Everything that happens during your Cervical Screening Test appointment (hint: it’s very similar to the old Pap smear)
Wednesday 14 November 2018
Getting your first Cervical Screening Test, or in years gone past, Pap smear, is something of a rite of passage for women. You may have heard stories from your mum, other relatives or friends about what it’s like, or you might know nothing at all about it except that you need to have one.
If you’re 25 or over and you haven’t had a Cervical Screening Test yet, now is your time. To help you feel prepared, we’ve broken down exactly what you can expect.
What is a Cervical Screening Test for?
Before you know what’s going to happen, it’s good to know why we’re so bent on you getting a Cervical Screening Test in the first place.
A Cervical Screening Test takes cells from your cervix and tests them for a virus called human papillomavirus, or HPV. HPV is a super common virus that’s spread through sexual activity (and that’s any activity, including intercourse, but also sexual activity using the hands, oral sex and anal sex).
The thing about HPV is that it can go on to cause some types of cancer, including cervical cancer. Most people who get HPV don’t get cancer, but the link between the two makes it important to test for HPV, and if it’s there, make sure it doesn’t develop into cancer. You can read more about HPV, how it spreads and how it can cause cancer to develop here.
Having a Cervical Screening Test every five years means you can check if you have been infected with HPV, and if you have been, monitor for any changes that require preventative treatment.
I’ve had the HPV vaccine, does this mean I don’t need to get screened?
Sorry, but this one’s a no. The HPV vaccine protects you from some strains of HPV that cause cancer, but not all of them. So, even if you’ve had the HPV vaccine, you still need to get regular Cervical Screening Tests.
Wait…what and where is my cervix?
We’re glad you asked!
Your cervix is located at the top or ‘end’ of your vagina, inside your body. While some women call all their genitals their vagina, technically the outer parts (you might call them lips) are your labia. Your vagina is the opening and passage that starts from inside your labia and continues up inside your body to end where your uterus starts. It’s where menstrual blood comes out and where a baby travels through in a vaginal birth.
Your cervix is the tissue at the end of your vagina that connects your vagina and your uterus, which is the organ where your menstrual tissue grows and a baby is grown during pregnancy. Your cervix allows your menstrual blood to pass out of the uterus and through the vagina, and for sperm to travel through the vagina and into your uterus during sexual intercourse. At the end of pregnancy, it widens and opens for the baby to pass through.
Now that you know where everything is and why we want you to get it checked out regularly, let’s get into what exactly goes down at a Cervical Screening Test appointment.
Making your appointment
Women need to have a Cervical Screening Test every five years from the age of 25. If your time has come, you’ll need to make an appointment with a GP to get screened.
Your doctor’s surgery might prefer that you book a longer appointment, so tell the receptionist that you’re booking to get your Cervical Screening Test done so they can make the appropriate appointment for you. Or, if you’re booking online, pick the option for ‘other’ when it asks for the reason for your visit and pop in “Cervical Screening Test” so the doc knows what you’re coming in for.
Some women prefer to have their Cervical Screening Test done by a female, and others don’t mind. The most important thing is that you feel comfortable at the appointment, so book in with whoever helps you to feel most relaxed.
The Cervical Screening Test is provided for free under the National Cervical Screening Program, which means you don’t pay for the test or for it to be sent away to the lab to be analysed. You might need to pay for the appointment with the doctor, though, so check what the fees are when you book your appointment.
Bring your Medicare card and Healthcare card if you have one to your appointment.
On the day
Once you’ve made your appointment, it’s important you go! If you’re feeling nervous about it at all, schedule some time to do something nice and relaxing beforehand to take your mind off it.
If they don’t know, tell the doctor it’s your first time having a screen and ask them any questions you have. If you’re feeling a bit nervous or embarrassed when you get to the appointment, let your doctor know so they can make sure you’re comfortable before they get started.
When it’s time to get down to business, your doctor will ask you to take off what you’re wearing on your bottom half and lie down on their bed (and no, we’ve checked, doctors don’t care at all if you’re wearing your nice undies or if you’ve recently had a bikini wax!). They’ll put a sterile sheet under you and give you one to put over you as well.
Your doctor will have you lie back with your knees bent and feet on the bed. They’ll put on some gloves to keep everything hygienic, prep their equipment and do the screen. When they’re ready, the first thing they’ll do is take an instrument called a speculum, which will help them open your vagina so that they can see your cervix. You can see a speculum in picture below. They can be made of plastic or metal and have a rounded tip and sides, to make it easy to insert. Your doctor might put a condom or some lubricant on the speculum to make it more comfortable to be inserted, too. After they’ve put it in, your doctor will squeeze the two handles together to gently open the speculum, which opens your vagina.
You might not know it, but your vagina is a super strong set of muscles. These powerful muscles can help deliver a baby and account for some of the pleasure of sex. But, when you’re nervous, they can also squeeze pretty tight. This can make it difficult for something like a speculum to be inserted.
When your doctor is prepping the speculum, take a few deep breaths to help you relax your muscles. It might help you to think about something happy, like your favourite holiday destination. Your doctor will be able to tell if you’re tense, so they might ask you to take a deep breath out as they first insert the speculum, and remind you to relax as much as possible. Remember to continue taking deep breaths when the speculum is in (holding your breath makes your muscles tense).
Once the speculum is open, your doctor can take a little swab of your cervix. They might pull out a torch or light so they can see (it’s dark down there!) and then they’ll put a small brush up through the speculum and into your vagina until it reaches your cervix. They’ll brush it round a little to get some of your cells, then remove it and put it in a sterile tube to be sent to the pathology lab. Then they’ll take the speculum out and you’re all done! The whole thing usually only takes a few minutes.
What do you mean by ‘uncomfortable’?
You might have had women say to you, “The Cervical Screening Test doesn’t hurt, it’s just uncomfortable.” But what does that really mean?
Well, different women mean different things by this.
Some find the experience uncomfortable because they’re embarrassed about their bottom half being naked in front of the doctor, or because being naked in front of others isn’t something their culture would normally find appropriate.
Some women find the speculum uncomfortable. They can be made of plastic or metal, which can mean they feel cold and a little odd up there.
Some women are talking about the actual brushing part when they say uncomfortable. Having your cervix touched with a brush isn’t an everyday experience, and it might feel like a tickle or a prod.
The most important thing to know is that while your Cervical Screening Test might feel ‘uncomfortable’ for the reasons above or other reasons, it shouldn’t ever hurt. If you feel pain at all during your appointment, whether that’s when the speculum is being inserted or opened, or during the screening procedure, tell your doctor straight away.
What else might be done at my appointment
Your doctor might do a pelvic exam after your Cervical Screening Test. This involves gently pushing on your belly while they feel your vagina and cervix with their hand. This gives them an indication of the health of your other reproductive organs, like your uterus and ovaries.
Your doctor might ask if you want to do a sexual health check at the same appointment as your Cervical Screening Test. If you say yes, they’ll talk through your sexual history and if they think it’s useful, might do some tests to check if you have any sexually transmitted infections (the Cervical Screening Test only checks for HPV, so you need to have other tests done to look for other infections). You can find more information on getting tested at Stop the rise of STIs.
When do I get my results and what happens if they’re positive?
It will take about two weeks for your results to come through. Ask your doctor how they want to deliver the results to you; some doctors will call to tell you whether the results are negative or positive, and some will only call if they need you to come back in. If you haven’t heard anything after a couple of weeks, you can always call the doctor’s surgery and check in.
If HPV isn’t found, all you have to do is come back in five years for your next screen. The National Cancer Screening Register will also send you a reminder when you are next due.
HPV infections usually clear up on their own and very rarely cause abnormal cells or cancer. If HPV is found, your doctor will talk to you about the next steps. They might need to do other tests, or they might just re-test again for HPV after a shorter period of time to see if it’s gone away.
Is a Cervical Screening Test the same thing as a Pap smear?
In December 2017, the National Cervical Screening Program changed. Before this, women were advised to have a Pap smear every two years. Pap smears and Cervical Screening Tests are done in the same way, but the Pap smear tests for changes in cervical cells that might have happened as a result of HPV infection. The new Cervical Screening Test, tests for the HPV infection itself, which can lead to changes in the cervix. This means that your healthcare provider can monitor HPV if it is detected and intervene if there are any changes to cells in your cervix.
You can read more about why the Cervical Screening Test replaced Pap smears here.
Hopefully now you’re feeling comfortable and ready for your first Cervical Screening Test. If you have any questions about the process, you should ask your doctor, or visit the links below for more information.