Hey, lady. I know it's been all quiet on the Western Front (Cunt?) this week, but I need to ask you something. Ready? OK.
When was the last time you had a cervical smear?
I know. Fuck ME, right? What a drag. You're probably clicking on the little x in the corner as we speak. IF I DON'T THINK ABOUT IT IT MIGHT GO AWAY. Guess what? It isn't going away.
It is really REALLY important that you go for a cervical smear, if you haven't already. And not just because of Jade Goody (RIP).
I went for my first one last week. It was no biggie. You take your pants off, 'pop yourself' up on the couch, the nurse fiddles around in your ladybits, and then you pop yourself off the couch again, put your knickers back on, and get on with your day. Easy.
In fact, it was so easy that I completely forgot about it. Or I did, until I got two letters through the door that didn't look thin enough to simply be saying 'you're fine, be gone with you for another three years!' They looked like cancer letters. OH MY GOD THEY WERE CANCER LETTERS.
They weren't cancer letters. What they were were letters which explained that my results were 'abornormal', that I had something called 'moderate dyskaryosis', which would need looking at during something called a 'colposcopy'. I swear, I understand more Gaelic than I did that letter (Alba gu bràth!) Despite the fact that the letter said 'it is unlikely you have cancer', I immediately collapsed in a heap on the floor, weeping that I had been cut down in my prime.
After lying on the floor for about twelve hours, I re-read the letter. It said that if I have any questions about my results, then I should contact my GP or NHS direct. I still wasn't really sure what 'moderate dyskaryosis' was, and had thoroughly shat myself when I googled it and ended up on a cervical cancer forum. Everyone had signatures that said stuff like 'abnormal smear test result, May 2008/ invasive cervical cancer diagnosed two weeks later'. I decided that I didn't like the internet. The internet didn't sugarcoat.
My boyfriend called NHS Direct, because I was 'too upset to talk', and explained the situation while I lay face down on my bed. They said that as it wasn't urgent, that they would call us back in six hours. They never called back. I felt like a loser. Stood up by a public service. THANKS DAVID CAMERON.
The next day I called my GP and asked to speak to the nurse. She came on the phone but only to say 'I have a train to catch and can't go through this with you right now' in a really shitty voice, even though I was sobbing. This made me feel like even more of a loser and even more alone. It was my first ever smear test (I'm 25). It was completely foreign territory.
I'm not one to slag off the NHS. I'm too scared that the ghost of Aneurin Bevan will come and haunt me while I'm sleeping (although, actually, as the first ever NHS representative, I would have appreciated him popping along and telling me that no, you don't have cancer. No one bloody else was.) I felt very alone. I didn't really understand what was going on 'in there', and there didn't seem anyone who was able to tell me. I became convinced that I was going to die, that my boyfriend would have to deliver a tearful eulogy while looking delicately handsome in a perfectly cut suit. I started wondering to whom I'd leave my iTunes in my will.
Turns out, feeling like this is totally normal. Most women who get an abnormal smear result freak the fuck out. And, considering that either 1 in 20 or 1 in 12 (the letters differed in this regard) will get an abnormal smear in their lifetime, that's one hell of a lot of panic attacks going on. So, if you're worried about going for your smear, or have already had an abnormal smear result, I have some advice for you.
Firstly, it is EXTREMELY unlikely that you have cancer. Cervical screening is not a 'cancer test' which you have FAILED, it's a pre-emptive method for finding abnormal cells which may turn into cancer one day. These cells are called dyskaryosis (mild, moderate, or severe), and even if you have severe, it still doesn't mean that you have cancer. These cells often take a REALLY LONG time to develop into cancer, which is why it's so important that you get those fuckers while they're young.
Secondly, you are not a slut. Abnormal cells on the cervix are often associated with HPV, a sexually transmitted infection. When I first heard this, I wanted to gather all the men I'd slept with together in a room (I won't tell you how many, but let's say that it's in between a gathering and a party) and demand 'WHICH ONE OF YOU ARSEHOLES GAVE ME HPV?' in the manner of Shirley Conran's Lace. But that was before I realised that there is no test for HPV for guys, which is totally unfair but then, as women, we are all used to that. Anyway, once I'd read up on HPV a little more, I realised that most people have it at some point or another. Seriously, that shit is RIFE. There is no point declaring celibacy now, because HPV can linger in your system for years and years, so you might as well enjoy yourself. Good news: most people will fight off the infection in 1 to 2 years. It's when you have a low immune system and can't fight it off that HPV starts partying in your cervix and messing things up. Stopping smoking can help stop this happen (I haven't smoked in one week, MOFOS!)
If you're freaking out about HPV, I would advise you to watch that episode of Girls called 'Vagina Panic' in which Hannah gets it and is totally casual about the whole thing. Maybe if the NHS had some kind of service where a Doctor rang you up and went 'hey Sugartits, you have an abnormal smear but don't sweat, it isn't cancer, yo,' we would all feel like that. But we don't and I didn't, so instead I watched that episode like five times. Remember what Jessa says: 'all adventurous women have it.'
Thirdly, DON'T GOOGLE. It will just scare you more, and much of the information is designed to cover its own arse in case the worst happens. Instead, read this Scenic Guide to Your Abnormal Pap Smear from The Hairpin. Although written for an American audience, it is absolutely brilliant at putting your mind at rest, and goes into far more medical detail than I do here.
Lastly, and for me this is the most important bit of advice: talk about it. When I got my abnormal smear result, I felt completely and utterly alone. It felt as though I was the only person who had ever had bad shit going down in her cervix after a smear test. And I was too embarrassed to talk about it. Until I started talking about it. To everyone. And encouraged them to talk about it. Here is a list of people who know about my vagina panic: My mum, my boyfriend, my flatmate, my boyfriend's brother, my boyfriend's brother's girlfriend, my boyfriend's mum, my boyfriend's sister, my boyfriend's boss, my fellow Vagenda editor, my mum's friend, my granddad's cousin's wife, my auntie, and my French male cousin. I would have told my Dad, but it was a bank holiday and I didn't want to piss on his chips by chatting to him about my vagina. I'd already had my bank holiday party ruined when this horrible girl from my school days (HPV personified) turned up at the Notting Hill Carnival when I was trying to have a good time with my friends and not look mental as a result of not being able to smoke a single sodding roll up, so I didn't want to perpetuate the fun-ruining cycle. (BTW, if you're reading this Dad, I love you and I'm fine, I think.)
I digress. The worst thing about my abnormal smear result was how I felt inexplicably ashamed and embarrassed about it, as though it was my fault. Why is it that women don't feel that they can talk about this stuff? As soon as I opened up about it, and my friends and family did the same, it emerged that everyone knew at least ONE person who had an abnormal result. In fact, if 3.7 million women were screened in the year 2010-11, and one in twenty had an abnormal result, that's a HELL OF A LOT OF WOMEN who have all been through the same thing. As my wise doctor friend told me, the not-talking about it perpetuates ignorance. Oh how I wish I had known about this HPV and colposcopy stuff before I'd got that letter. It would have saved me so much grief and anxiety.
It's so important that women feel able to talk about this stuff. Before I got my first smear test, no one told me that I shouldn't have sex the night before, or use lubricants or creams. I didn't even really know what the test was looking for, and what the possible outcome might be. In my case, it meant that I was referred for colposcopy, which is when you lie spread eagled on a bed while a doctor or nurse looks up your skirt at your cervix through what looks suspiciously like a pair of binoculars. Indeed, the whole process could be said to resemble a Benny Hill sketch. The nurse then paints your cervix with various chemicals which help the abnormal cells to show up. If they do show up, as they did in my case, they'll often offer you treatment then and there. The most common is LLETZ (Large Loop Excision of the Transformation Zone), which is a snappy way of saying that they use an electrically charged loop to remove all the bad cells. It's a bit scary because they have to 'earth you' and your mum can't hold your hand in case she gets electrocuted, which would make the day suck even more. I won't lie, it isn't the best fun I've had all year (especially not the bit where they inject anaesthetic into your cervix) but, having read Caitlin Moran's vivid description of her traumatic posterior labour the night before, I felt like I wasn't qualified to moan too much. The nurses were absolutely brilliant, so reassuring, and they kept the radio on during the procedure. Unfortunately the song that was playing was Coldplay's 'Fix You', a song I have always hated because it makes me cry even though I don't like Coldplay, and which I will now forever associate with having my cervix electronically scraped out. Awesome.
Afterwards, you and your mum get to look at a photograph of your cervix, which is actually quite cool. Some of my friends thought it was weird that my mum got to see it, but then I pointed out that I actually CAME OUT OF HERS, which shut them up. Then the nurse told me I didn't have cancer but that I couldn't have sex for six weeks. Not ideal, but I'll take it, THANKS NHS!!!!!
The moral of this tediously long and detailed story is that silence breeds ignorance, which breeds panic, which breeds you thinking you have cancer when you probably don't. There is absolutely nothing to be embarrassed about if you get an abnormal smear result, and talking about it REALLY REALLY helps. The more we talk about it, the more in control we feel. Unfortunately an abnormal smear result is something many women will experience in their lifetime, but if the choice is celibacy vs colposopy, I know which one I'd take. One afternoon of cervix rummaging is totally worth ten years of sex (I'm not telling you to go around having unprotected sex willy-nilly, BTW. Wear a condom. It might not stop you getting HPV, but it will stop you getting a whole lot of other stuff you shouldn't have to deal with) Plus, your boyfriend/girlfriend/loved ones will bring you soup and grapes and flowers, and you won't have to do any heavy lifting for AGES. Treatment is nearly 100% effective, and the sooner you get it, the less likely it is that it will EVER turn into cervical cancer.
So, if you start feeling guilty about your cervix/HPV, don't. Remember Girls: all adventurous women do. But being adventurous also means that you need to pay more attention to this stuff, so please do go for that smear test. It could save your life.
Normal Vagenda service will now resume.