By Aoife Tobin
Smear tests. I can already feel the vaginas tensing at the thought. It may not be a pleasant experience, having your cervix tickled, legs splayed in front of your childhood doctor, but it is so necessary and could save lives.
A smear test is conducted to detect any changes in the cells of the cervix that could potentially lead to cancer. Cells can change for a number of reasons- being on the pill is one, HPV (Human Papillomavirus) is another. Almost everyone who is sexually active will come into contact with HPV at some point in their lives. The introduction of the cervical cancer vaccination for young women is a huge step forward for cancer prevention, however a lot of women my age missed it by a mere year or two, and this is why smear tests are so important. Men are less affected by HPV, but still carry it (why they don't get vaccinations to prevent them spreading it is beyond me, but that's another argument), and that's why if you’re sexually active, use of protection or not, you should have a smear test.
The morning of my 25th birthday the first thought I had wasn’t “Fuck, I’m 25”, it was “Fab, I’m eligible for a free smear test”. Call me weird, but I was pretty excited about it. I had heard so many stories of women younger than me going through treatment for cervical cancer, some ultimately dying from it, all because of a lack of access to free smear tests before the age of 25. Don’t get me wrong, if you’re under 25 and feel there is something going on (spotting, bleeding after sex (every time), painful, long and heavy periods), go see your doctor and get an early screening if they feel it’s necessary. Every year in Ireland approximately 300 women are diagnosed with, and 90 die of cervical cancer (IFPA statistics). It is the second most common cause of death due to cancer in women aged 25-39. That may not seem like a huge number, but when you think about how small Ireland is, it’s scary enough. And they are only the detected and diagnosed statistics.
You must be reading this thinking I personally had a brush with cervical cancer, or someone close to me did but that's not the case. Sure, cancer has affected my family, close friends, pretty much everybody, and detecting and treating it early is key. My results came back fine. But the point I’m trying to make is, get your smear tests done. Give yourself peace of mind for three years. Get treated early if something is detected. I had my smear test in August of 2016 and I’m going to write about exactly what happened during it, to hopefully put other women’s minds at ease, and if I can just encourage ONE woman who hasn't gotten her own smear test yet to do it, I’ll see it as an accomplishment. I have spoken to so many friends, colleagues and acquaintances about smear tests and a lot of them haven’t bothered to register or get it done despite getting the letter from Cervical Check for a number of reasons. "It’ll be too awkward". "My doctor is a man". "I’ve had my doctor since I was a kid". !It’ll hurt"!. "I don’t have time". "No way is anyone looking down there". "Eugh, speculums!". "I feel fine". "What are the chances". "I’ve only had one sexual partner". "I’m a lesbian". "I don’t have HPV". "I didn’t get the letter".
Frankly, all the above excuses are bullshit. Doctors see vaginas all the time, and if you’re worried yours looks weird or there’s a problem, your smear test is the PERFECT opportunity to voice concerns. If you’re stuck for time, make an appointment for your lunch break (I promise it takes ten minutes tops) or see if your doctor or any clinic does a late evening or Saturday clinic. If you’re not comfortable with your childhood doctor peering into your vagina, make an appointment with a different clinic (there’s a list on CervicalCheck.ie). Cells can change regardless whether you’ve slept with one or one hundred people, men or women. In order to get the letter inviting you for a smear test, first you have to register online at CervicalCheck.ie with your PPS Number under the ‘When is my next smear test’ tab. Once you do that, they will send a letter out a couple of weeks after your 25th birthday encouraging you to make an appointment. If you haven't made an appointment after a few weeks... they'll send you out another. So save the trees and just do it. I made my appointment with my regular GP who I’ve been seeing since I was a wee one. I’m pretty open and relaxed about all things sexual health/vag related so it really didn’t bother me letting her have a look.
Disclaimer: this is where I begin to go into detail about my vagina so any family members who’d like to look me in the eye again, stop reading. Or keep going, I really don't care. Anyone who has been up close and personal with my vagina, I do apologise, try remember it as it was. I woke up that morning and had a shower, gave the bikini line the once over and put on my best cotton knickers. I rocked up to the clinic, letter in hand and took my seat in the waiting room.
When I went in I had a quick chat with my GP, told her what I was up to, how the fam was and she praised me for coming to get my smear test done and explained that she was worried at how few women my age actually go and get their smear tests done and asked me to encourage my friends to get them. And this is what I’m doing now. She explained quickly what a smear test was, what she would be doing and asked if I had any questions. She then asked me to strip from the waist down and pop on the bed. She pulled over the curtain and I quickly pulled off my leggings (I know, grim, but they’re breathable, right?) and knickers. I was a little conscious that I might have a little goop (I didn’t know what word to use here... ‘secretions’ and ‘discharge’ are a bit clinical, ‘wetness’ makes it seem like I was a little too excited for a smear test. But hey, a vagina is a vagina) so I had a wee pack of wipes handy and gave it a quick wipe. Just like before you get a wax, you want your lady garden to look presentable, right? Well, I did. I popped up on the bed, and put the paper towel over my crotch. I realised I still had my socks on.
She asked if I was ready and opened the curtain. She had the speculum and the vials in plastic and that's when I got a little nervous. I had had a speculum in before but its like getting an injection or blood drawn, not entirely fun. She asked me to open my legs and she turned this unbelievably bright light on. I’m sure it made everything look STUNNING. She said everything looked fine from the outside (yay) and then put two (I think?) fingers in and said “Yeah I think we can use the small speculum here” (Still got it). I was told to relax and she said it helps if you slightly raise your pelvis to avoid increasing discomfort when the speculum goes in. I stared at the ceiling tiles as she pushed it in, that was fine, and then she began to crank it open.
Now ladies, this is what everyone is afraid of. The dreaded cranking open of the speculum. I promise if you relax your vaginal muscles and tilt your pelvis upward it is far more comfortable. When she had it opened fully, it wasn't breezy and didn’t feel like my vag was wide open. I felt some pressure on the back wall of my vagina but nothing too unbearable. See: Girls season 1 episode 2, “Does it hurt?” “Yeah, but only in the way it's supposed to”.
She told me I had a slight abrasion on my cervix but not to worry, as this can just be a common side effect of using the pill. Then she showed me what she was about to put in me. The swab. This is what I can only describe as a mascara wand, a longish probe with a wee brush on the tip. She explained that this is used to extract the cells from the cervix and may feel a little uncomfortable or ticklish. She was right. It was a weird sensation- she swirled it around a couple of times and it felt like what I can only describe as rubbing the bristles of your toothbrush against the roof of your mouth. But a little rougher. And in your vagina.
It lasted no longer than ten seconds and then she popped it in the vial and removed the speculum. Done. She said there may be some very light bleeding afterwards (because you're essentially getting your cervix scratched), which there was so I’d recommend wearing a liner for the rest of the day just in case. I got dressed and she asked me if I had any more questions or concerns, which I didn’t but I asked her for a new prescription for my pill (two birds, one stone and all that) and went on my merry way. About three weeks later I got a letter from CervicalCheck telling me my results were normal and that they will be in contact again in three years so I can arrange another test.
It was such a relief, knowing I’m fine and don't have to worry about it again for another three years. My doctor was so thorough and explained everything as she went along to put me at ease. It was in no way as painful as I had anticipated and I can’t reiterate the importance of getting it done enough. I’m lucky that my results were normal. And even if they weren’t, I would feel lucky that something was detected early because the earlier the detection, the quicker the treatment, the higher the chance of recovery and survival.