When the letter arrived, I was convinced that the NHS had already ordered the paint required to daub the big red cross on my front door. The idea of going for a cervical cancer screening gave me the willies – partly because my cervix had entertained quite a few willies and I was convinced that Judgement Day was upon me.
‘Dear Slut Slutty Slut Slut! Come to the doctor at your earliest convenience, because we have heard on the on dit that your foof is full of ghosts, poison, and bits of Brian Blessed’s beard. We will examine it with our steel instruments from Victorian times before telling you the EXACT DATE OF YOUR DEATH. Here’s a clue. Don’t make any plans after June.’
This is not what the letter said, but it is what I took from it. I threw it in a drawer and covered it with unopened Visa bills. Maybe I would get run over by a bus or find myself in the path of an oncoming combine harvester and my body would be Nutribulleted, so no-one would ever know the dark and terrible secrets that lay within.
The problem with vaginas is that everything is internal. If you have a penis and something has gone wrong with it, you know about it. But all we’ve got is the vague sense that what goes up may eventually kill you. Tampon user? Say hello to Toxic Shock Syndrome – everyone knows someone who knows someone whose cousin’s friend in the year above had it, and fell down dead in assembly. Fan of penetrative heterosexual sex? Penises are basically Shearings coach tours for a dazzling array of diseases. Even if you’re a nun, there’s a slim chance you might have HPV.
Obviously this is all hyperbole, and if you’re safe, responsible and make the effort to take care of yourself, you shouldn’t have anything to worry about. But we do worry. This is why the number of women under 35 having smear tests has hit a record low, with cervical cancer rates increasing year on year.
As my friend Helene said, ‘If I break my leg or my ear falls off, that isn’t my fault. But I have this weird, irrational sense that I’d be blamed if something went wrong with my fanny – and, like my bank balance, I’d almost rather not be faced with the truth because I assume it’s probably awful.’
It isn’t awful, and having a smear is the very, very best thing you can do for yourself – even better than adding avocado to all your sandwiches, or drinking tiny bottles of Champagne in the bath. Here’s a list of the questions I had before I went, plus what Future Me would tell Past Me.
How long can I put this off for?
Until two weeks after your next period, basically. It’s best to go in the middle of your cycle and not when you’re menstruating – and ideally don’t have sex within 72 hours of your appointment. After that, don’t delay! The sooner you book it, the sooner it will be done, and you’ll feel sensational once you’ve been smeared.
Am I going to die?
Yes! We are all going to die some day, although there is a good chance someone will be able to work around this by inventing an app. But you’re not going to die at the doctor’s. In fact, the sooner you go for a smear, the better your chance of living a long and healthy life, because if there is a problem you’ll be able to sort if.
Also, once you’ve been, you’ll feel much less stressed and more cheerful about life in general. I couldn’t wank at all in the run up to my first smear because I was convinced that every bit of my bits was a cell of death. There is no better climax than the ‘relieved orgasm’.
Will the doctor judge me, shout at me, or magically be able to list every single one of my sexual partners since sixth form when they look up there?
Firstly, the smear test will be conducted by a nurse and secondly, no. Every nurse I’ve ever met in any context has lived to make their patients feel more secure and normal, regardless of their body shape or type, sexuality, race and age.
They won’t ask you anything other than ‘how are you’ and ‘are you alright’? They won’t even comment on the colour of your knickers. If your job involves going speculum deep and looking at fannies all day long, judgemental prudes need not apply. Remember, they have seen thousands and thousands and thousands of fannies. YOURS IS NOT THE WORSE ONE.
Does it hurt?
I’m not gonna lie – it does twinge a bit. And I wish I’d known this going in because I’d read lots of pamphlets and features stating that it was painless, so when I felt that twinge I immediately assumed slight pain was a sign of cancer, and I had to ask the nurse if that was a sign of imminent death.
It is invasive and awkward, but it’s a necessary discomfort. My fit friends tell me that if you feel like you’re having a heart attack when you come off the treadmill at the gym, you’re staving off an actual heart attack later. I guess this is similar.
What happens next?
Well, you put your pants back on, obviously. The results should take about two weeks, and that fortnight will take you back in time – every day will feel like the night before you got your GCSEs! And you’ll probably get a letter saying, ‘It’s all good, come back in three years.’
But you might get a letter advising that your results are abnormal and you need to come back in. DO NOT WORRY. Fewer than one in ten women have abnormal results, so if you’re in a room with 55 women, at least five will have got a scary sounding letter and thought ‘Dooooom!’ Off the top of my head I can name at least four very close friends who have had abnormal results, but I’m not going to because even I recognise that you have to draw a line somewhere.
What usually happens then is that you’re asked back for regular smears so the doctors can see how the cells evolve. Remember that our bodies are constantly fighting off pre-cancerous cells everywhere, not just around the cervix – and the vagina contains microorganisms which are there to keep you healthy.
The main thing is, you’re absolutely not alone if you do have an abnormal result, and it isn’t abnormal on account of anything you have or haven’t done; it’s just that the body’s cells are always changing, and you need to keep an eye on them.
For what it’s worth, every doctor I’ve ever asked about it has said that the reason women under 25 currently aren’t screened is that a very high number of younger women will have abnormal results because their cervixes are still settling – but it’s exceptionally rare that they will have pre-cancerous cells.
If you’re still scared, Past Self, there’s a brilliant list of reassuring information on the Jo’s Trust website. And make sure you organise some kind of a treat or reward for yourself, post smear. I had a Snickers. Courage! And remember, speculums aren’t supposed to feel great, but being responsible and taking good care of yourself really does.
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This article originally appeared on The Debrief.