Everything you should know before your first smear test that the invitation letter won’t tell you

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1 year ago | UPDATED 1 year ago

At some point in your 25th year an important and unfriendly letter drops through your front door inviting you to your first cervical screening (smear test) to check for abnormal cells that cause cervical cancer. Although the letter explains why booking an appointment is important, it also leaves a lot to the imagination— and, inevitably, Google.

So, in case you’re currently falling down a Web MD self-diagnosis panic spiral, we spoke to Babylon‘s women’s health expert Dr Elise Dallas and gynaecological health pioneer from Daye, Valentina Milanova, about everything you should know before your first smear test that your invitation letter definitely won’t tell you:

You can’t go for an appointment when your period is due

After summoning the motivation to book a doctor’s appointment, clear your diary and get to the clinic, there’s nothing more frustrating than realising you can’t even have a successful smear test because you’re on your period. “The NHS advises avoiding getting a smear during your period as the blood cells on the sample make it difficult to read the test,” explains Valentina of the rule. “You cannot be tested during your period, so make sure you make an appointment before or after your period is due,” reiterates Dr Dallas.

You shouldn’t have sex in the 24 hours before your test

Doctors recommend you don’t have sex in the 24 hours before your test because the cells that line your cervix, which are being tested, can get irritated and inflamed. This irritation, as well as sperm, lube, and chemicals in some contraceptions, can affect your test results. So, it’s best to resist for the day before.

There’s more than one size speculum

Obv, every vagina is different. So, there’s more than one size speculum your nurse will choose from when she does your smear. “Just like vaginas, speculums come in different sizes. Factors like genetics, age, health and sexual activity determine your vagina’s size and how stretchy or elastic your vaginal walls are,” explains Dr Dallas.

“However, your cervix is often quite deep inside, so choosing a short small one may not suit your needs. It’s important for your comfort that the health care professional chooses a speculum that fits your vagina comfortably but one in which your cervix can be reached.”

You might experience some minor cramps or bleeding after your test

After your smear, your cervix might be a bit irritated or sensitive so, cramping and bleeding that feel sort of like getting your period are actually pretty common. The bleeding should be fairly light and stop within a few hours, according to the specialists at Lloyds Pharmacy. But, in the less likely event you’re in a lot of pain or bleeding heavily then make sure to contact your GP.

You should still go for your smear test even if you’re a virgin or lesbian

“I will often have women in my clinic who have missed their screen invitation intentionally as they feel they are not at risk as they have never had penetrative sex (either a virgin or a lesbian),” says Dr Dallas. “All women and people with a cervix aged 25 to 64 are entitled to cervical screening on the NHS. While sexual history may influence someone’s risk, it shouldn’t determine whether or not they have a cervical screening.

“The HPV virus is a sexually transmitted disease,” she adds. “So, according to the NHS, if you’ve never been sexually active, you can decide not to have the cervical screening test. Although the risk of developing cervical cancer is related to sexual activity, virgins can also get cervical cancer, although their chances are extremely low.”

Your nurse might ask you to put your hands under the small of your back to tilt your pelvis and help locate your cervix

“Your cervix is the entrance to your womb (also called your uterus), and sometimes it can be difficult to find because usually, the cervix sits straight at the top of your womb, facing towards your lower belly,” explains Dr Dallas. “However, some women have a tilted womb making the cervix lean more towards the back, which can make it harder to see during your smear test. Nurses sometimes suggest popping your hands underneath your bottom as this helps to tilt it forward. Sometimes just tilting your pelvis up towards the ceiling is enough.”

You can ask to stop entirely or for a break at any time

When having any genealogical procedure done, it’s easy to forget that it’s your body and you’re the one in control. And taking a break during a smear test could make the procedure easier for you to handle. “The vagina is a muscle and can clench up if highly anxious so remember to try and breathe during the exam,” says Dr Dallas. “It may help to agree on a word or hand signal so the health professional knows to stop immediately if you want them to. Sometimes it is easier to take a pause after the speculum has entered but before the nurse opens it to find the cervix.”

The test usually takes less than five minutes

Although the prospect of a smear test is daunting, the procedure is only uncomfortable and over in minutes. “The whole appointment should take about 10 minutes, which will include you undressing and dressing at the end and discussing any concerns you may have,” explains Dr Dallas. “If you are worried or feel you may need longer, you can always request a double appointment.”

“Whilst it may be uncomfortable, it shouldn’t be painful and will be over before you know it,” adds Valentina.

Featured image credit via Healthwatch/NHS England