The cervix, the dungarees and the pants

It all started with my own cervical screening appointment – I’m one of those who has a tendency to procrastinate about almost everything, except certain aspects of my health… maybe it’s my Pharmacy training or maybe it’s because I’m from the Jade Goody generation, but I received my letter and got it booked within a week. 

Did you know that all people with a cervix aged 25 to 64 years are eligible for NHS cervical screening? 

All those between 25 and 49 years of age should be invited every three years, and those between 50 to 64 years will be invited every five years.  Those aged 65 and over will also be invited if they have had a recent abnormal test, and they should be encouraged to request screening if they haven’t had any since they were 50 years of age.

I turned up to my appointment having completely forgotten to wear clothing that would make the experience easier – is there anything less appropriate than dungarees when getting naked from the waist down?  In the past I’ve found wearing a floaty skirt or dress enables the undressing process to be much faster and require less clothes folding (although fewer places to hide the pants)! Please do share your tips for clothing choices below.

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The nurse I saw was absolutely delightful - she asked if I wanted a chaperone, talked me through my history, asked me the dates of my periods, discussed my cervical screening history, explained what she was going to do and how long results would take, and in general made me feel incredibly comfortable.   I got my dungarees off (eventually), left my socks on, and clambered up on the bed, very grateful for the curtain and the extra paper.  More lovely chatting occurred as the nurse returned complete with plastic speculum. A few changes to my position (apparently my cervix wanted a game of hide and seek), then the funny feeling where you can feel something happening inside, and then it was all done. I didn’t quite time the process, but the undressing definitely took longer than the procedure!

I’m not going to pretend it was fun, it was a little bit uncomfortable, but I definitely didn’t find it painful. I do however believe that we each experience things very differently, which is why measuring discomfort and pain is such a challenge for medical professionals.  The most difficult part I always find about scans and procedures, is staying still – I like to focus on a spot on the ceiling and try to concentrate on my breathing.  This is where all of the relaxation and meditation techniques I’ve learnt over the years can be really useful. Not to mention a friendly nurse who can distract me with conversation!

As I was escaping the building, after the rather lengthy process of getting back into my dungarees and the awkward wiping-away-lubricant moment, I bumped into our lovely social prescriber friend, Mags, who wanted to know if the Women’s Health Hub would support some awareness work - of course! For cervical screening – even better!  Obviously I over shared and told her where I’d just been.  Just a few minutes later and back at the hub, we were visited by the fabulous Katie, a care coordinator from the One Life Centre, who wanted to chat some more about the cervical screening awareness week.  I overshared again, obviously - I was just so excited by the serendipity of it all!

The next week was spent reading about cervical screening and obsessing over why almost a third of those eligible don’t take up their invitation.  Katie sent through lots of resources and links to Jo’s Trust, including some printable pants to cut out and colour in! The pants came from We Are All Smear Ready, the accessible and supportive craftivism campaign that acts “like a big sister”, encouraging those who are most likely to skip appointments to get themselves along for their screening. 

Jo’s website talks in detail about the national research carried out in 2016, which found that 25-29 year olds were the most frequent group to skip their appointments, stating “embarrassment and body image” as two of the major barriers.  The work highlighted a great need for education on the role cervical screening plays in cancer prevention, as well as the importance of starting conversations! 

As everyone who visits the Women’s Health Hub will know, encouraging challenging conversations and initiating discussions about taboo topics are things we feel rather passionate about, particularly when they relate to women’s health.  As one of my absolute favourites always says “Shame derives its power from being unspeakable” (Brené Brown, Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead).  The more we talk about these difficult topics, the more we kick shame to the kerb, embrace the messy and empower ourselves with knowledge!

What better way to start conversations than with a board full of pants!  They sat in the foyer of the One Life Centre for a week alongside a full range of posters, leaflets and facts beautifully set out by Katie.  I even got to spend a few hours in the foyer myself, chatting about the pants, shamelessly letting my cute baby engage people in conversations, and speaking with nurses and practice managers about the more practical aspects of surgeries booking cervical screening appointments.

Did you know that if you book an appointment for a smear but don’t make it, you will not get a reminder until your next test is due?

During cervical screening awareness week the surgeries sent out text messages to their patients who were either due or overdue their checks, and they each put on a whole host of extra appointments, including plenty in the evenings to ensure working hours were not a barrier.  While I was stood in the foyer I saw just what an impact the campaign and behind-the-scenes work by Katie was having, including one lady who I chatted with twice: once to book her overdue appointment after receiving the text message, and again when she returned later that same day to attend it!

One theme that came up during my conversations was those who would rather not know that they are at risk of cancer.  I struggle to understand this entirely, probably because I am quite curious at heart, but I do get the fear of thinking there could be something wrong and wanting to pretend it isn’t true.  The wonderful thing about cervical screening though is that it has the ability to prevent cancer from even developing – I think this might be where we get a bit confused and worried.  We aren’t screening to find cancer, we are screening to find cells that have the potential to become cancerous.  It’s such a fine distinction and possibly one that can get missed when we are bombarded with lots of information and feeling anxious.

In fact, if you are worried that you might have symptoms of cervical cancer, booking a GP appointment is your first port of call rather than booking a screening appointment.  This got me wondering just how many of us would know what these signs or symptoms are.  While I was stood in the foyer I read the Cancer Research UK leaflet so I’ll share a snippet of things to watch out for:

·        Any unusual bleeding

·        Bleeding or pain, during or after sex

·        Bleeding after the menopause

·        Bleeding between periods

·        Changes to your vaginal discharge

·        Or, any other changes that aren’t normal for you. 

The leaflet also runs through how to chat with your doctor or nurse about your concerns and includes some considerations for reducing your risk. 

There’s so much information out there that it can be a challenge to distinguish between the good, the bad and the hideously incorrect.  This is one of the ways we, at The Women’s Health Hub, hope to be able to support you, by signposting to evidence-based resources and information, and sitting with you as you work through it, so that you can absorb knowledge that empowers rather than terrifies or overwhelms you.

I reckon I’ve waffled plenty, and I didn’t want to fill this full of facts or figures – there are plenty of places to look for those. I’ve shared useful links throughout and would thoroughly recommend the Jo’s Trust website - it even has a helpline.  The purpose of this post is simply to start some conversations!  We left the board up in the Hub and the chats we’ve had with people as a result have been fabulous, not to mention the looks from folk walking past - not quite as impressive as when I walked through the centre of Hartlepool carrying it but still quite good. 

Thank you so much for taking the time to read this - we hope by keeping it open to both free and paid subscribers that we can really raise awareness and encourage folk to attend their cervical screening appointments. Please do consider sharing this post with a friend (let’s really make a start on those conversations) and we’ve popped a button below for subscribing to future posts too. I’m now going to leave you with a very important question that I would love your thoughts on below!

 Lottie x

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