I Had My First Smear Test and…. It Was a Complete Non-Event

I am in my late twenties. In my country, people with cervixes are offered cervical smear tests (often called “Pap Tests” in the USA) every three years from the time they turn 25. These tests detect abnormal cells on the cervix and act as an early screening for cervical cancer or warning signs thereof. Until this week, I’d never had one, despite being several years overdue.

Two medical swabs face down on a surface. For a post on cervical smear tests.

The reasons for this are varied, but there are two main ones. The first is practical: I moved house a lot prior to moving in with Mr CK (11 times in 9 years by my count) and as such had to register with a lot of different doctors in different cities. I’m not sure one of the letters inviting me to book in for a smear even found its way to me until I was at least 27. The second reason is that I was scared. I had a horrible experience when I got my IUD put in about 3 years ago – pain that rendered me entirely unable to function for three days and very much struggling for over two weeks. Therefore, understandably, the idea of anything going near my cervix elicited a strong and visceral NOPE reaction from me. So I just kept putting it off.

What eventually pushed me into going for one was a person in my extended poly/swing network having something flag up on their screening. I realised that by not knowing my status, I am not only putting myself at risk (and there is some history of cancer striking young in my family) but also putting my lovers at risk. And I couldn’t do that. I made the appointment.

On the morning of, I asked Twitter how much pain I should expect. Answers ranged from “none” to “maybe a bit but it’s over quickly” to “you probably wanna book the day off work”. (It was a little late for that, of course). I popped a couple of ibuprofen, just to be sure. Had I not been driving, I might have gone straight for the codeine, which my doctor gave me for the severe pain when my IUD acts up.

So what happened?

I went in and the lovely nurse introduced herself and asked if I was happy to have a student nurse present for the test. I said I’d rather not as it was my first time, and they were both fine about that. She asked about my STI testing history. I said we test every three months and had in fact been the week before. She asked if I knew about HPV, and I said yes.

I went behind the curtain, took my knickers and jeans off, and got comfortable on the bed thing. (I’ve never understood the point of a privacy curtain when they’re literally about to look at your insides, but there you go). The nurse explained that she would open my vagina with a speculum and do a quick swab of my cervix. She said I might feel some pressure, but it shouldn’t hurt.

Having one’s vagina opened with a plastic speculum is never comfortable. (Unless you’re into that sort of thing. Which I actually am when it’s with a sexual partner in a roleplay scenario. But dear god, fun medical play is a MILLION MILES from an actual medical exam). I winced a bit but remembered to breathe. I braced myself for severe pain.

“There you go, we’re done”. And the nurse was removing the speculum from my vagina and taking off her gloves.

“What, that’s it?” I could hardly believe it.

“Yep!”

Wow, I thought. That really was nothing.

The whole thing took less than five minutes. I felt no pain and only the mildest discomfort. A tiny price to pay indeed for knowing my status, protecting myself and my sexual partners, and possibly avoiding cervical cancer in the future.

So why am I telling you this non-story?

Honestly, I was fully expecting to have to tell you a horror story involving immense pain, shitty judgemental clinic staff, an unplanned day off work or all three. But none of this happened.

So instead I thought I’d share this story in the hopes that, if you’re afraid of getting your cervical smear, this will put you at ease. The staff should be kind and understanding. You shouldn’t feel any pain – even if your cervix is extremely sensitive and grumpy, as mine is.

Please – if you have a cervix, get your test. It takes five minutes, it doesn’t hurt, and it’s a tiny thing that could potentially save your life. Just go. I’m now kicking myself that I didn’t go three years ago!

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Image from Pixabay.

Ask Amy #5: “When should I start getting STI tests?”

It’s been a while, but it’s time for another reader question! Don’t forget you can submit your own questions to me to be answered – anonymously – via Twitter or email.

A red condom and some pills. For a post about STI testing.Today’s lovely reader asks:

I have a possibly-stupid question about sexual health testing: I’m quite new to having any kind of sex, and have never had PIV sex. What point should you start getting tested? I obviously want to practice safer sex, but should I get tested now or does it not matter so much until I start having penetrative sex?

We had a bit of back-and-forth discussion and then they followed up with a second question:

To complicate things a bit, I’ve also learned that I have vaginismus. I’m planning to go to the GP about this, but it made me realise that I have zero idea what would happen when getting a tested for STIs! I assume this would involves things going into my vagina?

First: on when to test

My view is that anyone who is having any kind of sex with other people should be getting tested regularly, whether that sex is penetrative or not.

Different activities carry different transmission rates: broadly speaking, anal is riskier than vaginal, which is riskier than oral, which is riskier than hand sex or toy sharing. However, any sexual activity with another person does carry a level of transmission risk, including – for HSV or herpes – any skin-to-skin contact.

Please don’t take this as intended to scare you, dear reader – forewarned is forearmed.  Knowing the facts means you can take steps to look after your own and your partners’ health.

What barriers and safer sex methods you use is entirely up to you. Personally, I use condoms for PIV and shared toys (unless they’re pure silicone and without a motor, which can be boil-sterilised) and have hardly ever bothered with barriers for oral or hand sex. I’ve always been fine. Your level of acceptable risk may be different, and that’s completely fine. A good rule of thumb is to let the most risk-averse person set the level of precautions (e.g. “I don’t insist on barriers for oral but I’ll happily use one if a partner wants to”). And of course, whatever protective methods you ultimately decide to use or not use, it’s vital that this goes hand-in-hand with an open and honest conversation about testing practices and sexual history with your partner(s).

For more info on how to have this conversation, check out Reid Mihalko’s ‘Safer Sex Elevator Speech’.

Finally, this bears saying over and over again: Most STIs aren’t that scary, and the majority can be cured with a simple course of antibiotics if they’re caught early. A huge percentage of the population (between 50 and 90% depending on who you ask) is carrying the HSV virus, and the majority will never have an outbreak and may never know they’re carrying it. Even HIV, which many regard as the worst of the worst, is completely manageable these days and those diagnosed can live a full and normal life.

Knowing your status is your first and best weapon in protecting yourself, so please start getting tested as soon as you start having sex with other people.

Now, on to the second question: what actually happens when you go for a test?

It slightly depends on the clinic.

I’ve been going for STI testing regularly since 2009. Back then there tended to be a full, clothes-off-feet-up-in-stirrups examination by a nurse. But that hasn’t been the case for years. And as someone who has moved around a lot, I’ve been to quite a few different clinics.

Every clinic I’ve been to in the last 6+ years has asked for either a urine sample or a self-swab, the latter being more common. This is a tiny tiny thing that you put in your vagina for a few seconds, swirl around and then pop into a sterile container and give to the clinic nurse. You do this in private, either behind a curtain in the consulting room or in the bathroom. (If you’re having anal or oral sex, they should do rectal and throat swabs too, though I sometimes have to prompt for this). They’ll also do a blood test, which is the most reliable way to screen for blood-borne infections such as syphilis and HIV.

The most important bit is to speak to the nurse/practitioner on the day about any concerns you have, including your vaginismus. The swab things are really tiny (much much smaller than even the smallest tampon), but if anything going into your vagina is a no-go for you, they should offer you another option such as a urine test. STI testing shouldn’t have to be painful or uncomfortable.

At some point during the test, they’ll ask you some questions about your sexual history, especially your most recent partners. Some of the questions might seem weird or irrelevant, but it’s important to answer them honestly. A good healthcare practitioner shouldn’t make you feel judged for whatever you tell them, and if they do, you’re within your rights to gently push back or even ask to see somebody else.

After that, you usually wait two weeks for your results. Some clinics will text you to tell you everything is okay, and others operate on a “no news is good news” policy. If there are any issues, they will call you and ask you to come in to discuss the issue and your treatment options.

And that’s it! Go forth, lovely reader, and have lots of responsible safer sex.

Again, please submit your questions to me for an anonymous answer on the blog. Patreon supporters get priority!