Like a bizarre rite of passage for people with vaginas, some months after your 25th birthday a letter arrives from the NHS inviting you to have a cervical examination. No one wants this letter to arrive, or to have to physically make an appointment because everyone knows that ‘smear tests’ are unpleasant.
What is a cervical screening? In simple terms, it’s a swab of tissue taken from your cervix to detect changes to the cells. These changes are called cervical abnormalities or precancer. It is NOT a test to find cancer, but it is a prevention against it that many people are aware of, but as with anything to do with vaginas, is rarely talked about openly. About 94% of results come back clear but cervical screenings actually save up to 5,000 lives in the UK a year.
For me ‘smear’ not just a repulsive word but an active reminder that my vagina, despite it’s mystical powers is always at risk. When I turned twenty-five the last thing I wanted to do was be laid out on stirrups, legs up, vag out, sticky in the cold, clinical air of the doctor’s room. I didn’t want gloved fingers fiddling around, and shoving a clamp to open up my cervix. That pain is like your worst period pain in the space of 3 minutes! But I did, and my first ever results came back abnormal.
I’m 29 now and have had two smear tests, both have come back abnormal and both have required treatment. The first stage is a biopsy. A cervical biopsy is a procedure to remove tissue from the cervix to test for abnormal or precancerous conditions. This procedure is not very nice and usually requires you to go a Colposcopy clinic at the hospital. Again, fanny in the air but this time there may be a team of trainee nurses around you PLUS your cervix on the big screen! (They always ask if I want to see and I never have.) The biggest worry for me is that I might fart actually. It really causes me anxiety before I get in the stirrups. Anyway, the procedure involves that wonderful clamp we’ve (by this point) come to know and mildly detest. It makes you ache as it opens your cervix up. The Colposcopist will then take sample tissue from the cervix to be tested. This is usually just a few pinches. The pain is sudden and over in a breath. After the biopsy, there is some cramping and you have to take it easy for a day or so. No sex or strenuous exercise or baths for 7 days.
After the biopsy I had last year, I read Viv Albertine‘s biography Clothes, Music, Boys (which I recommend to anyone interested in the 70’s London squat scenes and fearless and exposing writing) – In the second half of the book she talks very openly about developing cervical cancer and despite all the gritty, horrifying details about treatment I found it really comforting. I suppose that is why I’m writing this now, to hopefully be of some comfort to someone. There are loads of websites and articles out there with information but sometimes it takes some one you know to share their experience to make any of it seem real. After a few weeks, the results came back showing the presence of CIN3 in my cervix which means severely abnormal cells, usually caused by the HPV* virus and if untreated will cause cancer and spread to surrounding areas. This obviously freaked me the fuck out and I went back a few weeks later for a LLETZ procedure (Large Loop Excision of the Transformative Zone). Basically a wire loop with an electric current (diathermy) is used to remove these cells. All of these procedures and treatments I was still downplaying in my mind. I thought it fairly common and was unprepared each time for both the discomfort and the actual severity and importance of having initial smear tests. The LLETZ procedure is apparently 99.8% effective and the NHS will ask you to go back after six months to check this.
*”Human papillomavirus (HPV) is an extremely common virus. At some point in our lives most of us will catch the virus. Worldwide, HPV is the most widespread of all sexually transmitted viruses; four out of five (80%) of the world’s population will contract some type of the virus once in their life . If you catch HPV, in the majority of cases the body’s immune system will clear or get rid of the virus without the need for further treatment. In fact, you may not even know that you had contracted the virus.” – http://www.jostrust.org
I went back for my check up recently and they found that the LLETZ had not been entirely successful and that I still have CIN3 in my cervix. They took another biopsy and I have to wait 4 weeks for the results. I posted about this on Facebook because I believe more people should be talking about vaginal health, especially smear tests because they are so vital. A few friends came back to me to say that they had never been tested, or never gotten around to making the appointment and I have to say to them and to everyone reading, please, please make an appointment. If you are in Bristol and you don’t want to go alone, I will go with you for support if you want. 3,000 people a year are diagnosed with cervical cancer in the UK and this is due to persistent infections and issues caused by HPV. Your time is worth it. Your body and piece of mind are worth it. Cervical cancer is the number one cancer killer in people under 35.
I don’t want to see any person with a vagina suffer because of stigma, limited support and just general discussions around smear tests. Treat your body with respect and care and always remember how lucky we are in the UK to have access to free and regulated cervical screenings. There are huge number of people even in the UK who are not having smear tests simply because they cannot read or speak enough English to understand the letters from the NHS. I overheard a couple at my local GP surgery speaking to the receptionist who had to explain the letter and the man refused the test on behalf of his wife saying that ‘it was inappropriate and not important’. Because of the stigma of female bodies, especially the vagina, people’s lives are at risk and this is wrong.
So, after all my experiences, still ongoing but not quite so embarrassed about having my vag out, I implore you, if you are able, go get tested.
Check out more information on cervical cancer, screenings, treatments and other people’s stories: https://www.jostrust.org.uk/
Poem by Jane Goldsack: https://moonworld.co.uk/2014/10/04/youre-so-vain/