Doctor and patient meeting

Does a smear test hurt? What happens if I have abnormal cells? We ask gynaecologist Dr Anita Mitra for her expert (and honest) advice on the routine smear test

The NHS reports that one in three women don’t attend their cervical screening because of ‘embarrassment’, yet it’s the single best way to reduce your risk of cervical cancer. With one in 142 of UK women diagnosed during their lifetime and 99.8% of cases preventable, it’s more important than ever to keep up to date with your appointments.

Here, Dr Anita Mitra, gynaecologist and author of The Gynae Geek: Your No-Nonsense Guide to ‘Down There’ Healthcare (Harper Thorsons, £14.99) helps tackle our biggest concerns…

1. What are smear tests for and why should I get one?

A smear test, also called a cervical screening test, is a way of checking for abnormal cells on the cervix (neck of the womb). It’s the most effective way of preventing cervical cancer. If the test finds abnormal cells, they can be treated to reduce the risk of them turning into a cancer in the future.

2. How often should I have one?

You’ll get a letter inviting you for a smear up to six months before your 25th birthday. It will come automatically and that’s why it’s important to keep your address up to date with your GP surgery.

From 25 to 50 years, you’ll have a smear test every three years, and then it’s extended to every five years until you turn 65.

3. Is there a right time during my cycle that I should get a smear text?

There isn’t a specific ‘right time’, but it’s preferable to avoid getting it done when you’re having your period as the blood can make it more difficult for the person in the lab to see the cells.

4. Should I prepare for the appointment in any way?

I’d recommend wearing something that’s easy to remove – no-one wants to be struggling with an awkward zip. Otherwise, just go about your routine as normal.

5. Is a smear test painful?

It can be slightly uncomfortable but the smear test shouldn’t be painful. To help you feel as comfortable as possible, you’ll be shown how to lie in the correct position, with your feet together and your knees apart.

The nurse or doctor will then use a speculum to hold the walls of the vagina apart so that they can see your cervix. A small plastic brush with flexible plastic bristles is placed onto your cervix and rotated several times in order to gently exfoliate some cells to send to the lab for analysis.

The whole thing takes less than a minute. It’s not unusual to get a little bit of period-like pain afterwards but this should go away within a few hours. It’s also very common to get some spotting after the smear test, but this isn’t a sign of anything untoward, simply that the brush has scratched your cervix.

6. How long do results take to come back?

The NHS Cervical Screening Programme aims to get your results back to you within two weeks of having the test. There are some areas of the country where this may take a little longer, so it’s worth asking your GP surgery how long the current wait is in your area.

7. What happens if I have any abnormalities?

If you have an abnormal result, the lab will automatically send this information to your local hospital so that they can send you an appointment for a colposcopy. This is a special examination to take a closer look at your cervix to try to identify any specific abnormal areas.

Doctors will take small biopsies (a little pinch of tissue) to give a better idea of how severe the abnormality is and to help decide whether treatment is needed. Treatment usually involves having the cells removed.

8. Are there any symptoms I should look out for?

Smear tests are not designed to help people with symptoms, and in fact, the whole reason to do smear testing is because precancerous cells don’t tend to cause symptoms. However, things that you should see your GP for include: bleeding in between your period, bleeding after sex, discomfort or pain during sex and abnormal discharge (including a change in colour or amount).

9. I’ve never had sex before, do I still need a smear?

Cervical cancer and precancerous changes are caused by the human papilloma virus (HPV), which is spread through sexual contact (including vaginal, anal and oral sex, as well as skin-to-skin contact in the genital area). If you’ve never had any kind of sexual contact then you’re unlikely to have precancerous or cancerous cells, so you may choose not to have a smear test.


Did you know that you could earn 150 Vitality points for completing your smear test? Check out the Member Zone for more information.