Cervical smear tests: your questions answered
What should you wear, how often should you get a smear, and what happens if you get an abnormal result? IMY BRIGHTY-POTTS gets the low-down
HAVE you ever wished you could ask more questions about cervical screenings or smear tests, but are worried you’ll sound silly?
The cervical screening programme helps save thousands of lives in the UK each year. But, it’s fair to say they can be a bit awkward or nerve-wracking for some people.
Remember, if you’re worried or unsure about anything, it is always absolutely OK to ask healthcare professionals for more information.
In the meantime, we asked experts to answer some of our most pressing questions about smear tests...
1. What age can you stop having screenings?
Amanda Caley, clinical specialist for Zilico, who works across 15 hospitals across the UK in colposcopy, says: “The UK has one of the most robust screening programmes in the world, and at 64 you go for your last annual screen if there are no abnormalities.”
Professor Jay Chatterjee, consultant gynae-oncologist at The Lister Hospital, part of HCA Healthcare UK, notes that “the risk of cervical cancer significantly decreases after the age of 65 years”.
2. How often should I go for a smear test?
When it comes to routine cervical screenings, Amanda explains that how frequently they are offered “isn’t the same across the UK.
“In England, we start at 25 and until you are 49, you get screened every three years. If there is an issue you may have to be screened more frequently.”
However, in Wales, routine screening has been extended to every five years instead of three.
It’s every five years in Scotland, too.
For people who don’t identify as female but may still need screenings, Amanda says: “If you aren’t registered as a female with your GP but have a cervix, do phone your GP service and ask to join the list.”
3. Can you book a cervical screening at any time?
Amanda says: “You can’t do it at anytime. It has to be your turn, you can’t call at 19 and ask for a screening.”
Prof Chatterjee adds: “Unless there is a medical reason as to why you need a smear test before 25, they are not routinely carried out until this age, as the risk of cervical cancer is very low.”
However, if you are concerned about any unusual symptoms or have a family history of cancer, speak to your GP.
They can answer any questions you have, and provide personalised advice and reassurance. 4.
How worried should you be if you’re called in for a biopsy?
First and foremost, getting an abnormal result on your smear test does not mean you have cancer.
Cervical screenings don’t diagnose cervical cancer. They’re designed to prevent cancer from happening – by checking for certain strains of HPV and cell changes, which may mean you’re at greater risk of developing the disease. These can then either be monitored or treated, as required.
If cell changes are detected during your screening, the next step is usually a colposcopy, which enables a healthcare professional to take a closer look at your cervix. If necessary, a small sample of cells (biopsy) may be taken for further testing.
“A colposcopy will take place in a hospital setting, but the nurses will try their best to make you comfortable,” says Amanda. “You will be assessed there, answer some questions and sit in a chair with stirrups.
“There will be a few dyes used to change the colour of the cells to see if everything is normal. If all of those things are indicating you need a biopsy, then you would [have one].”
5. What should you wear for a smear test?
You can wear anything you like – but for practicality and comfort, Amanda says: “Don’t wear a big jumper, or a jumpsuit. You look fab but you will end up sat in your bra. Wear a nice maxi dress or some joggers. Make it easy to get on and off.”
6. How many tests do you do in a typical day?
This depends on the clinic, but Amanda says: “Within primary care in a GP surgery, the nurse will do up to 10 people in the morning in a smear clinic, but it does vary.”
7. Is there any body judgement?
Amanda is adamant: “No!” she assures. “We have seen everything and we couldn’t pick you out of a crowd after. The clinics tend to be more female-led, which may put you more at ease. We are just in there to have a look at your cervix.”
8. Is it easier to do a screening post-birth or during menopause?
“No, it is just different. In reality, there are five different types of speculums you might use and you will be assessed based on what makes you comfortable. We can use a very small speculum if it will make you more comfortable,” explains Amanda. Prof Chatterjee adds: “It is advised you wait at least three months after giving birth before booking a smear test.
“In menopausal women, using vaginal oestrogen can make getting an adequate smear easier.”
9. Will it be uncomfortable after?
“It normally doesn’t, but everyone is different,” says Amanda. While many people experience no physical discomfort after a smear, some people may do – and it’s OK to tell your nurse or doctor if you are anxious.
“If you tense up, it will be more uncomfortable. Take a paracetamol beforehand if you are really worried. Take a deep breath, and breath out as the speculum comes out,” Amanda advises.
10. Should I wax or shave before?
“If you want to, yes, if you generally like to, but you don’t need to for your screening,” says Amanda.
“It makes no difference to us if you are hairy or hair-free.”
While many people experience no physical discomfort after a smear, some people may do – and it’s OK to tell your nurse or doctor if you are anxious
Amanda Caley from Zilico, above
11. Can I have my screening if I am on my period?
“Not really,” says Amanda. “Cells from the lining of your womb are coming away and those cells are not being looked for. Call and ask beforehand.”
Warmer weather is always welcome but it could wreak havoc on our sleep. Worried about getting a good night’s kip? These are the sleep mistakes to avoid...
1. YOUR ROOM IS TOO HOT
“A cooler temperature is optimal for sleep,” advises Dr Rebecca Robbins, sleep scientist and sleep expert to Savoir Beds (savoirbeds. com), who says around 18ºc or 19ºc is best.
She explains: “Your body’s ability to regulate temperature is a big part of how it regulates sleep. During rapid eye movement sleep, the brain’s temperatureregulating cells switch off and your temperature is impacted by your surroundings.
“If your bedroom is too warm and stuffy or your sleeping surface is unable to breathe and disperse moisture, you may begin to sweat and overheat.”
She suggests your sleep might be disturbed if the temperature rises above 23.8ºc. However, some people may struggle with pollen if their bedroom window is open at night.
Max Wiseberg, airborne allergens expert and creator of Haymax (haymax.biz), says: “Put pollen filter window screens over the windows and then you can open the window.
“If you do have air conditioning, as long as they’ve got good filters, that would help.”
He also recommends using an allergen barrier balm around your nose and eyes.
2. YOU’RE GOING TO BED TOO LATE
With lighter evenings and warmer weather, you might be spending more time in the garden, or having dinner a bit later. But Dr Robbins advises us to commit to a bedtime routine and stick to it.
“Falling asleep at the same time and waking up at the same time is everything. It allows the body to work with – rather than fight – its natural circadian rhythm, our body’s internal clock that controls the timings of every organ system and bodily process.
“If we stick to a schedule, our body learns when to expect sleep and wakefulness.”
3. YOU’RE LAYING AWAKE FOR HOURS IN THE NIGHT
Lying in bed feeling hot and bothered at 3am is frustrating, but just hoping to drift back to sleep could be counterproductive.
“It’s something many of us were told to do – stay in bed if we wake up. But it’s actually one of the worst things that we can do if we’re struggling to sleep,” Dr Robbins says.
Instead, she advises getting up after 15 minutes, keeping the lights low and doing gentle yoga, reading or some non-stimulating tasks – like folding laundry – before returning to bed.
4. BEDDING IS NOT UP TO THE JOB
Your mattress and bedding also play an integral role in ensuring you get enough sleep.
“Sleep-related neurons are highly temperature-sensitive so an unsupportive mattress, or a mattress which retains heat, will limit the quality of your sleep,” says Dr Robbins.
You might also want to rethink your duvet, suggests sleep expert Patrick Ross from Nectar Sleep (nectarsleep.co.uk).
“The last thing you want is to be tossing and turning inside a high tog duvet. Instead, make sure you pick up some linen or cotton bedding which is much more breathable and absorbent, to help keep those night sweats at bay.
“Alternatively, say goodbye to a duvet altogether... grab yourself a lightweight sheet that will keep you covered – but cool – at night.”
5. YOU’RE DEHYDRATED
Patrick says: “Dehydration can negatively affect how well you sleep at night, so staying properly hydrated is key.
“Don’t guzzle litres of water directly before bed, but keep drinking glasses of cool water throughout the day instead.”