Let’s talk smear tests: your questions answered by a GP

Whatever you're worried about, we've got you covered thanks to Dr Rachel Hines, a GP specialising in women’s health and menopause.

“Give yourself plenty of time and take someone in with you if you’re feeling nervous. Remember to breathe deeply, focusing on each inhale and exhale – it can really help make your smear test a little easier,” begins Dr Hines.

So, let’s get into what to expect, some common (and totally normal) questions and tips to help you feel more comfortable.

Screening is offered to women and people with a cervix aged 25 to 64 in the UK.¹ Although it helps to find any abnormalities before they can turn into cancer, it's not a test for cancer; it's a test to help prevent it.²

“When you have a smear test, it's looking for HPV as a human papilloma virus because over 99% of cervical cancers are caused by HPV,” explains Dr Hines. “So, when you have a cervical smear, it’s actually a HPV test that’s being done,” she continues. “It picks up signs of abnormalities and therefore should be preventing cervical cancer, hopefully.”

There are some reasons not to have a smear test, such as during pregnancy, if you've had a total hysterectomy or shortly after giving birth – but your GP can advise based on your situation.

HPV is passed on by sexual contact, it’s quite contagious. “It’s passed from one person to another quite easily,” says Dr Hines.

But it’s important to remember you don’t need to have penetrative sex to contract HPV. You can get HPV from:³

There shouldn’t be any shame associated with HPV. It's a contagious disease that around eight out of 10 people will be infected with at some point in their lives.⁴ Your body may be able to fight off the infection with time, however, HPV usually causes no symptoms and the only way to know is to keep attending cervical screenings.

“It can be difficult to sort of get your head around… HPV is a viral infection and it’s passed by sexual contact, but it's not a sexually transmitted infection like chlamydia or gonorrhea,” she says.

Unlike other STIs, Dr Hines continues: “Your body will clear HPV by itself.” Most HPV infections don’t cause any problems and are cleared by your body within two years.

Treatment is generally only needed if HPV causes problems like genital warts or changes to cells in the cervix.³

“The HPV vaccination is brilliant and we're starting to really see a drop in numbers of cervical cancer cases, but you still need regular smears,” she says. “The HPV vaccine is given usually from the ages of 12 to 13 – in year eight of school – before you're sexually active,” she continues.

It's encouraged by the NHS that you still get the vaccine when you're older if you haven’t already.^5,6

“Of course, a nurse or doctor may notice certain things that you think need to be reviewed, like skin changes, growths or anything that could cause concern,” she says. “But not because of things like different shapes and sizes.”

Something they do keep an eye on are any changes that are causes for concern, such as conditions that can develop as we age. “So actually, it's a really nice opportunity for someone to perform an overall vaginal examination to see if there is anything different,” she says.

After your nurse or doctor has finished taking the sample, they’ll take out the speculum and then you can get dressed.

“It can feel odd, and it can feel uncomfortable, but it shouldn't be painful,” says Dr Hines. “It's a slightly odd sensation when you have it done, but if you do feel pain at any point, you need to tell whoever's doing the smear test. It's really important that you don't feel like you must just go along with it. If it's hurting, tell them to stop,” she adds.

Communicating about how you feel is the key to having a more comfortable cervical screening. If you’ve had a bad experience before, tell the nurse or doctor who’s doing the screening, so that they can allow plenty of time if you’re worried or anxious.

“There are different ways and techniques to make it not uncomfortable,” says Dr Hines. She also pointed out there are different sized speculums (because – you've guessed it – there are loads of different sizes and shapes of vaginas). So, if it doesn’t feel like a good fit, they may try another one.

You’ll be monitored closely and may need to attend more appointments or begin treatment – it's important you attend any follow-up sessions.

Dr Hines' top tips for your smear test:

She says you could also take a pad or liner with you, “in case you experience a bit of bleeding or spotting”. A little bit of bleeding after a smear test is completely normal, however, if you experience heavy bleeding or bleeding that doesn’t stop after a few hours, contact your GP.¹¹

Taking your headphones in may also help you to feel more at ease. Pop on your favourite song and focus on the lyrics or how it makes you feel – by the time it’s over, your smear test will be too.

With Dr Hines' knowledge and top tips, you can feel confident and ready for your next appointment. To book a smear test, contact your GP, or simply wait for a letter to come in the post.

Curious about what different period blood colours mean? Read on to find out what’s normal and when to check in with your doctor.