What happens if you have an abnormal smear test?

Let’s face it: Nobody likes getting their smear. And whether it’s laziness or just pure unadulterated fear that it might feel like someone is scraping out your insides with a trowel (it doesn’t), an incredibly worrying one in three women haven’t had a smear test.

So that’s why I’m going to share my experience, because if I hadn’t attended my smear test on time I could have been writing a very different blog.

First off, let’s call a spade a spade (regretting that trowel analogy already) and I’ll admit that I don’t particularly like getting a smear test either. Here are five reasons why:

1. The way I’m constantly torn between “I need to go full Hollywood so the nurse doesn’t judge me” and “best just leave it untouched for a week or two in case they think I’ve made the effort especially for them.”

2. The fear that I might take my pants off too soon. I’m not sure what the scenario is where this could happen but IT COULD.

3. The awkward bit where they let you go behind the curtain to change and you’re not sure whether you should shout to them that you’re ready or just let them work out that you’ve been sat there naked from the waist down for longer than is socially acceptable.

4. The way the clamp thing is so bloody cold. Why have we created cars that can quite literally park themselves but no one has invented a speculum that regulates to body temperature?

5. The fact there’s a very real possibility that you might bump into the nurse IRL. Like you could just catch their eye in the supermarket and think to yourself “ooh where do I know them from?” and then all of a sudden you’re hit with the realisation of OHMYGOD THAT’S THE PERSON WHO’S SCRUTINISED MY PRIVATE PARTS.

So I’m not going to sugar coat it, getting a smear test isn’t exactly my favourite way to spend a morning. But it’s not the worst thing in the world either. Awkward and uncomfortable at most, but certainly no biggie.

What is a biggie, though, is that cervical cancer is the most common type of cancer in women under 35.

I’m not here to preach, but I am going to explain why I’m so grateful I attended my first smear test on time and talk about what happened, in case there are other people in the same boat.

Opening the tell-tale NHS letter two weeks after my first smear test, I wasn’t at all nervous. I’d only just turned 25, I was healthy, in a long-term relationship, and none of my friends had had abnormal smears. I didn’t even consider that I’d be given anything other than the “all clear, we’ll see you in three years.”

The letter said I had low-grade (CIN1) changes (also know as dysplasia) to the cells on my cervix which, if left untreated, could turn into cancer. It stressed that it didn’t mean I had cancer (although they couldn’t be certain), but hey – there was still something potentially cancerous going on in my vagina, right? It was enough for all my millennial angst and first world problems to suddenly seem a lot less significant.

The next step was a colposcopy; a microscope going up my cervix with the added indignity of everything being displayed on a massive standard issue NHS monitor (and let me tell you, nothing makes you feel more insecure about your lady parts than having to look at them magnified in high definition in front of your mum, a male doctor and a nurse who also just happened to once work at your old primary school.)

Then the doctor said he had to take a sample for biopsy, and I knew from all the furious Googling I’d done in the weeks before that they only take the sample if things don’t look right. Yet it was still a huge shock when the subsequent letter revealed that the changes in my cells had gotten worse over a few weeks and had now reached CIN2, meaning my abnormalities were now classed as “high grade.” (There are three stages of CIN in total.)

I needed a Loop (also called LEET or LLETZ) Biopsy next. An “electrosurgical” procedure where a “fine wire loop with an electrical current” would burn off the bad cells. I’d tried to put on a brave face so far but this time, fuelled by fear, I felt indignant and angry. I’m a nice person. I’m polite to strangers. I’d never cheated on a test, let alone a person. I’d never even had a “slut phase.” So why was this happening to me? Quite simply because things like cancer don’t discriminate. (It’s also important to point out that cervical cancer isn’t linked to sexual promiscuity. The myth that it might be is because the virus that causes cervical cancer, HPV, is spread through skin to skin contact during sexual activity – skin to skin meaning little protection from condoms. However, 90% of women will have HPV at some point in their lives. Most will never even know about it and their body will just clear the virus like it would a cold – but an unlucky few will develop cancer. HPV is so common that it can be considered a normal consequence of having sex, whether you’ve slept with one person or 100.)

I was given the choice of having the operation under local or general anaesthetic. I chose local because the waiting list was shorter, but I was absolutely terrified. The weeks leading up to my appointment were mostly spent crying or making awkward jokes about the amount of people who’d now seen my vagina, because dark humour is the only way I can handle serious situations.

But honestly: The operation was nowhere near as bad as I imagined. That’s not even me doing classic British stiff upper lip stuff or trying to look brave on the internet. Genuinely, like most things in life, the idea of the procedure was far worse than the procedure itself.

First of all the doctor injects your cervix with anaesthetic to numb it. The needle looked quite scary but it didn’t really hurt; it was more like a little prick (probably not the first little prick to ever see a cervix, wuey.)

While the biopsy was taking place it felt a lot like having period cramps. It was uncomfortable, but not painful exactly, and it took about 20 minutes. Afterwards I was told to expect some bleeding and not to do too much exercise (score), no swimming, and no sex for about six weeks. I did bleed over the next few days, although nothing major, and the dull period-pain-like feeling lasted for about a week. (I should point out though that everyone’s experience is different and I’ve spoken to a small number of people who did suffer more pain and bleeding than I did.)

The doctor explained that they’d write to me to let me know if the treatment was successful, and that they’d still need to test the cells they’d removed to check they weren’t cancerous. He assured me that the odds were stacked in my favour due to my age, but naturally I spent the next few days reading every article I could find about any woman 25 or younger who’d had cervical cancer.

The four weeks I had to wait for my letter were some of the longest of my life (and involved a lot of online shopping because hey, if I’m going to have cancer I may as well do it with a new MAC lippy.)

When the letter finally came it said the treatment had removed all the abnormal cells and the biopsy confirmed I didn’t have cancer. I was so relieved I cried.

I had to go for another colposcopy in six months’ time to make sure the abnormal cells hadn’t returned, but as it stood, I was okay. Normal service could resume and I could go back to worrying about how my nose looked in profile and whether it was too uncool that I still listened to Panic! At The Disco.

My six month colposcopy took place a few days before Christmas (I’d received my first abnormal smear results in April, so this had gone on for the best part of a year). A few weeks into the following January I received a letter to say my results were normal, my body had cleared the HPV, and I could return to having smear tests every three years. I can’t describe the relief.

I’ve made jokes throughout this blog (because of the aforementioned inability to handle serious situations) but I know how lucky I am that I turned out to be okay in the end. I also know that there are hundreds of people in my position who don’t get good news. Cervical cancer is no joke, but I wanted to try to normalise it with humour and talk openly about what can be, for lots of women, quite an embarrassing and awkward subject.

And finally I know that, had I not gone for my smear when I did, I could have received a letter at some point with some very different news. So please, if you’re putting off a smear test: Don’t. In the UK just under a thousand women die from cervical cancer every year. In a few months alone my cell changes went from CIN1 to CIN2, so it’s never worth the wait. A smear test is important: It saves lives. 5,000 every year in the UK, to be exact.

So if you’ll excuse the pun: stop fannying around. Get your smear.

If you’ve had an abnormal smear, please share your experiences in the comments below. One of the scariest parts for me was not knowing anyone else this had happened to. It helps to know you’re not alone.

10 thoughts on “What happens if you have an abnormal smear test?

  1. Thank you Laura, this is so important! My first smear (nearly 3 years ago)had first grade changes, thankfully I was monitored every 3-6 months with no change until about six months ago when the cells changed to CIN2. The NHS were brilliant and had me in for treatment, loop biopsy. That was in November 2016. I’m feeling optimistic about my next smear in April. Always helps knowing you’re not the only one!

    Liked by 1 person

    1. One of the worst parts was feeling like I was the only person it had happened to – then as soon as I started speaking about it I realised it was so much more common than I thought! Hopefully this will encourage people to talk (thanks for being the first!) and help others who’ve gone through it to feel a little less scared and alone. Thank you for reading it and hope everything goes okay for your next smear. x

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  2. My wife (then girlfriend) had the exact same experience when she was 23 (we lived in Wales and you can smear tests earlier there) your story is so like hers that when I was describing this post she thought I was taking the piss.

    Thanks for sharing, i hope a lot of women read this and feel some reassurance from it. And I hope just as many men read this. As a man I felt it was important for me to go with my partner to her smear and colcoscopy or I’d never understand what she was going through.

    Liked by 2 people

    1. It’s really lovely to get a male perspective – I think one of the reasons it’s not talked about often is because women are scared of what men might think. I bet lots of people will be reassured by your comment too – thank you. Your wife’s story being similar to mine just shows how many people are going through exactly the same thing but afraid or embarrassed to talk about it. Hope she’s now okay too.

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  3. This is exactly what happened to me but
    I really struggled with the biopsy for the few weeks after – bad pains etc. Going for my next smear soon and nervous, but it won’t stop me going!!

    Liked by 1 person

    1. Oh no – I’ve spoken to a couple of people since I wrote this who said they suffered with pains and some who had lots of bleeding, so I’m going to add in a note to say everyone’s experience is different. Hope everything goes okay with your smear – I had mine a few months ago and I felt sick opening the letter! They’ve asked me to go for another in 12 months instead of three years this time, but there weren’t any cell changes which was a huge relief. Good luck!

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  4. A great read. Your story literally mirrors mine. I had my 6 month follow up colposcopy 2 weeks ago so I am just waiting for the results, and hoping for the first time in 4 years I have a normal smear and the treatment has worked. I too feel so passionately about women attending their smears, and I am somewhat less than polite to friends/young women I come across who say they avoid it as it’s “embarrassing” or “uncomfortable”. I often say “do you know what’s worse than that? F*cking cancer!” All the best for the future, and keep spreading the word! Xxx

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    1. Thank you for reading and commenting, and I definitely understand what you mean. I started to take it as a bit of a personal insult when people I knew still didn’t go to their smears. I was all “if I hadn’t gone to mine I might’ve got cancer, does that not scare you more than five minutes of discomfort!?” I think there’s quite a few unhelpful articles online as well which might put some people off, but hopefully my account will put a few people’s mind at ease if they’re facing treatment. Good luck with your results and all the best to you too 🙂 xxx

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