A speculum is nobody’s idea of fun, but cervical screening is one of the simplest ways to prevent cancer. This guide strips away the awkwardness so you know exactly when to go, how to prepare, what happens in the room, and what your results mean.
Pap vs HPV test
A Pap smear (cytology) looks at cervical cells to spot abnormal changes. An HPV test looks for high-risk human papillomavirus types that can cause those changes. Many clinics now use HPV testing from ages 30 to 65, often every five years if negative, with a Pap follow-up if HPV is positive. From 21 to 29, a Pap every three years is common. Always follow the schedule advised by your clinician.
When to book, and when to delay
Aim for mid-cycle if you can. Avoid the heaviest days of your period, though light spotting is usually fine. For the 24 to 48 hours before your test, skip sex, tampons, vaginal medicines, lubricants and any douching, as these can obscure cells. There is no grooming requirement. Hair, piercings and underwear choices do not affect the test.
What actually happens
You will be asked brief questions about your cycle, contraception and any symptoms. Be honest; it shapes your care. You undress from the waist down and lie back. A lubricated speculum is gently inserted so the cervix can be seen. A soft brush collects cells in seconds. You may feel pressure; pain is not expected, so speak up if you are uncomfortable.
Comfort tweaks that help
You can ask for a smaller speculum, extra lubricant and for the clinician to talk through each step. Bringing your feet together with your knees relaxed outwards can ease pelvic floor tension. Slow belly breathing and a short pause to reset can make a big difference.
Results, decoded
If your result is negative or normal, you return at the advised interval. If your result shows HPV positive with normal cells, you may be asked to repeat testing sooner or to have a colposcopy, depending on age and local protocol. Mild cell changes, such as ASC-US or LSIL, often clear on their own; you will be guided on repeat testing or colposcopy. High-grade changes, such as HSIL, or persistent abnormalities, usually lead to colposcopy and treatment of pre-cancer if needed. Treating pre-cancer prevents cancer.
Red flags to act on
See a clinician promptly if you have bleeding after sex, persistent pelvic pain, unusual discharge, or any bleeding after menopause. Screening does not replace care for symptoms.
Special situations
Screening is still recommended if you have never had penetrative sex, because HPV spreads through intimate skin-to-skin contact. Screening can be done during pregnancy and with an IUD in place; tell your clinician so they can adjust the technique. If you have a history of abnormal results, are immunosuppressed, or smoke, you may need closer follow-up. Stick to the plan you are given.
Simple prep that makes it easier
Book mid-cycle where possible. Avoid sex, tampons, lubricants and vaginal medicines for a day or two beforehand. Bring previous results or dates. Practise slow belly breathing and bear down lightly as the speculum goes in to relax pelvic muscles. Plan something kind afterwards so the appointment feels routine rather than daunting.
Cervical screening catches changes early, when they are simple to treat. Put it in your diary, prep smartly, ask for comfort adjustments and keep your follow-ups. That is cervical self-care.
First published by Women & Home
Compiled by Jade McGee
Also see: Lalla Hirayama speaks out on the life-saving importance of women getting PAP smears
