Attending a routine cervical screening can be incredibly daunting and uncomfortable for women, and the anxiety might have set in from the moment the letter arrived through your front door.
But the appointments are so important for detecting any abnormal changes within the cells in your cervix, which could eventually become cancer.
Gynaecologist Dr Susanna Unsworth spoke to The Mirror about cervical screenings and shared her top advice for making them a more comfortable experience.
The doctor, who is also the in-house gynaecology expert for INTIMINA, said this Cervical Screening Awareness Week: "Cervical screening is something that I feel really strongly about and it's a test that I would encourage everybody to attend.
"The reason for cervical screenings is to try and pick up changes in the cervix before they've turned into cancer, as changes that are abnormal but are not cancer and can be treated really effectively and will reduce the risk of them turning into cancer as time goes on."
The women's health expert went on to share some top tips for making your cervical screening a more comfortable experience.
She claimed there are a number of things you can do before and during the appointment that can help ease any anxiety you might have, including requesting a specific nurse or doctor and asking for a smaller speculum.
"I know a lot of women do get nervous about the idea of going for their cervical screening. I think part of it is not really knowing what to expect. So if you are nervous, there are a few things that you could do that might make things feel a little bit easier," the doctor explained.
"First of all, think about who might do the test. A lot of the time it might be a practice nurse, so if you can find out who might be doing the test, you could potentially make an appointment ahead of time to have a chat with them, find out what will happen and they might even be able to show you the equipment that they're going to use so that you feel you've got all the knowledge before you attend the appointment.
"You can also consider requesting for the test to be performed by a specific doctor or nurse, or someone of a specific gender.
"It may also be helpful to ask for an early appointment so you are not having to wait the whole day before attending the test.
"Consider booking the appointment about a week after your period – this is often when women experience the least amount of discomfort during their cycle."
On the day of the appointment, Dr Unsworth recommends taking some simple pain-relief medication such as paracetamol or ibuprofen ahead of the appointment if you've previously struggled with pain at cervical screenings.
"Cervical screening should not be painful, but everyone has different thresholds at which they experience pain, so do not feel worried about taking something that might help things feel more comfortable," she says.
If you feel nervous about going for the screening on your own, you could always take someone you know along with you, who could wait in the waiting room for you and it's a good idea to think about what you might want to wear on the day of the test. If you don't feel comfortable removing trousers or shorts, you could wear a dress or skirt that you can just lift up.
You can also take a cover of some sort with you if that will help you feel less exposed.
"We do provide covers or pieces of paper that you use as that modesty blanket, but some people might like to take their own if they feel more comfortable with that," she continues.
During the cervical screening, you can make several requests to aid your comfort, such as asking for a smaller speculum to be used and asking if you can have the test performed in a different position if you are struggling with back pain.
Dr Unsworth added: "Some women feel more comfortable inserting the speculum themselves. Don't be afraid to ask your professional if you would prefer to do this.
"And think about using some relaxation techniques during the test, such as breathing techniques, stress balls, or listening to music through headphones (although not too loud as you still need to be alert to your healthcare professional if needed)."
The medical professional went on to share that there are a few special situations for cervical screenings, where you might need to request additional help or could use alternative services for your screening:
Menopause
Women in perimenopause and post-menopause may experience more discomfort when having cervical screening due to the changes that take place in the vagina and vulval tissues as a consequence of oestrogen hormone levels starting to drop.
If you are starting to notice any dryness or discomfort in the vagina or vulva at this phase in life, the addition of some vaginal oestrogen treatment can be very effective at treating this problem. A boost of treatment a few weeks before your cervical screening test can make a huge difference and may be worth discussing with your healthcare professional in advance.
Don't wait to have a painful experience before asking for this treatment – is much better to treat it before attending for your test.
Those with a history of sexual trauma
If you have experienced sexual trauma in the past, attending a cervical screening can be even more difficult. In this situation, preparing yourself before the test can be even more helpful. Ensuring the test is going to be performed by someone you can trust is important. You may find it helpful for the test to be performed by someone who already has some prior knowledge of your previous history as you may not want to disclose it or discuss it at the time of the test.
Consider practising the conversation you might have ahead of the appointment. It may be helpful to write things down if it is difficult to talk about. Letting your healthcare professional know you are worried or anxious can help them support you better. Don't be afraid to ask to stop if it gets too much.
There are also specialist clinics that can offer cervical screening to those who have experienced sexual trauma in the past - https://mybodybackproject.com/.
Vulval/vaginal pain conditions
If you have been diagnosed with a vulval or vaginal pain condition, you may need to do some preparation before having your cervical screening test. Seeking support from a women’s health physiotherapist, using vaginal dilators and accessing appropriate medication from your doctor can be very helpful, such as specialist pain relief, skin emollients and also vaginal oestrogen.
You may also wish to ask to be referred to have your cervical screening performed in a centre where they have other equipment, such as adjustable beds, that can make the test easier to perform.
Note - there are also clinics that offer cervical screening for trans-men or non-binary persons who may not feel able to access screening as easily.
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