This morning I went for, what is termed here in the US, as my ‘Well-woman’, it sounds much more pleasant than smear-test, pap-smear or any other horrific terminology that you’ve come up with for testing your lady-parts.

However, it’s prompted somewhat of a discussion on Twitter and, I feel it’s my social responsibility to take a moment and hop upon my soapbox for a moment and encourage all of you female readers out there to take the first (and most difficult leap) and go get yourself checked over and for those of you who haven’t gone in a while, make the call!

For those of you unaware of what a pap smear/smear test actually is, it’s a test used to detect cancerous cells in your girlie bits.  Anomalous cells (not necessarily cancerous) serve as a sort of early warning system, they can generally be treated (or eradicated), which helps in the prevention of cervical cancer.

Nearly three women in the UK die of cervical cancer every day and it’s the most common cancer in women aged 20-29.  Many people believe that cervical cancer is hereditary, in fact, almost all cases are caused by a common virus called HPV (human papillomavirus) that you could catch as soon as you start having intimate relationships. (Cancer Research UK)

The discussion with my friends on Twitter, was about when to start having this test done.  According to various sources (vague or what, eh?) the consensus seems to be, that a couple of years after you become (and I quote a friend here, who was attempting to evade those pesky spam-bots on Twitter) ‘active in the boudoir’, generally speaking, this is between 20 and 25.  The American Congress of Obstetricians and Gynecologists (ACOG) recommends starting screening at age 21 (since they say that is a few years after initial sex for most American women, however I think the age of people having sex has drastically dropped over the last decade or more!) though women with certain risk factors may need more frequent screening.

The American College of Obstetrics and Gynecology (ACOG) Pap Smear Guidelines on frequency of testing are;

• Starting at age 21, women should receive a Pap smear every other year – until the age of 29.
• Women over the age of 30 who have had three negative Pap smears in a row can switch to being screened once every three years.
• For women over the age of 65 with three negative Pap smears in the previous 10 years, cervical cancer screening can be stopped altogether.
• Women who have had complete hysterectomies do not require cervical cancer screening.

Some guidelines recommend more frequent screening for younger women; for instance in England, screening is recommended every 3 years for women under 50, and every 5 years for those over.  In Wales, Scotland and Northern Ireland, Pap smears are offered to women from the age of 20, it is the same in Germany and New Zealand.

Here in the US, with our specific healthcare coverage, we get a yearly ‘well-woman’ exam covered by my insurance company.  This is breast exam (also very important ladies!), abdominal exam, pap smear, blood pressure, urinalysis and blood screening.  For those Americans reading, it’s worth checking with your health insurance company what your policy covers,

Here’s some facts from the ACOG website:

Today, 1 in 145 women in the United States will develop cervical cancer in their life time.

If the cancer is found and treated early, as many as 90% of women who have it, can be cured.

Nearly 5,000 women die from cervical cancer each year.  Many more are cured because it is found early with a Pap test.

Other ways to avoid cervical cancer include being monogamous, practice safe sex and don’t smoke!

Where can you go to get a Pap test?

• Doctor’s office (eg, obstetrician–gynecologist, family
physician, pediatrician, or nurse practitioner)
• Family planning clinic
• Health department

How is a Pap test performed?

• The doctor or nurse will insert a small instrument into
the vagina and use a swab or a little brush to wipe
some cells from the cervix. It takes just a few seconds.
• A medical laboratory then checks these cells. The
doctor’s office will inform the woman of the test results.

I must speak up here, because this makes it sound like a walk in the park, however, after having spoken to a half-dozen friends this morning and a number of them reporting that it hurt, a LOT (one of them said she’d rather run head first in to a wall to avoid the pain), another friend had a mental image that terrified her (”In my head it was a massive metal thing like an eyelashes curler gone wrong”) and for me, personally, I’d heard my mother complain about the pain every time she went, so the entire concept terrified me, resulting in me putting it off going for as long as I possibly could.

Your doctor/nurse, will use a speculum during the procedure, normally a pretty small, smooth plastic device (some of them even come with built-in flash lights!) this is what normally causes the pressure.

Thankfully (and luckily) mine have never been particularly painful, momentary discomfort (and sheer embarrassment, though, I’ve learned with female issues, you leave your dignity checked at the receptionist desk on your way in!), followed by a few hours/a day or two of general icky-feeling and I’m done for another year.

However, the stomach churning and nerves, don’t ever really go away.  The more nervous or scared you are, the more painful it can be.  My friends doctor advised her to try something herbal to calm her down before hand and to take an ibuprofen ahead of her appointment.

Also, if you tell your doctor/nurse that you’re apprehensive, (like I did to my dentist) they tend to make a note of it, so they know for next time to be extra reassuring when you come by for your check-up (I told my dentist I was terrified, she replied, ”I can see that, you’re clenching the chair pretty hard” and from then on, it was in my file that I was a cry baby and I love them for it!)

Check out this Running in Heels 2009 article about Pap smears and cervical cancer, Lucy Hood (writer) references reality star Jade Goody’s battle with the disease and suggest that, had the English system adopted a lower screening age, they perhaps could have caught her cancer a little earlier.

”As women we are nurturers and caretakers and we commonly put ourselves last, yearly visits to your OBGYN’s office are VERY important.”

For more information:

American College of Obstetricians and Gynecologists
Telephone: (202) 638-5577 or (800) 673-8444
Web: www.acog.org

National Women’s Health Information Center
U.S. Department of Health and Human Services
Telephone: (800) 994-9662
Web: www.4woman.org