What to Expect from a Smear Test

One thing I didn’t know before embarking on this deep-dive into our down theres is that some people have such gorilla-grip pussies they can shoot a speculum across the room at the GP.

This is a level of power I can only daydream about as I squeeze out some kegels in the Uber home after the pub. And this anecdote – shared by several people – is one of many that shows how the experience of having a smear test can be just as varied as the many people who need them. 

A smear test, also known as cervical screening, is a routine check on the health of your cervix by a nurse or doctor, who looks at your cervix through a speculum (which, if you didn’t know, looks like this). They’ll also take a cell sample and send it off to check for certain types of human papillomavirus (HPV) and changes in the cells covering the neck of the womb. Most people will be called for a test every three years between the ages 25 to 49 (you’re posted letters telling you when to book) and then every five years from the ages of 50 to 64. 

That said, regularity of appointments can change depending on the results. It’s totally normal to be asked to come more frequently, so don’t worry if you are. And if you’d like a more visual idea of what to expect, Steph McGovern recently had her cervical screening done live on Channel 4 to help raise awareness. Go on, Steph!

If you’ve never had one before, or you’re dreading your next visit, the following guide will hopefully help with your fear of the smear.

The point of a smear is to test for HPV – so what if you do test positive? Imogen Pinnell, Health Information Manager at Jo’s Cervical Cancer Trust, explained that “HPV is really common – around four in five of us will get it at some point. A few types of HPV (high risk types) can cause the cells in your cervix to change, and by detecting them through a smear test we can find who is at higher risk of cervical cancer and offer treatment or monitor you more closely.” 

Pinnell added that if the test is positive you will be asked to return for another smear the following year, to detect if your HPV has gone (which happened to me this year, see ya bitch), or if you might need a colposcopy. 

A colposcopy is basically the next Pokemon evolution in smear tests, where they look a bit closer and potentially take a biopsy, and usually takes place in a hospital rather than at your GP’s office.

Before you’ve experienced a smear test, it can be pretty daunting. While everyone and their nan might tell you it’s the easiest thing in the world – which isn’t always true – it doesn’t mean you’ll miraculously feel fab about going for one. It’s important to recognise that some people have reasons to find smears difficult that others may not experience, such as being a survivor of sexual violence, being a trans man or non binary person with a cervix, cultural barriers or certain health conditions.

“It’s totally normal to be nervous about it, and you’re not alone if you feel that way,” said Pinnell. “You might feel better knowing what to expect – so you could ask a friend or family member what it was like for them, speak to your nurse or doctor, or you can call our free, confidential helpline.”

Discussing with your practitioner how the entrance exam is going to be held is a smart move to know what to expect. It’s also important to trust your smear technician, and if you get bad vibes, know it’s well within your rights to request a different person to do it. 

Kira, 31, whose transmasc partner was made to feel uncomfortable by a nurse who didn’t “understand how you can be a man and need a smear test”, wishes that her partner had left the room rather than continue with their smear. “I think FTM [female-to-male] people do get left behind in conversations about smears and reproductive health,” she said. “They're often a high risk group that actually need more check-ups, but get the fewest.”

For those like Kira’s partner, who have lost trust in medical practitioners after a bad experience, it’s also worth reaching out to those in your community for advice and support. Through the fat community online, I learned that the angle I’d be examined from may need to be different compared to my thin peers, so when I was asked to rest my ass on my fists during my exam (to give the nurse easier access) it didn’t take me by surprise, and, therefore, didn’t make me spiral into feelings of inadequacy or exclusion. 

It’s also worth noting that changing the traditional position of your smear can be asked of almost anyone with a cervix. If you have a tilted cervix, for example, you may be asked to adopt the fisting position (not that kind). There are also other positions – such as the lateral position – that you can request for your own comfort.

Jessica, 27, said they wish they’d known that you can’t be even “spotting from your period”, let alone in the full throes of jam week, when going for a smear. They warned that, “Even though I was coming towards the end of my period, because there was still slight spotting they wouldn’t do it, and I had to make another appointment.” The surgery should double check this with you while making the appointment, but smear tests are usually done in the middle of your cycle. 

Speaking of vaginal blood, Grace, also 27, wants more people to know you should bring a panty liner along to your appointment just in case: “Nobody told me that you can bleed a bit afterwards, so I didn’t wear a panty liner. RIP the knickers I wore that day.”

Sarah – who is 37 and has a “low and difficult cervix” – said there are different size speculums you can request, as well as different kinds. “After breaking three speculums and finding the plastic ones are not ideal for me, we tried a metal one and my smear was over in seconds,” she explained. 

Sarah is one of many who recommended asking for different speculums when uncomfortable. Wallis, 27, said that those with the coil might also want to discuss their contraception prior to the test. 

“If you have the coil, they will often check your threads while they’re up there,” she said. “The first few times I had it done, I was really unprepared and didn't feel like I could say no. Now, I discuss it up front whether I want it or not.”

Due to the need to get inside the fanny canal, the more relaxed you are, the easier things tend to be.

For those with conditions like vaginismus, that might be easier said than done – but there is support available for those who experience any kind of vulval pain. Pinnell also said that, as well as discussing what support you need with your nurse or doctor, you can also “bring headphones to listen to something” or “practice some breathing exercises” to distract yourself during the examination.

It may also be worth booking a double appointment so you have plenty of time to make yourself comfortable. 

After you’ve wiped the lube off your labia with blue roll, left it in a nice little pile on the bed and pulled your bottoms up, it can be easy to fall into a post-smear cringe. The best way to overcome it? Remember all the people who have had them before. Your mam. Your nan. Your worst enemy. Victoria Beckham. Everyone unflappable, gorgeous and chic you’ve ever met.

@GINATONIC