So you're about to turn 25, and the letter's landed on your doormat: it's time for your first ever smear test. Or, alternatively, you've long bid farewell to 25, and you've just been putting off the test because you're not sure you can stomach it. There are, understandably, a whirlpool of questions and anxiety surrounding smear tests, though there's one question that typically pips them all: is a smear test painful? Here's what you need to know about the process — and why you shouldn't put off booking that test.
As the NHS explains, approximately 3,000 people are diagnosed with cervical cancer every year in the UK. The purpose of the smear test is to detect "abnormal changes in the cells of the cervix," caused by high-risk human papillomavirus, or HPV. While one in 20 people will have these "abnormal changes," most won't contract cancer or even need any treatment; some, however, will need to have the cells removed to prevent them from becoming cancerous. The NHS Cervical Screening Programme was established in the 1980s, and since then, there's been a steady decline in cases of cervical cancer — about a 7% yearly decrease. In short? The programme exists for a reason, and if you're invited to receive a smear test, it's really worth taking that offer.
During the test, the doctor or nurse will insert a speculum (pictured below) into your vagina and open it so that the cervix is visible, the NHS says. Using a "small soft brush," they'll collect some cells from your cervix, while will be sent to a laboratory. Within about two weeks, you'll receive a letter containing the results.
Now for the big question: is it painful? According to the NHS, while some might find it a little awkward or uncomfortable, most don't experience pain during a smear test. To minimise discomfort, the NHS advises trying to relax (far easier said than done, admittedly): try taking deep breaths, or bringing someone with you for a bit of support. Asking your doctor or nurse to talk you through the process might help, too. And if you do experience pain? Be sure to let your doctor or nurse know, so they can make any possible adjustments.
As My Health London notes, there are circumstances in which smear tests might be more painful. For example, vaginal infections, including thrust and bacterial vaginosis, might result in pain during the test. Post-menopausal people, or others with low levels of oestrogen, might also find the test uncomfortable, as a result of dryness or inflammation in the vagina. In this instance, My Health London says, oestrogen cream might be applied inside the vagina to resolve the issue. The procedure could also be painful if the doctor or nurse doesn't apply enough lubrication to the speculum, or if your anxiety is causing you to tense your pelvic muscles.
The cervical cancer charity Jo's Trust cites further situations in which a smear test might be painful. If you have vaginismus, cervical ectropion, or endometriosis, or you've received female genital mutilation (or FGM), you could experience higher than average discomfort. The charity advises informing your doctor or nurse of any health issues before the test, enabling them to adjust their approach as necessary.
Jo's Trust offers a guide to smear tests — and how to make them more comfortable — that's well worth a read if you're a little nervous. Useful tips? You're well within your rights to ask the doctor or nurse to stop if you're in pain; you can also request that they use a smaller speculum. Breathing exercises, meditation apps, podcasts, or music might also help. Jo's Trust also offers in-depth information for survivors of sexual violence, who might find smear tests distressing. And again, if you're acutely anxious about the test, let your doctor or nurse know beforehand, so they can offer support or tweak the process where possible.
As Jo's Trust observes, cervical screening — alongside the HPV vaccine — is the best way to protect yourself from contracting cervical cancer. While nervousness or anxiety about the procedure are completely understandable, booking that appointment will enable you to safeguard your health.