Pretty much as soon as I entered the room though, the nurse asked me why I’d brought my Mum in. I explained that I had found the test traumatic last time and for a couple of other reasons as well, I just needed someone I trusted with me. The nurse then told me that it was very strange that I would bring someone in with me and that she’d never seen anyone else need to do that before. My Mum was told to wait in the room next door while I had the test, so I was effectively on my own. So before we’d even started the test, I was feeling humiliated and upset for being what I now felt was strange. And the test didn’t go much better. We had the same problems with excruciating pain and the nurse not being particularly gentle while she tried to find my cervix. She kept telling me that my cervix was in a funny place and that I shouldn’t be in so much pain. Despite all this, somehow, she managed to take a sample and I left.
I remember leaving the Doctors Surgery and bursting into tears – I felt like there must be something really wrong with me. Everyone else I had spoken to or heard talk about having a smear test said it was, at worst, a bit uncomfortable, but was over in a couple of minutes. So why wasn’t it like that for me? Ever since then, I have felt embarrassed about the whole process and the fact I couldn’t do what every other women could apparently do.
Then a few months ago, I received my next invitation letter and my anxiety hit the roof again. This time, I really was tempted to just not go because after two horrible experiences and some other life events that have happened, it felt like burying my head in the sand was the easiest thing to do. Problem was, I had been getting some bleeding in between my periods and knew that, if I went to see my GP about it, the first thing she would say is that I needed a smear test. Plus, the bleeding was also giving me massive anxiety because I had no idea what was causing it. So I could either ignore my letter and continue to worry about the bleeding, or book an appointment and worry about the test instead. I went for the second option.
Out of all the medical tests I’ve had (and some have been pretty horrible) I think this was the one I felt most anxious about. In the weeks leading up to my appointment I was getting panic attacks, not sleeping properly, nightmares and generally just felt awful. The day came and this time my appointment was with a new nurse I had never seen before. I decided to go in on my own and I’m pretty sure as soon as I sat down the nurse could tell how anxious I was! She talked to me for quite a while, going through the normal questions and asking about previous tests. I tried to explain to her about the problems I had had with my previous tests and how worried I was about being there. I also spoke about my Ehlers-Danlos Syndrome, and how it can make it more painful to lie in the correct position. She was very sympathetic, listened to me and I didn’t feel judged at all, which started to put me at ease. As I lay on the bed, she explained exactly what she would be doing and showed me the instruments she would be using. She had got out a smaller speculum at my request and showed me exactly how it worked. Then she told me she would talk me through everything she was going to do and that if, at any time, I was finding it too difficult, I could ask her to stop.
The first time she tried I think I nearly shot through the roof because of the pain it caused, but true to her word, she immediately stopped and gave me some time to just breathe, move around and relax. When I was ready, she tried again, and this time, although it was uncomfortable, I wouldn’t say it was painful. I tried to focus on my breathing to keep myself calm, but after a while, the nurse told me that she was unable to find my cervix and would need to try again. My heart sank. But the nurse was lovely about it. She told me to make my hands into fists and then place them under my bottom, as this would help to tilt my cervix into a better position. She then tried again, and in a couple of minutes the test was complete. I think I nearly cried with relief this time rather than from pain or embarrassment.
After I’d got dressed, I sat down with the nurse again, and she told me that I have a tilted cervix, which is what makes it harder to find. She reassured me that a lot of women have it, so it’s nothing strange or abnormal about me. She also told me that I have something called a cervical ectropion, which is very common among women who are on the pill, and could well be causing some of the pain and bleeding. I honestly just wanted to cry – finally someone was explaining to me why I might find having a smear test more difficult than some. This time, I left my appointment feeling relieved and empowered, all because I had a supportive nurse that really listened to my needs and worries.
Now don’t get me wrong, I’m still pretty anxious about having to have my next cervical screening in three years time because I know that it is still likely to cause me pain. And being disabled just adds to the issues by making it more difficult to access. But I guess I wanted to tell my story because it shows just how important it is to find a medical professional that you can really talk to about your worries when it comes to your smear test. There are so many different things that can be put in place to make the experience more manageable for you – that could be using a different sized speculum, having a friend/relative come with you (which, by the way, is completely normal and lots of people do it!), making adjustments for a disability or even going to a specialist hospital clinic for people who find smear tests particularly difficult.
So whether it’s your first smear and you’re scared of the instruments they use, whether you need to wear fancy underwear or if they will judge you for how you look down there. Or if it’s your third, fourth, fifth plus test and you’ve had experiences in the past that might make the whole process more difficult for you. My biggest piece of advice is to just talk to someone. Whether that’s your Mum, sister, friend, GP, the nurse or even a charity like Jo’s Trust (0808 802 8000). If something is worrying you about your smear test – anything at all – please talk to someone. I promise you’re not alone in finding it difficult. And the more we speak about our own experiences, the more people will realise that every smear test is different and that it’s OK if yours isn’t a straightforward process.
Have you found having a smear test difficult? What advice would you give to others in a similar position?
