Monday, 20 February 2017

So Your Smear Is Abnormal...

Your first cervical smear is always the scariest. When that dreaded letter drops through your letterbox, just before your twenty-fifth birthday, you're not exactly going to be jumping for joy. I know I wasn't. That's why I put my smear off for over a year; working myself up into an anxious mess every time I even thought about booking the appointment. But let me tell you now, your smear? It's nothing! Lie down, spread your legs and take a few deep breaths. It's over before you know it, I promise. It's what comes next for some women that's scary.

After my smear, I wondered why I'd made such a big deal out of it. And then I waited for my results. A few weeks passed, and I'd put the smear test out of my mind. My grandma advised me if I hadn't heard from the lab within a few days, my results were likely to be clear. So you can imagine how surprised I was when my letter finally arrived, about three weeks after my test, telling me they'd found abnormal cells on my cervix. 

If you're anything like me, you're probably going to feel scared, nervous and worried if your results come back as abnormal. I firmly believe that a lot of those feelings come from fear of the unknown. If this is your first time being called in for a colposcopy, you might find that the NHS leaflets provided don't help in preparing you. You want to know what to expect at your appointment, and what an abnormal result really means. So here's what you need to know...

The wait time for your colposcopy appointment will vary depending on where you live. I was seen within three weeks of receiving my appointment letter; within six-seven weeks of my first smear test. If you're on your period when your appointment comes around, you'll have to reschedule. I was worried about this, as my period was due the day of my colposcopy. Typical, right? Thankfully, my period has never been regular, and it didn't let me down this time either! If you're at all worried about being on/due on your period for your colposcopy appointment, I'd recommend ringing the clinic to discuss your options.

On the day of your appointment, you'll want to pop a sanitary towel (medium to heavy flow) in your handbag. Don't worry if you forget, though; the hospital do provide sanitary towels. Don't even think about tampons; believe me, you're not going to want to be shoving anything up there straight after your appointment! Before your appointment, take a shower, or a long hot bath, and make sure you leave plenty of time to get to the hospital; allowing for traffic, and finding a parking space. 

Once you arrive at the hospital, you'll be seated in a waiting room before being seen by a nurse. In my experience, the nurses are incredibly friendly and really put you at ease! The nurse will ask you some pretty standard medical questions, including questions about your sexual health, what contraceptives you use, and if you have any questions. It's okay to ask lots of questions; and it's okay to ask none! The nurse will then explain what an abnormal smear test result means, and lead you through to the examination room.

The examination part of the appointment comes next. At my colposcopy appointment, there were three nurses; all female, all lovely! You'll be directed to a toilet, or changing room, and asked to change into a gown. Take your time, don't rush; and, if you have the opportunity to, have a wee! Once back in the examination room, the nurses will help you onto the bed; and get you into the best position for them to examine your cervix, whilst making sure you are comfortable, too. Now comes the unpleasant part...

A colposcopy is not dissimilar to a smear test. You'll be opened up with a speculum, which will probably feel a little chilly from the lube, and the colposcope wheeled into place. One nurse will be between your legs, another taking notes, and the third by your head; talking to you, and keeping you calm. During the examination, you can watch your cervix on the screen by the bed; probably the only time you'll ever see your cervix! 

The nurse examines your cervix through the colposcope; which shines a bright light into your vagina as the nurse looks through the lens, which act as binoculars. Your cervix and vagina are then swabbed with dye; this is done to highlight any areas of suspicious cells, and feels no different to the swabs taken by your GP at your smear test. A little uncomfortable, but not painful. At this point, the nurse may ask if they can perform a biopsy; taking away a small piece of tissue from the cervix for laboratory testing. If you're watching your cervix on the screen, I'd recommend looking away at this point!

A cervical biopsy is best described as a pinching, or cramping, sensation; and should only take a minute or two. With that done, the nurse will help you sit up and explain what she's seen on your cervix. In my case, she gave me the good news that she was confident the cells were not cancerous, and that I'd receive the biopsy results in a few weeks. It's easy to assume the worst when they ask to perform a biopsy during the examination (I did!) but I think, in some cases, it is purely a precaution.

Before you head into the toilet, or changing room, to get dressed, you'll receive an information leaflet and advice from the nurse. For example; no sex for five days, sanitary towels over tampons, no baths. It's important to follow the nurse's advice to allow your cervix to heal, and prevent infection. Once you've changed (don't forget your sanitary towel, you're going to need it!) you'll be allowed to go home, where you should spend the rest of the day resting. 

What to expect after your appointment? Your discharge in the first few days after your appointment will be brown, or black, as the vagina flushes out the dyes used to stain your cervix. You're almost certainly going to need a sanitary towel for a few days, at least. Expect some cramping pains, too; not dissimilar to period pains, really. Pop some painkillers, if you're finding it hard to cope with, and cosy up with a hot water bottle! It's important to pay attention to your discharge, and the pain. If it's green, or smelly, and you're experiencing pain worse than usual period pains (everyone's 'usual' is different!) pop along to your GP; you could have an infection. But if you follow the nurse's advice, and listen to your cervix (allowing it to heal in it's own time), you should be fine!

A few weeks after your colposcopy appointment, you'll receive a letter; either from the hospital or the laboratory. If your results are clear, as many are, you'll be discharged from the hospital and asked to return to your GP for a smear test in three, or five years time. In some cases, the hospital may ask that you have a follow-up smear in six months, or a year. And that's it; you're done. You can forget all about your cervical health...for now! Don't forget to book in for your next smear test when it's due. Having had an abnormal result on my first smear, I'm even more aware now of just how important smear tests are. Don't delay your smear test. As soon as that letter lands on your doormat, book the appointment; get it over with. It's really not as bad as you think! 

Further information about the smear test and colposcopies.

Do you think the smear test age should be lowered? 

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