Getting a smear test doesn’t need to be scary. We share eight ways you can take the anxiety out of your next cervical screening

Let’s be honest – getting your cervix checked by a total stranger is no-one’s idea of a good time. Trips to your GP are rarely fun, but we understand that they’re a necessary part of putting our health and wellbeing first. Why then, do thousands of us dread that little envelope every three years?

I’ll admit, despite getting regular reminders from my GP since hitting 25, it took nearly five years for me to give in and get my first cervical screening. Thanks to a mixture of embarrassment, nerves, and a fear of the unknown (sprinkled with a liberal, general dislike of all things medical-professional-related), I joined the thousands of women who missed out on their smear tests each year.

As many as one in four of us skip our smear tests – despite screenings saving around 5,000 lives each year. According to the statistics, around 3 million of us in England alone skipped our smear tests between 2015-18. Thanks to rebranding in 2019, which saw smear tests labelled as ‘cervical screenings’, along with a successful public health campaign, waiting lists began to soar as more and more women began booking in tests.

If you’re still nervous about booking your test, or are anxious about what to expect (and how you can make it more comfortable), we’re here to help. Here’s (just about) everything you need to know about getting a smear test.

Who can have a smear test?

If you’re aged 25-65 and have a cervix, you may benefit from having a smear test. Those aged 25-50 can expect a reminder to book your screening every three years (unless otherwise advised), while those aged 50-65 should expect to have a cervical screening every five years.

Women aren’t the only ones who should consider getting a check-up. If you are a transgender man who hasn’t had a total hysterectomy, or are a non-binary individual with a cervix, getting a smear test could help to spot HPV early on – potentially spotting cells that could become cancerous years before they have time to fully develop.

Even if you’ve had the HPV vaccine, it’s important to know that this can only help protect you against two of the 15 strains of the virus. Having a smear test is still important.

If you’re under 25, there’s no need to book a cervical screening. Of the women diagnosed with cervical cancer each year, less than 1% are under 25, with 0 deaths from cervical cancer occurring each year according to Jo’s Cervical Cancer Trust. Current research suggests that cervical screening doesn’t help reduce cervical cancer diagnosis amongst the under 25s. However, if you are worried you may be experiencing any symptoms such as bleeding after sex or in between your periods, you should speak with your GP.

Why is getting a smear test important?

Getting checked out can help prevent up to 75% of cervical cancer cases. Smear tests are a key part of preventing cervical cancer, as they can help identify potentially worrying cells years before they have time to develop into something more serious.

How to make your smear test more comfortable

1. Bring moral support

If you’re feeling nervous, there’s no need to go it alone. You can bring a friend, family member, or your partner along to help provide moral support during your test. They can come in with you, hold your hand and help keep you distracted, or if you’d prefer, can just wait for you to be done in the general waiting area.

2. Get comfy

Carefully choose your outfit. Wearing loose-fitting clothes that you can easily lift (such as a skirt or dress) mean you can leave your clothes on without the additional worry of having to get undressed.

3. Timing is key

While you can get your cervical screening done during your period, this can decrease the likelihood of getting enough cells for your doctor to check for HPV. To avoid any need for a repeat visit, try and book your screening for towards the middle or end of your cycle if possible. Many period tracking apps can let you know when you should next be due.

4. Research

If you’re feeling anxious, knowing what to expect can help you to feel more relaxed and prepared in the run-up to your appointment. Don’t be afraid to let the nurse or GP known that you’re feeling a bit uneasy. From personal experience, once the nurse knew I was nervous, she started talking through each step before she got started so I knew what to expect and wouldn’t tense up as much. It may not sound like much, but it made a huge difference.

5. Double up

When booking your appointment, you can request a longer (a double) appointment. These give you a little more time to take things slow, without the added pressure of watching the clock. If you are a survivor of sexual assault, have a learning disability, or are particularly anxious, you don’t have to disclose the specifics – just ask for a double appointment when you book.

6. Just ask

If you are feeling embarrassed, you can request a female doctor or nurse. While it isn’t always possible (or you may have to wait a little longer for someone to become available), most GP services will do their best to accommodate you.

Similarly, if you’re worried about feeling any pain or discomfort, you can ask for them to use a smaller speculum. If you have sex or use penetrative sex toys without experiencing pain, a speculum shouldn’t cause any problems.

Once your screening has begun, if you feel any pain or discomfort, let the nurse or GP know. You may be able to change position, take things more slowly, insert the speculum yourself, or use more lubricant. If you feel nervous, uncomfortable, or overwhelmed, you can ask them to slow down or stop.

7. Be prepared

It’s worth remembering that spermicide and excessive amounts of lube shouldn’t be used for around 24 hours before your smear test, as these can interfere with your results.

Before going in for your test, try and spend five to 10 minutes practising deep, mindful breathing techniques. This can help you (and your muscles) to feel more relaxed and at ease.

8. Be open

Before your exam, take a few minutes to think if there is anything relevant that you should tell your nurse or GP. If you have a tipped uterus, aren’t sexually active, or infrequently have penetrative sex, this could make the exam a bit more uncomfortable. If you usually experience pain during penetration, have vaginismus (an involuntary muscle contraction of the vagina), or a history of sexual trauma, letting them know can help them to tweak their approach to help you feel more comfortable and in control.

Remember: no-one is here to judge you!

No matter how nervous you may feel, chances are, your doctor or nurse has seen dozens of genitals already that week – if not more. How your vagina looks, how trimmed you are, any natural smells, even worrying about accidentally farting during your exam are all natural fears we experience. It’s good to remember that no matter who is performing your smear test, their focus is fully on your health – not on what your genitals look like. The chances are, you’re giving it much more thought than they are.

What happens after your smear test?

Over the next 24 hours, you might experience a little spotting or light bleeding. For your own comfort, wearing a sanitary pad or panty liner can help. If you feel any continued pain or significant bleeding, it could be worth returning to your GP.

Results take around two weeks and typically come in the post. For over 90% of women who are tested, their results come back as normal. If no HPV is found, you should be invited for your next screening in three to five years. If HPV is found, but there are no changes in your cells, you will typically be invited to come back for a screening in a year to check that the HPV has gone.

If cell changes and HPV have both been found, you should get a letter inviting you for a colposcopy for further tests. If your first test was unreliable or couldn’t find enough cells to check, you should go for another screening after about three months.

Finding further help, support and information

For more information on how to and when you should book your smear test, check out the NHS guide to cervical screening. For detailed information on cervical screenings and symptoms of cervical cancer, visit Jo’s Trust or check out their detailed guides on cervical screenings for those with a learning disability and those who have experienced sexual violence.

Find out more about cervical screenings as a trans man via the NHS and Cancer Research UK websites.

If you are worried anxiety may be holding you back from looking after your health and wellbeing, or from doing day-to-day activities, it’s important to know that help and support are available. Find out more about anxiety, how it can affect you, and how working with a trained therapist can help you to manage anxiety disorders.