
Contrary to popular belief, smear tests aren’t just for straight women. A successfully smeared Sarah Berry offers some tried and tested tips to help you get through it
No one enjoys getting a smear test. Some see it as an annoying inconvenience, some hate getting their vag out, others dislike intrusive medical examinations while there are those who fear getting an “abnormal” result. I used to have a massive phobia of being penetrated and put off my test for years. But when I heard that 1,000 women a year to die of cervical cancer I knew I had to face my fear.
Smear tests can the human papillomavirus (HPV), which can cause cervical cancer. While HPV originates from sexual contact with men, a recent survey found that nearly one in five lesbian women who had never had sex with a man were infected with HPV. “Lesbian and bisexual women may contract HPV through their own previous sexual behaviour with men, explains Dr Anne Szarewski from London University’s Centre of Cancer Prevention, University of London. However, HPV may also be transmitted through lesbian sex by a female partner who has had previous heterosexual sex.”
What happens?
All women between 25 and 64 can get a free test every three years from your local GPs or sexual health clinic. During the test, a speculum is inserted into your vagina to gently push the walls apart so the nurse/doctor can see your cervix. A small brush-like instrument is gently wiped across the cervix it in order to collect some loose cells. Then the speculum is removed and the procedure is over. The whole thing can take under a minute
Picking your practitioner
• If you are very nervous, book a pre-smear appointment with the nurse/doctor so you can talk through your fear. If you feel they do not understand you, you can ask for someone else.
• I you prefer, you have the right to request a female practitioner if you would prefer.
• Consider booking a double session for your smear test so you don’t feel rushed.
Prepping for your test
• Feel free to ask the practitioner for a speculum if you wish to practise at home.
• For those not used to being penetrated, practise inserting a cotton bud, your finger or a dildo into your vagina.
• If you feel like your vagina is too tight, relaxing your kegals might help – these are the muscles you use to stop and start weeing. Squeeze and relax them until you feel more in control.
• A dollop of lubrication can also help (I actually took my own to get smeared!).
• Over the counter treatments like Bach Remedy or Kalms can help calm nerves or, if you are really fearful, you could ask your GP for a short course of Diazepam.
• If you feel your fear runs deeper, talk to your GP about seeing a therapist.
During the smear
• You are entitled to bring a chaperone to your smear so you may want to enlist the help of a calming friend or girlfriend.
• Breathing exercises are good for nerves: breathe into your tummy for a count of five and out for the same, then repeat.
• Having a pillow under your pelvis can help you get in the right position.
• Pushing your vagina towards the nurse can help relax your kegals.
• Leaning your leg that’s closest to the wall against it can help keep them spread.
• Hugging a pillow or a teddy bear can be reassuring (and you can hide under it if you don’t want to see the procedure!).
What if I’m abnormal?
An abnormal smear does not automatically mean you have cancer. “An abnormal smear is most likely to mean that you will need to have a further examination (not too different from a smear) and may need to have a tiny part of your cervix (the size of your little fingernail) removed under local anaesthetic,” says Szarewski. “Removing abnormal cells takes only a couple of minutes, the cervix heals up and the treatment may save your life.”
• The Vulval Pain Society has a fab Smears Without Tears flier. Find it at www.vulvalpainsociety.org
• For more information on cervical cancer visit www.jostrust.org.uk
• To find a lesbian / bisexual-friendly therapist, you can read about Sarah here or look at www.pinktherapy.com