Why I’m Defaulting On Cervical Screening

medical professional holds up a specukum for a patient, suggests pelvic exam

It’s an important check for many women, but the test isn’t always as painless as practitioners make it seem.

It was a cold, dark, quiet night in 2017. I sat in a warm, deep bubble bath, my mobile phone in one hand and a large glass of red wine in the other.

If I didn’t know how important it was to go, I wouldn’t go.

That was my message to my Mum.

I was traumatised after the second cervical screening appointment that I’d ever been to. I put my glass on the bathroom cabinet, curled my arms around my knees and rested my head on my arms.

I felt… violated.

The first time I went for a cervical smear, it took me 7 months to gear myself up for the main event. I’ll never forget it; it was the week before my third wedding anniversary- the perfect distraction for this undignified procedure.

Or so I thought.

Before we began, the nurse needed to check my credentials. I gently pointed out my incorrect title on the form and she snapped at me.

“Well it doesn’t really matter, does it? Most marriages end in divorce anyway.”

Considering that my upcoming wedding anniversary was distracting me and motivating me? Yes, it mattered a great deal.

“Well, I suppose, but these things never last. Right then, shall we get on with it?”. I was ready to leave there and then.

The nurse inserted the speculum, and I was okay with it. It felt cold and invasive, but I was okay. A few minutes, I told myself, a few uncomfortable minutes.

Then she started opening it, and feeling a bit stretched became quite uncomfortable.

Okay, this is it, I can deal. It won’t be so bad.

A bit more.

Heh… okay… I suppose it is medical, after all.

A bit more.

Okay… oww. this hurts, I should probably say something.

 Quite a bit more.

OUCH! Help! What the hell are you doing to me, lady?! This can’t be a modern medical procedure?!

I left my first appointment sore, feeling physically and emotionally assaulted and like I’d been torn in two. It happened, and none of it felt even remotely okay. I would rather they drew blood than I had to go through that again. That’s how much it hurt; I was willing to overcome my fear of needles and give up blood. Somehow, even blood draws felt more humane.

It took me about three weeks to really get over the first time. I was sore and shaken. I also bled a little bit, but I knew that was normal.

The second time, I had a much nicer nurse, and I felt much more reassured about things. This would be a breeze, I thought, and I knew what to expect. I almost skipped to the treatment room. I was confident and happy and felt safe in the hands of such a lovely nurse.

“Bend your knees up, and just sort of… foof! Let them fall open,” she said.

I stared at her, taken aghast by what she’d just asked me to do. I don’t let my legs just fall open, not even for sex.

As daft as it sounds, I couldn’t do it. I had to physically and tentatively move them open. Such a bold reveal just wasn’t in me.

This nurse was a lot more clinical, grabbing the swivel light from the wall and hovering it over my hips. I stared at the ceiling as her light illuminated my private bits – the shame. She also gave the speculum a quick swish under the tap, as though that would somehow warm up things.

She was a lot more gentle with me, but then she started talking to my cervix.

Yes, talking to it.

“Where are you? Oh, there you are! You’re a shy little thing, aren’t you?”

Please, kill me now.

When she held the speculum so she could take the sample, she managed to dig one of the blades into the wall of my vagina. It was a different pain from last time, but it still hurt nonetheless.

Enough, I couldn’t be dealing with any more of these damn things.

Of course, I am absolutely not advocating for every woman to pass up her right to cervical screening, and it absolutely comes down to recognising your individual risks. The risk groups for developing cervical cancer include:-

  • Being a smoker – Smoking alone doubles your risk.
  • Having a weak immune system
  • Taking the combined oral contraceptive pill. The NHS website does not specify, but the link refers to the combined oral contraceptive pill. There is no mention for the Mimi (POP) pill.
  • Having more than 5 children
  • Having genital herpes
  • Exposure to DES ( diethylstilbestrol)

For me, the risk is quite small. So small in fact, that I’m willing to wait three years for the urine test to become available. I calculated my low-risk given that:

  • I don’t smoke – not then, not now, not ever
  • My immune system is pretty kick-ass
  • I take the progesterone-only contraceptive pill (POP)
  • I don’t have any children, nevermind 5!
  • I don’t have herpes, genital or otherwise
  • I was born in 1988. Use of diethylstilbestrol stopped in 1970

That leaves only my age, and many things can happen in three years. Cancer.net also specifies women in their “mid-thirties” as being more at risk – I’m not quite there yet!

There is ongoing research for tests that detect pre-cancerous cells in urine. If it can be done and be more reliable than conventional cervical screening, then it will mean an end to painful and humiliating procedures for women in low-risk groups. An end to pain and tense muscles for women like me, who struggle with anxiety.

There is some theory that some doctors and the NHS staff are paid to carry out cervical screening, regardless of risk. The more they do, the bigger the pay packet they get. To some extent, I have an iota of evidence that might back up this theory, but nobody can really say for certain.

I do follow the news on this story, and I hope, really hope, that our government decides to roll out the simple urine test soon. I also know that our media likes to remind us about the fate of Jade Goody and how important cervical screening is. Testing for cervical cancer may be important, but so is the physical and mental damage caused to some women by these invasive procedures. We talk about sexual assaults and the trauma that they bring, but we don’t talk about the trauma that these invasive tests can leave some women experiencing. In some parts of the world, women are now provided with masks to help hide the shame of attending medical centres for cervical screening. That’s great, but whether your mask is made of papier mache or gritted teeth, masks also hide insufferable pain. 

When I received my letter last month, I tossed it in the bin. Important or not, above all else, routine screening was not worth the risk of catching Covid-19. Besides, I highly doubted that routine screening was going ahead during the pandemic, anyway. Call it cancelled by mutual agreeement.

Cervical screening does hurt, it is invasive, and unless you have a substantial risk of developing cervical cancer, it is also quite often unnecessary. I can’t tell you what to do, but do your homework and determine your risk. It’s your body, and only you get to decide what happens to it.

Until next time,

Stay safe & have fun,

Helen xx

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