My first time... getting a smear test!
Ever wanted a WikiHow for the socially anxious? Look no further.
Self-care note: This newsletter talks about cervical screening and genitals. If you find this distressing or triggering, remember to take it at your own pace. You may prefer to read small sections, wait until you feel ready to read it all, or choose not to read it at all.
Content note: "My first time…" is a series that leverages personal experiences to provide readers with insights into various scenarios. Due to their experiential nature, articles within this series may not fully capture everyone's experiences. To address this, we always ensure to provide resources that offer support to individuals from diverse backgrounds. In this instance, the writer is a cis woman, but cervical screenings are beneficial to individuals of all genders. As such, you will find links to relevant resources.
It was a sleepy Friday morning when, shortly after moving to Scotland, I was startled awake by the screeching sound of letters being passed through my door — a noise that still makes me jump to this day.
As I shuffled towards the door, I found myself face-to-face with a letter from the NHS informing me that, as I was approaching the sweet age of 25, it was time for my first smear test. I'll be honest, despite my lack of excitement at the idea of anything gynecology-related, I wasn't particularly worried.
That is until the day of the test arrived. I had no idea what to expect, what to wear, or who to talk to, so I started googling. I know, not my best idea. From Reddit rabbit holes to NHS deep dives, I found myself swinging between information that felt too anecdotal or, quite the opposite, too dry.
If you've found yourself in a similar predicament, feeling lost in the maze of information about cervical screenings, or if you're about to get your first smear test, here's our how-to guide on what to expect from your first time, written with some precious insights from Kat Wilson.
Kat is a workshop facilitator and coordinator based in Glasgow. She is currently leading a project with her company, Culture Junction, focusing on the barriers to cervical screening, funded by NHS Lanarkshire. Kat has vaginismus and is the co-founder of the Vaginismus Network and co-host of the Flowers of Scotland podcast.
Whether you're preparing for your first smear test or seeking to support someone who is, read on to find out how to make the experience easier.
What is a smear test?
A cervical screening, commonly known as a smear test, is a test to check the health of your cervix, which is the opening between the vagina and the uterus.
It's not a test for cancer, it's a test to help prevent it. It’s considered one of the best ways to protect yourself from cervical cancer as regular screenings can reduce cervical cancer diagnoses by up to 96 per cent.
If you have any last-minute worries about cervical cancer, you can find out more about it here, from how it presents to what treatments are available.
What happens when you get a smear test?
First off, you’ll receive an invitation letter in the post when it's time to book your appointment. This usually happens for women and people with cervixes as they reach the age of 25 and continues until they are 64. In the letter, you’ll find information about how to book the test as well as where you can go for the screening. Most smear tests are performed in a GP surgery by a female nurse or doctor.
Once you have booked your appointment, it’s time to head to your local surgery or the designated location. You will sit in the waiting room for a while, then your name will be called for you to go into the doctor’s or nurse’s room. Here, they will ask you a couple of questions about your general health and sexual activity, followed by an explanation of the procedure. You can also ask questions yourself, and if you’re feeling nervous, be open about it as they’ll have plenty of reassurances for you.
Now, time for the test. The doctor or nurse will put a clean paper sheet on the bed, then they will draw the little curtain so that you can have a bit of privacy as you undress from the waist down. You’ll also get a little paper sheet above your genital area as you lie down on the bed, just to give you that extra privacy.
“If you feel kind of awkward and uncomfortable at the idea of lying on a bed with nothing on in the bottom half, I have a tip for you,” Kat Wilson says. “You can just wear a skirt or a dress that can make you feel less exposed.”
The way you will lie down is with your back and bum on the bed, legs spread open. Then, the nurse or doctor will use a tool called a speculum (pictured below), which is a smooth, tube-shaped instrument designed to gently separate the vaginal walls for better visibility of the cervix.
Basically, that tool is inserted into your vagina (with lots and lots of lube) and needs to go all the way up to your cervix. The experience can be different for everyone, but the majority of people describe it as painless, just a tad uncomfortable. What everyone agrees on, however, is that it feels cold.
Ok, the speculum is up there, what is it doing? During a smear test, a small sample of cells is taken from your cervix with a little brush inside the speculum. The sample is checked for certain types of human papillomavirus (HPV) that can cause changes to the cells of your cervix. These are called "high-risk" types of HPV. If these types of HPV are found, the sample is then checked for any changes in the cells of your cervix. These changes can then be treated before they progress into cervical cancer.
Now, trust me when I say that the description of the test is probably longer than the test itself. On average, you’ll be in and out in five to ten minutes. Once it’s all done, you will be provided with some paper to remove the lubricant, and you’ll dress up again. After that, you will be informed about when you’ll be able to receive the results (here you can find all the different answers you can get). It can usually take up to eight weeks, and they’ll come back to you in a letter.
“Don't let the thought of the results put you off,” Kat tells me. “Obviously, nobody wants bad results, but it's better to get those results early than later, right?”
While it's natural to feel anxious during your first smear test, it is a very routine procedure, and even if abnormal cells are found, this is quite normal and just something to keep an eye on. The whole point of the test is to catch cancer before it even has a chance to develop, so keeping up to date with your smear tests could be life-saving.
How to prepare
“A good thing to do before your first smear is to learn about it,” Kat tells me. She recommends Jo's Trust, a cervical cancer charity, as an excellent resource. “They have loads of information on the website about what to expect, from the process itself to aftercare.”
“I’m aware that, for some people, reading about what happens doesn't sound very nice and it can sound quite scary instead.”
You don’t need to read through all the medical intricacies of the examination, but it can be good to read up on how to prepare to make things easier if you’re feeling a bit nervous.
When asked about what she recommends to the attendees of her workshops to prepare for their cervical screening, these are Kat’s top five suggestions:
Take somebody with you, if having company makes you feel more comfortable;
Book a longer appointment;
Bring your headphones with you, if you think you'd rather just listen to some music and relax;
If you have the opportunity to do so, talk it through with family and friends;
Be kind to yourself.
In Kat’s experience, many people are put off getting a smear test as they worry about the look, smell, and overall perception of their vulvas. “People often ask me if they need a bikini wax to have the screening, and if they will be judged for their appearance,” Kat says. “The answer to all of these questions is of course not.”
“Nurses and doctors don't care what you look and smell like, it doesn’t matter,” she continues.” “I do however understand that people can feel shame and embarrassment about that part of their body.”
Just remember that nurses and doctors have seen thousands of vulvas and that they’re there for your health, not to judge you.
What if I don’t identify as a cis woman?
At the moment, only people who are registered as female with their GP surgery or clinic are automatically invited for cervical screening. However, anyone with a cervix can benefit from a smear test.
According to the Jo’s Trust website, if you are registered as male, aged between 25 and 64, and want to go for cervical screening, you can:
ask your GP surgery to send you invites directly;
put a reminder in your phone or calendar to ask for an appointment every 3 or 5 years, depending on your age and where you live.
There are also expert clinics, including some trans-led clinics, that offer cervical screening. Although these clinics can’t invite you automatically, you can book an appointment with one.
The above mentioned Jo’s Trust offers various resources for trans and non binary people, including both explainers and testimonials written in collaboration with the LGBT foundation. You can read them all here.
I struggle with any kind of penetration — what should I do?
If I could give any advice to my younger self, it would be to properly learn about the process of smear tests and just have the confidence to try it. I didn't have my first smear test at 25. I had it at 35 because I was so worried about my vaginismus possibly making it painful or even impossible. The thing is, you can just go for it, even if it doesn't go well. You can just try again. But also, don't beat yourself up if you're not going for it when you first get the letter. Just don't be like me and ignore it for 10 years. Start actively working towards being prepared for it, it’s in your best interest.
Kat Wilson
If you have a history of sexual trauma, or are living with conditions like vaginismus and vulvodynia, where you know that penetration is painful most or all the time, one thing you can do is let the doctor or nurse know. “Just say — Kat suggests — ‘This is possibly going to be painful or difficult for me, so can you please be gentle and bear that in mind?’“
She continues: “Always remember that it's your body. It's your appointment. You don't have to do anything that you don't want to do. If you are finding it too uncomfortable or too painful then just stop, don't beat yourself up about it. Go away and come back at another time.”
You can also ask for various accommodations during the appointment, such as different shapes and sizes of specula, more lubricant, or to take a break.
It's your body. It's your appointment. You don't have to do anything that you don't want to do.
As mentioned above, longer appointments can be booked, making sure you don’t feel any kind of pressure.
“A lot of people don’t know it’s a possibility, but you can ask the surgery to give you a double appointment,” Kat says. “Granted, you might need to wait a little longer, but it means you’ll have an extra 20 minutes to feel more at ease.”
If you want to prepare on a more physical level, you can also use dilators at home to become accustomed to the sensation and increase comfort.
“I would say go and be kind to yourself,” Kat concludes. “You know what, why not take yourself out for a cake or a nice coffee afterwards?”
Who knows, our next newsletter might be titled ‘10 best treats to get after a smear test’ 🎂
Join us in Glasgow for our next reading group 🍒
📌Glasgow Zine Library 📆 26 March 💸 Free! ⏰7-8.30pm
The Sex Positive Reading Group is for anyone interested in learning more about sex education, sexual health, how we relate to the people around us, and how society impacts that. We welcome people of all genders, sexualities and ages in a non-pressured, non-academic setting.
Reading materials will be provided (this month we’re reading So Hormonal) and we'll be discussing one chapter per book: we want anyone to feel and be able to participate! If you have accessibility requests or other queries, send us an email at pillowtalkscotland@gmail.com.
This reading group is a mixed space, i.e. it welcomes both straight and queer people, just so you know what (and whom) to expect when joining us.
Other spicy events happening soon🌶️
The psychology of attraction. 20 March, Glasgow.
Navigating online dating. 21 March, Edinburgh.
Sex Positive Reading Group. 26 March, Glasgow.
The Unjustness of Just : a space for women to share their stories. 7 April, Glasgow.
Sex & Drugs & all that Jazz (or How to crochet your way to health), a lecture by Professor Jamie Frankis. 9 April, Glasgow.
Book Launch: Shane Strachan. 25 April, Glasgow.
Breast Quilt as part of the Comfort exhibition. 1st February to 18th April, Glasgow.
The purpose of Pillow Talk Scotland is to provide information. You must not rely on the information on this newsletter as an alternative to medical advice from your doctor or other healthcare professional. You must always consult your doctor or healthcare professional if you have any concerns about your medical condition, diagnosis or treatment. Pillow Talk Scotland is not responsible or liable, directly or indirectly, for any damages resulting from the use of information contained within this site.
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