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How to prepare for a smear test
Cervical screening (smear test) checks the health of the cells in your cervix (the opening of your womb). The test looks for the types of HPV (human papilloma virus) that can cause cervical cancer. If you’re found to have a high-risk type of HPV, your cell sample will be checked for any changes. Because of this, it’s important you book and attend cervical screening when you’re invited.
Here, I explain what happens during a smear test, and offer some tips to help you feel more comfortable.
What happens during a smear test?
A cervical smear test is a screening test used to take a sample of cells from your cervix using a small, soft brush. Smear tests help to prevent cervical cancer from developing by looking for abnormal changes to your cervix. It’s estimated that they help to save around 4,500 lives every year in the UK.
Some people delay their appointment because they feel embarrassed or worried about having a smear. But, there’s no need to avoid cervical screening, and it shouldn’t be painful. If you’re nervous, there’s steps you can take to help you feel more comfortable.
Below is what to expect during your smear test.
- During your appointment you’ll be asked to undress from below the waist behind a curtain and lie down. You’ll usually be given something to cover the lower half of your body, such as a large paper towel or gown.
- You’ll be asked to lie on your back with your ankles together and your knees apart.
- The nurse performing your smear will put some lubricant gel onto a speculum (a plastic shaped cylinder).
- When you’re ready, the speculum will be gently inserted into your vagina and then opened to get a clear view of your cervix.
- A small, soft brush is then used to take a sample of the cells in your cervix.
After your smear test, the collected cells are sent off to a laboratory for testing. You’ll usually get your results within two to six weeks.
Does a smear test hurt?
Some people find smear tests uncomfortable, but they shouldn’t be painful. Different things can affect how it might feel, like feeling tense or nervous. It can be difficult but try to relax as much as you can during your smear. If you’ve found cervical screening uncomfortable in the past, you could try the following.
- If you’d find it helpful, take a loved one with you.
- Listen to some relaxing music before your appointment to help you feel calmer.
- There are different sizes of speculum, and you might find a smaller one more comfortable. Ask the person doing your smear if this is possible.
- If you have vaginal dryness due to the menopause, you could try using a special vaginal moisturiser or vaginal oestrogen cream in the weeks before your smear. But, it’s important to stop using these two days before your appointment. Ask your GP for more information.
Some people have a tilted womb, also sometimes known as a ‘tilted cervix’. It’s common, and means your cervix isn’t straight. It’s usually nothing to worry about, but you might find it makes smear tests a little more uncomfortable.
If you have a tilted cervix, it can help to sit on your fists by putting them under your bottom, as this can make your cervix easier to find.
How can I make my smear test easier?
Here are five ways to help make your cervical smear test easier.
- Ask for a smaller speculum if there’s one available.
- Book your smear with a familiar nurse if you’d prefer, or of the gender you’re most comfortable with.
- Speak to the person doing your smear beforehand if you’re feeling nervous or anxious. They’ll be happy to talk through the process with you.
- Use deep breathing or mindfulness techniques to try and help you relax before and during your appointment.
- You could also ask whether you’re able to insert the speculum yourself, although this might not always be possible.
Remember, you’re in control during your cervical smear test. If you want it to be stopped at any time, just ask.
Do I need a smear test if I’m not sexually active?
Some people think that if they’ve never had sexual intercourse they don’t need a smear test, but this isn’t correct. This is because HPV, a virus that increases your risk of developing cervical cancer, is spread through any sexual contact. This includes skin to skin contact of the genital area.
If you’ve never had sex, it’s true that you’re at lower risk of cervical cancer, but there is still a risk you could develop it. This is because there are other risk factors such as smoking, and having a family history of cervical cancer.
If you’re not currently sexually active but had sex or sexual contact previously (including oral sex or sharing sex toys), still attend your smear tests.
Everyone with a cervix should have cervical screening, regardless of their gender identity or sexual orientation. But, if you’re registered with your GP as male, you may not be invited for an appointment. So let them know if you would like to receive regular cervical screening invitations.
What should I avoid doing before having a smear?
Avoid using a spermicidal (sperm-killing) or oil-based lubricant in the 24 hours before having your smear, as this can affect the results. You should also try to avoid booking your smear during your period as this can also affect any sample taken. If you start your period unexpectedly before your appointment, reschedule for when your period has finished.
If you’ve been prescribed a cream containing oestrogen for vaginal dryness, you should also stop using it two or three days before your cervical screening appointment.
I’ve missed my smear test, what should I do?
If you’ve missed your appointment, or you’ve been putting off going for a while, contact your GP to arrange a smear test. You might feel worried if it’s been a long time since your last test. But, the best thing to do is to get checked.
Between smear tests, contact your GP if you experience any of the following symptoms:
- bleeding between periods, after sex, or the menopause
- pain or discomfort during sex
- unusual vaginal discharge
- pain in your hip bones (pelvis)
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Sources Sources
- Smear test (cervical screening test) Macmillan Cancer Support. Macmillan.org.uk. Last reviewed 1 April 2021
- The cervix. Jo’s Cervical Cancer Trust. Jostrust.org.uk. Last updated 9 July 2020
- HPV primary screening. Jo’s Cervical Cancer Trust. Jostrust.org.uk. Last updated 16 March 2020
- HPV and cervical cancer. Jo’s cervical cancer trust. Jostrust.org.uk. Last updated 16 May 2023
- NICE Clinical Knowledge Summaries. Cervical screening: What is the NHS Cervical Screening Programme. Cks.nice.org.uk. Last revised September 2022
- Myths and facts about cervical screening. Jo’s Cervical Cancer Trust. Jostrust.org.uk. Last updated 12 November 2020
- Cervical screening results. Cancer Research UK. Cancerresearchuk.org. Last reviewed 15 March 2023
- How to make smear tests more comfortable. Primary Care Women’s Health Forum. Pcwhf.co.uk. Accessed July 2023
- Our cervical screening tips. Jo’s Cervical Cancer Trust. Jostrust.org.uk. Last updated 31 May 2022
- The menopause support guide to preparing for your smear test. Menopausesupport.co.uk. Accessed July 2023
- Let’s talk about…smear tests after menopause. Blog. Jo’s Cervical Cancer Trust. Jostrust.org.uk. Published 15 October 2019
- Let’s talk about…smear tests when you have a tilted cervix. Blog. Jo’s Cervical Cancer Trust. Jostrust.org.uk. Published 12 November 2020
- Cervical cancer and HPV: what are the risk factors? NICE Clinical Knowledge Summaries. Cks.nice.org.uk. Last revised February 2022
- Cervical screening: who is eligible for routine cervical screening. NICE Clinical Knowledge Summaries. Cks.nice.org.uk. Last revised September 2022
- Spermicidal. Cambridge dictionary. Dictionary.cambridge.org. Accessed July 2023
- What happens at cervical screening? Jo’s Cervical Cancer Trust. Jostrust.org.uk. Last updated 31 May 2022
- Good practice for cervical screening. Jo’s cervical cancer trust. Jostrust.org.uk. Last updated 12 November 2020
- Cervical Cancer – Symptoms. Cancer Research UK. Cancerresearchuk.org. Last reviewed 28 January 2020
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