The flip-side of a smear test potentially saving your life is that it can be a bit awkward. Here are a few tips to help you take ownership of the experience
The Irish Hospital Consultants’ Association annual conference revealed that nearly 90 per cent of women hadn’t responded to their CervicalCheck invite since the programme restarted in July. And while CervicalCheck’s director, Dr Noirin Russell, did add that “people are afraid to interact with healthcare and to some into healthcare settings because of fear of Covid-19”, it’s safe to assume that if it were a free medical examination that didn’t involve splaying one’s legs for a complete stranger before they have a scratch around with a tiny brush, there might be a greater uptake. Because no one except, perhaps, a pervert, enjoys going for a smear test.
Kathy Sheridan, writing for The Irish Times, was bang on. “It makes no sense that nearly nine out of 10 adults are more frightened of the infinitesimal risk of catching Covid-19 in a consulting room than of cervical cancer,” she said. “The smear test is a one-on-one public service, discreetly and gently carried out – and it’s free. How do they square their fear with the chronically ill person who has essential hospital appointments during Covid or someone with a medical emergency?”
Fear and (self) loathing
Likely it’s the fear of having a smear itself that’s really putting women off, whether out of perceived pain, the government’s catalogue of testing errors, or having last been on the receiving end of a particularly gruff, heavy-handed nurse (I will always remember Bríd and for all the wrong reasons). Feeling embarrassed (81 per cent), vulnerable (75 per cent) or scared of discomfort (58 per cent) are among the chief reasons why women avoid having a pap smear, according to a 2019 survey by the UK’s Jo’s Cervical Cancer Trust.
Do not drop your knickers for anything other than the smallest speculum
But it doesn’t have to be as bad as you think, or remember, with a few empowering tips. Firstly, when making your appointment over the phone, insist on having the smallest plastic speculum they have on the day. There is literally no need to have the default-size contraption, least of all an old-fashioned metal one, whose cumbersome and ice-cold ways will make you shudder to the core. Do not drop your knickers for anything other than the niftiest, smallest design, which does the job.
Secondly, speak up at your appointment also. In the same Jo’s Cervical Cancer Trust study, 68 per cent of women wouldn’t tell the nurse their fears because they were too embarrassed to – classic female trope ahoy – make a fuss. But the more aware they are of your unease, the better able they can calm your nerves.
On that note, insist on a liberal amount of lube. For many women, slow, uncertain insertion can be the most uncomfortable part of having a smear than the obligatory brush scrape. The less scanty they are with lube, the quicker the thing will (gently) slide in and the procedure will be over. Also, if you happen to know from using tampons or sex toys that your vagina slopes in any particular angle, pipe up – that too will help with navigation. And deep breaths, remember.
She not so much as scraped my cervix but tickled it
For years I had a nurse so compassionate and deft that I didn’t believe her when she said she’d finished. She not so much as scraped my cervix but tickled it. Sadly she’s no longer at my practice, but her empathy and dexterity lives on in my memory: thanks to having expressed my concerns and deal-breaker requirements in the first place was she able to respond accordingly. Ultimately, it’s about making yourself heard when you’re feeling vulnerable and therefore owning the experience.
Lastly, if you’re still in a tizz about making the appointment, ask your GP to prescribe a Xanax to take beforehand. Yes, really. When I voiced my squeamish concerns about an internal exam around ten years ago, my (female) doctor literally suggested this and made out the prescription there and then. One tablet really can take the edge off, and when combined with the above advice, a smear test is, at worst, an inconvenience.
For more information on booking your smear, visit CervicalCheck.ie.
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