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STIs, Vaginas & Vulvas

Getting your cervical screening

Cervical screening (also known as a smear test) is when a doctor or nurse takes a sample of cells from your cervix. Here we answer the most common questions about smear tests so you know what to expect.

What is a cervical screening? 

Cervical screening (also known as a smear test) is when a doctor or nurse takes a sample of cells from your cervix (this is the narrow part of the uterus (womb) that joins to the top of the vagina).

These cells are then tested for certain types of HPV (human papillomavirus) that are ‘high risk’, which means types of HPV that could potentially lead to cancer. Cervical screening is not a test for cancer, it’s a test to help prevent cancer. 

Screening is offered to women and people with a cervix aged 25 to 64. Eligible people are invited by letter, usually six months before they turn 25, and then every three years after that until they turn 65.

What happens at a smear test?

During the screening appointment, a small sample of cells are taken from the person’s cervix. The screening is normally done by a female nurse or doctor.

  1. The person being screened takes off their trousers/skirt and underwear and lies down on the examination bed with their legs bent and apart. They are given a paper bib to cover their bottom half. 
  2. The doctor or nurse inserts a smooth tube-shaped tool called a speculum into the vagina. This opens the walls of the vagina so that the cervix can be seen.  
  3. A soft brush is then inserted through the speculum to your cervix. The nurse or doctor rotates the brush a few times to collect the sample.  
  4. The sample is then put into a specimen pot which is sent to a lab for testing.  
  5. The nurse or doctor will tell you when you can expect your results. 

Remember
You are in control and can stop the test whenever you want to.  

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. You might hear the term ‘abnormal cells’; this refers to any cells in the sample that might contain high risk types of HPV. 

How do I prepare for my screening?

It’s a good idea to understand what happens at the screening so you know what to expect.

In the two days leading up to your test, you should avoid using any vaginal medicines, lubricants or creams as they can affect the results.

That’s all the preparation you really need to do!

It can be daunting undressing in front of a stranger but the nurse or doctor has seen far too many vulvas to care about what your vulva, body or pubic hair look like. If you’re still feeling self-conscious, it might be a good idea to learn more about the uniqueness of every vulva, including your own!

Can I go to my smear test on my period?

It’s best to book your appointment for when you won’t be on your period and avoiding the two days before and after your period. When you book your appointment, you will likely be asked where you are in your menstrual cycle so the appointment can be booked in for the right time. If your period comes unexpectedly, don’t worry, you can cancel and rebook your appointment for a better time.

I’m on treatment for pelvic infection or unusual vaginal discharge, can I go to my smear test?

It’s best to wait until you have finished the course of treatment. If you’re unsure, ask your GP.

Can I have sex before my smear test?

It’s best to avoid having penetrative sex for at least 24 hours before your cervical screening.

Should I shower before my cervical screening appointment?

You may want to shower before your appointment, washing your vulva (outside your vagina) with water only or unscented soap.

Never wash inside the vagina

The vagina is self-cleaning so you do not need to wash inside. Washing your vagina, even with just water, can lead to yeast infections and bacterial vaginosis as it washes away the good and bad bacteria.

Vaginas do have a smell, even clean and healthy ones. This is completely normal and nothing to be embarrassed about. If you are concerned about its smell you should talk to your GP.

Will it be uncomfortable?

Not everyone experiences discomfort from the procedure, but some do. It seems obvious, but if are able to relax your abdominal and vaginal muscles, the procedure will happen much quicker and with less discomfort. Take deep slow breaths and focus on relaxing all the muscles in your body.  

Have a look at some suggestions below about how you can make it easier.

I’m nervous, how can I make it easier? 

You might feel nervous to go to your cervical screening and that’s completely normal. Lots of people feel anxious for different reasons.

To help reduce anxiety and discomfort you can:

  • Bring someone with you for company and support
  • Ask to lie in a different position
  • Ask for a smaller speculum if the standard size is uncomfortable
  • Ask to put the speculum in yourself
  • Wear a skirt or dress- If you feel comfortable wearing a skirt or dress you can keep this on during the screening and only remove your underwear
  • Ask to meet with the nurse before you book the screening – This gives you chance to talk to a nurse about what happens during the screening and ask about any concerns you might have
  • Ask for a longer appointment – Allowing more time to prepare and process
  • If you’re really worried and know that it may be painful for you, for example, if you have vaginismus or vulvodynia, you can ask when you book your appointment about taking pain relief or any other options available to you
  • Ask that the nurse asks you each time before they do anything else or go any further

Ask when you book the appointment
To make it as easy as possible, it’s a good idea to mention any concerns you might have or if you would like any adjustments when you book the appointment. This means the nurse will be in a better position to support you and make the appointment as comfortable as possible.

What do my screening results mean? 

If no abnormal cells are found in your sample, you will not need any further tests. 

If abnormal cells are found, the sample is then checked for any changes in the cells of your cervix. These can then be treated before they get a chance to turn into cervical cancer. 

HPV is not the same thing as cervical cancer
If your test results come back as positive for HPV, this does not mean you have cancer. HPV is not a type of cancer; it is the name of a group of viruses, some of which can cause cancer.
Click here to learn more about what HPV is.

Do I have to get screened? 

The NHS recommendation is for all women and people with a cervix aged 25 to 64 to go for regular cervical screening.

If you have had the HPV vaccine, you are still at risk of cervical cancer as the vaccine does not protect against all strains of HPV. Similarly, if you are not currently sexually active, cervical screening is still important as you can have HPV for a long time without knowing it.

Some people feel nervous before getting a cervical screening, especially for the first time. They might be worried about the procedure being painful or uncomfortable, or feel worried about what the result will be.  

However, it’s important to try not to put off your cervical screening. It’s one of the best ways to protect yourself from cervical cancer.

If you want to talk to someone about getting a cervical screening, you can contact your GP, or a professional at Brook or another sexual health service.

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