I found that often perfectly natural women’s health issues are addressed under the TMI label, using all sorts of synonyms (lady parts, down there etc.) in order to avoid the unmentionable. There still seems to be a lot of shame and embarrassment attached to openly discussing all things vulva. This of course isn’t a very helpful attitude when trying to encourage especially younger women to look after their health. In an effort to demystify what happens in a gynaecological examination chair and what to expect when you get an abnormal smear test result, here are some of my experiences.
Pelvic exam and breast check
With the motto ‘Prevention is better than cure’ in mind, I try to get a full gynaecological check-up done every three years or so. This usually includes a breast check, a pelvic exam and a smear test – all the trimmings! General recommendations on how often women should get pelvic exams (internal examination of vagina, cervix, uterus, lower abdomen) seem to differ and obviously depend on your medical history. It’s best to check with your doctor.
I had my last check-up done very recently. The doctor started with examining my breast checking for any lumps. Everything was fine this time. But in the past I’ve had one breast check which brought up a small lump or thickening in my right breast. This meant I was referred to have an ultrasound examination in order to determine whether it’s anything that needs further taking care of. Thankfully it was just a harmless swollen gland which can occur before menstruation.
A breast check is something you can and should do yourself on a regular basis. Breast Cancer Ireland have a helpful self-examination guide and also an app you can download to get monthly reminders for your breast check.
After I’ve exposed my boobs to the doctor it was time to take my pants off. Of course you can put your top back on and only need to be naked from the waist done for the rest of the exam.
During the pelvic exam the doctor places two fingers into the vagina and presses down on the lower abdomen with the other hand. This time I’ve also got a free internal ultrasound exam. Who doesn’t love freebies?! The ultrasound is performed by inserting a thin dildo shaped object (for lack of a better word), which is covered by a condom, into the vagina so the uterus and ovaries can be displayed in detail onto a screen.
Personally I don’t really mind the internal exam and find going to the dentist much worse. To me it’s not painful, just a bit uncomfortable and it usually only lasts about 5 or 10 minutes.
Smear tests are recommended every three years and in Ireland women between the age of 25 and 60 can avail of free tests when registering with the National Cervical Screening Programme.
For the smear test a speculum is inserted into the vagina and a spatula is used to take a sample of cells from the cervix which is then send to a lab to test for cell changes. The whole process is over very quickly and in my experience only takes a couple of minutes. If you’re registered with the National Cervical Screening Programme (Cervical Check) you will be send a letter with your lab results. If the results come back as normal, you’ll be asked to come back for a smear test in 3 years and conveniently Cervical Check will send you a reminder when your next test is due.
Abnormal smear test result – Colposcopy
In my case I’ve received two results of persistent abnormal cell changes about 3 years ago. This meant I had to undergo an examination called a colposcopy. This is done in an out-patient clinic in a hospital and was all arranged free of charge by my doctor as part of the Cervical Check programme. To be honest, it all sounded a bit scary to me and images of Jade Goody immediately popped up in my head (the Big Brother reality TV star who died of cervical cancer).
I went for my appointment at the Colposcopy Clinic in the Mater Hospital not really knowing what to expect. The information leaflet Cervical Check had send me explained that a colposcopy is a closer examination of the cervix with a colposcope which is like a microscope.
Nervously I was sitting in the waiting room which was showing Jeremy Kyle on the telly – not the kind of programme to put you at ease, let me tell you. Thankfully my nerves were calmed after the doctor took the time to explain in detail what my test results meant and what the examination will entail. Of course the words ‘pre-cancerous cells’ are not easy to digest, but the doctor’s assurance and calm explanations gave me confidence everything would be okay. Abnormal cells detected with a smear test are not cancerous but could develop into cancer if left untreated. That’s why it’s important to get tested regularly and also follow up with abnormal test results.
The colposcopy itself takes a bit longer than a pelvic exam and I found it slightly more uncomfortable, not painful though. After examining my cervix, the doctor thought it was necessary to do a biopsy in order to fully determine the nature of the cell change. For that a small bit of tissue is cut out from the cervix and send to a lab for further analysis. Again, this wasn’t a painful procedure and it’s done very quickly.
Throughout the whole process, which took about 15 minutes, the nurses and doctor were so friendly and helpful that it made things much easier. In order for the internal wound created by the biopsy to heal and to avoid infection, I was prescribed antibiotics. The doctor said I might experience some bleeding after (I didn’t though) and I was also not allowed to put anything into my vagina for a couple of weeks after, including tampons, feminine hygiene products, penises, you get my drift. The lab results would be send to me through Cervical Check again.
After the whole thing was over I had planned to do a bit of shopping in town and then get some work done. But I wasn’t feeling that well so I headed straight home to my bed. The discomfort was comparable to heavier period pain, nothing completely unbearable but if given the choice between work and bed I opted for the latter.
More tests – LETZ procedure
Two months after the colposcopy I’ve received my test results showing abnormal cells referred to as CIN1. CIN is the medical name for cell changes of the cervix and the CIN1 grade indicates mild changes which are not cancer.
So far so reassuring. Though the result meant I required a treatment called the LETZ procedure. LETZ stands for loop excision of the transformation zone – sounds spacey. I didn’t realise I had a transformation zone in me. What essentially happens during that procedure is the removal of the part of the cervix containing the abnormal cells. This is done under local anaesthetic with a loop of fine wire which is heated by electricity. I know, seems like a hoot. But like the colposcopy, I didn’t find it painful, just uncomfortable and a bit sore.
The whole thing took about 15 minutes and afterwards one of the lovely nurses brought me a cup of tea and some biscuits. I had taken the day off and was fully prepared to spend it in bed with a hot water bottle, but I was actually feeling fine and went shopping instead. After the whole rigmarole I’m now required to have annual smear tests and have been back in the Colposcopy Clinic after more abnormal smear test results. So far everything has been fine thankfully and I haven’t needed any more biopsies or LETZ procedures.
Of course I can imagine doing much more pleasant things with my time but being pro-active about my health gives me some assurance that any negative diagnosis might come at an early stage where it may still be dealt with successfully. There’s so much focus on women’s health in relation to diet and exercise, which of course is important too, but we shouldn’t forget to include regular medical check-ups in our efforts to stay healthy.
Disclaimer: I’m no real, i.e. medical, doctor. I know nothing about medical stuff and the likes. This post is based on my own experience and information I’ve received from healthcare professionals throughout my cervical treatment. If you’re worried about your fanny, please talk to your GP.