Embarrassment isn’t the only reason some women fear smear tests, and we need to stop pretending it is
Earlier this year, I was approached by a national charity who wanted to me to take part in a campaign designed to encourage women to attend smear tests.
I said no.
Well, it wasn’t because I don’t believe smear tests are important, or that I don’t want to encourage women to attend them, let me just get that out of the way upfront.
While I absolutely agree that smear tests should be talked about, the WAY in which they’re currently being talked about is not in the least bit helpful for me. In particular, I have a problem with the oft-cited idea that the only possible reason a woman might have for either delaying a smear test, or failing to attend altogether, is simple embarrassment: that we’re all just silly girls who care more about the state of our Brazilian wax (or lack thereof) than our health.
I, for instance, am not in the least embarrassed by smear tests. I mean, sure, there are approximately eleventy-one thousand things I’d rather be doing on a Tuesday morning, and I think that’s probably true for everyone. I have, however, always managed to be fairly pragmatic about this kind of thing: I know the nurses who take my smear test are simply doing their job, and that they’ve seen it all before. I know they don’t care if I’ve waxed, or what kind of underwear I’m wearing. What’s more, the ones I’ve dealt with have all gone out of their way to make me comfortable, and put me at ease, so it isn’t embarrassment that makes me shake with terror on my way to every single appointment: if only it were that simple.
Here’s what DOES put off:
Smear tests can be painful.
We’re not allowed to admit that, though. In fact, all of the currently publicity surrounding the importance of smear tests totally ignores the fact that for some women (Obviously not for all women), they can be painful. Every single campaign I’ve ever seen on this topic – including the one I was asked to participate in – heavily pushes the idea that smear tests are simple, easy, and not in the least bit painful. That’s what the charity who approached me wanted me to tell you, and that’s one of the reasons I couldn’t do it: because, for me, – and for many women like me – that’s just not true.
I have always found smear tests painful: not to the point where I’ll avoid having them altogether, but certainly to the point where I dread each one, and have to talk myself into attending. There is no medical reason why this should be the case: for many women, smear tests really are easy and pain-free – it’s just not that way for me, unfortunately.
And I’m not the only one, either.
When I brought it up at my last smear test, the nurse simply shrugged sympathetically and told me that’s just how it is for some of us. On Facebook a few weeks ago, a friend started a thread asking if she really was the only woman out there who found smears painful – which is how the current round of publicity had made her feel. The answer was a resounding “no”: dozens of women responded to say that they, too, had had the same experience – and that they, too, had assumed they must be the only ones.
It is a fact that some women find smear tests painful: and it enrages me that this simple fact is so often ignored, or even outright denied, by those who wish to push the narrative that there is literally NO good reason to feel even the slightest bit apprehensive about them, because the test is ALWAYS quick, ALWAYS easy, ALWAYS pain free.
I can’t promise you that, though. I mean, I would love to be able to do my bit to reduce cervical cancer rates, but I’m not willing to lie or mislead people to do it. So I will encourage you all to have smear tests when you’re invited for them, but what I can’t – and won’t – do is tell you it’ll be easy.
I will encourage you all to have smear tests when you’re invited for them, but what I can’t – and won’t – do is tell you it’ll be easy.
And, I mean, it MIGHT be. For some women – maybe even for MANY women – having a smear test really is no big deal. It’s simple, straightforward, pain-free, and takes just a few minutes of your time, after which you can just go about your day as if nothing happened.
It’s not like that for me, though.
Because, the fact is, I suffer from severe health anxiety.
And, right now, I’m 3 weeks into what I’m told is likely to be an 8 week wait for the results of my most recent smear test.
If you’ve never experienced health anxiety – or, indeed, generalised anxiety, which I ALSO have – you can’t possibly understand what that kind of wait is like for me. In fact, you’re probably just rolling your eyes as you read this, thinking, “Eight weeks is nothing – you should just be grateful you get to have this test at all.”
I got that exact reaction (Although not in those exact words) from someone I tried to speak to about this earlier this week, and it made me feel so silly that I actually deleted this post (Which I’d already started writing at the time), worried that it would just garner the same, dismissive reactions. And, of course, I AM grateful that I’m one of the lucky ones who gets to have this kind of life-saving screening: I wouldn’t want to imply otherwise, and I certainly wouldn’t want to be seen to be scaremongering, or encouraging women not to have smears. So I sent the post to the trash folder, having decided that I just didn’t want to be the lone voice on the internet piping up to say, “Actually, I DO ‘fear the smear’ – and all of these lipstick smeared selfies talking about how it’s totally not a big deal, and is super-easy for everyone, have just made me feel like a complete freak for being scared of it, thanks.”
But then I cried all morning. And most of the next day. Because, the thing is, smear tests are vitally important, yes – but mental health is pretty important, too: and right now, mine is absolutely shot to hell. Every single morning during this 8 week wait, I get up early to feed the baby, and then I sit on the edge of the couch, my stomach churning with nerves, as I wait for the post to arrive. When I hear it drop through the letterbox, I literally (LITERALLY. IN THE LITERAL SENSE OF THAT WORD.) feel like I’m going to throw up.
smear tests are vitally important, yes – but mental health is pretty important, too:
Part of me desperately wants that brown envelope with the results to arrive, just so the wait will finally be over. The rest of me, however, has been living in fear of that moment for months now: ever since Max was born, in fact, and I knew that this smear test was the next big health-related hurdle I’d have to clear.
I think it’s great that women are being encouraged to attend smears, but I also think the reasons many women DON’T attend smears are very valid, and that, rather than just saying, “You should go for your smear, it’ll be totally easy!” (When, in fact, the truth is that it might not be…) the health service could maybe think more about what they could do to remove those obstacles and actually MAKE it easier.
Instead, a lot of the current campaigning seems to just minimise and dismiss what can be paralysing fears for some people, and it’s left me feeling like a bit of a freak, wondering why I – and I alone, if the current publicity is to be believed – am not in and out of the nurse’s office in two minutes flat (Both of my last tests have taken a good 20 minutes, while the nurse tried various different speculums, and I lay there in a cold sweat, wishing I was absolutely ANYWHERE else…), and then getting on with my life without a care in the world.
It just isn’t like that for me.
Instead, I’ve spent the last three weeks becoming increasingly more anxious, as I wait for the results of that test. Now, I know perfectly well that even if my smear test IS abnormal, it will not necessarily mean I have cancer. I know it could just mean that I’ll require further monitoring, or treatment to get rid of the suspect cells, and that the detection and treatment of those cells could, very well, save my life. I know all that.
The thing is, though, knowing that doesn’t reduce my anxiety, because, for me, “further monitoring” would mean a continuation of the absolute hell I’m currently enduring, while I wait to find out if there’s something wrong. It would mean, at the very least, another smear test – and given that I had to spend literally MONTHS psyching myself up for the last one, and returned home in tears after it, that’s not exactly No Biggie for me. As for the treatment to REMOVE any suspect cells, meanwhile… well, all I say here is that, again, if you’ve ever dealt with health-related anxiety, you’ll know why the very thought of that has been keeping me up at night for weeks now, and why I honestly don’t know how I’d cope with it.
(If you don’t have health anxiety, meanwhile – or, you know, empathy – you’re probably too busy typing out a suitably cutting response to the start of this post to have even read this far anyway, huh?)
Here’s the thing that no one ever understands: I’m actually not afraid that I’m going to die of cervical cancer (Well, I mean, I AM, but no more than I’m worried about dying of any other form of cancer…). No, I’m worried that if the result is abnormal or inconclusive, I’ll have to continue feeling the way I do now for another few months, while I go through more testing, and more waiting for results, always with the fear that it really WILL turn out to be something serious hanging over me.
The only thing to fear is fear itself, right?
And that’s the crux of it, really: I fear fear. And, having been living with it for almost two years now, from miscarriage and ectopic pregnancy, to childbirth and recovery, I’m really freaking done with fear now. I just want my life back – and, as strange as it might seem, I feel like this test is the last remaining obstacle standing in my way. If I can just get past it, I’ll be able to be me again, for the first time in months: and I’ll finally be able to start enjoying life as a mother, without this constant dark cloud of worry hanging over me. If I CAN’T get past it, though, and this test ends up leading to more tests, and more waiting … well, I honestly don’t know how I’ll cope.
To answer the obvious questions: yes, I’ve had counselling. I’ve tried medication. (Albeit only briefly: both of the psychiatrists I’ve seen feel – and I agree – that medication probably wouldn’t be a great way to treat my specific anxiety, because the side effects it can cause would likely just trigger a whole new set of fears…) I’ve made plans to go private next time, if only to minimise the wait time. (Last time my results only took 2 weeks with the NHS, so I assumed it would be the same again: I won’t make that mistake twice…) What I’ve learned from all of this, though, is that the only thing that actually works, and that helps me deal with my health anxiety, is to get concrete reassurance about whatever it is that’s worrying me. There’s no amount of mindfulness, or self-help books, or even Valium that will help me when the anxiety is at its worse: the ONLY thing that does help is being given proof that there’s really nothing to worry about.
And that’s why I’ve never missed a smear test – and, in some cases, have actually gone in early – even although I know that having one will effectively wipe out the next few weeks of my life. I still go – and I encourage other women to go, too – because I know it’s important, and also because I know that NOT going isn’t going to make me feel any better. No, if I didn’t go for my smear test when the time came, I’d STILL be stressed and anxious – the only difference is that THAT anxiety wouldn’t just last six weeks, or a few months: it would go on indefinitely, because I’d have no way of knowing whether or not my fears were actually justified.
It’s really easy to say, “Oh, it doesn’t matter if it makes you anxious, you just have to deal with it,” or words to that effect, but while I obviously DO “just deal with it,” and would never allow my anxiety to prevent me having screening, I also think that mental health DOES matter – and matters quite a lot, actually. And yes, I’d obviously – OBVIOUSLY – rather have 8 weeks of anxiety now, than end up with a disease that could easily have been prevented: that goes without saying, and I can’t stress enough how important it is to go for the screening anyway, even if it scares the bejesus out of you. (I have a feeling that people are going to want to respond to this post by saying, “Well, I’d rather have a few weeks/months of anxiety than have cervical cancer!” And I mean, yeah, so would I – which is why I always go for my smear. But just because cervical cancer is bad, it doesn’t mean that crippling anxiety is therefore good – you know? It’s preferable, yes – but it’s still debilitating and awful, and I guess that’s all I’m trying to say, here.) But these 8 weeks of anxiety – and potentially longer, should my results be abnormal – are also having a pretty negative effect on my health right now, and I know I’m not the only one who feels like that, because when I posted about my anxiety about smear tests on Instagram Stories this week, I got tons of kind messages from people saying, “Yeah, I feel exactly the same about it: write the damn post!”
So I’m writing the damn post.
I’m used to getting dismissive, and even sneery, responses when I try to talk to people about my health anxiety, and, in the past I’ve often allowed those responses to silence me, or shame me into thinking my feelings aren’t valid or important. Today, though, I’m digging this post out of the trash folder and hitting publish on it anyway, because if those responses have taught me anything, it’s that we need to talk MORE about mental health issues, not less. There’s still a huge stigma about anxiety: it’s still not taken seriously by some people, despite the massive impact it can have on the lives of those of us who suffer from it. And while I agree that we should be talking more about smear tests, and encouraging women to attend them, I also feel we should be talking about them HONESTLY, and not just pretending they’re a walk in the park, or shutting down those who are really frightened of either the procedure itself, or the potential result.
So, my name’s Amber, and I’ve been awake since 4:30am this morning, worrying that today might be the day I get those long-awaited results in the mail.
It wasn’t. Which means I’ll probably be awake at the same time tomorrow – and for three more weeks after that. I go through this every three years, and I want to talk about it honestly, because I know some of you do, too – and if you’re also going to be lying awake tonight, worrying about those results, maybe it’ll help you to know you’re not the only one.