What happens after an abnormal smear test?

I originally wrote this post back in 2015 but I’ve had quite a few friends recently who have had abnormal smear test results requiring further investigation or treatment and so I though it might be worth sharing it again...

I recently got a letter advising me it was time for me to have another smear test. As I’m pregnant at the moment I have to wait until three months after the baby is born but I wanted to write a bit about why I was being called for a smear test just 6 months after I had the last one, and what had happened in between. I know this isn’t the kind of thing everyone likes to talk (or read) about but I hope that sharing my experience might encourage other women to make sure they get regular smear tests, and so set their minds at rest if the results do come back as abnormal.

What happens after an abnormal smear test

I had my last smear test in August last year.
When the nurse at my GP’s surgery was doing the swab she commented that she could see something on the outside of my cervix but that it might be a bit of the uterine lining which can sometimes end up being on the outside of the cervix after giving birth. I didn’t really think much of it but a few weeks later I got a letter to say that abnormal cells had been detected and I should attend the colposcopy clinic at my local hospital. To be honest I wasn’t too worried about this. I knew that abnormal cells could possibly be an early warning of cervical cancer developing, but I also knew that I had kept up to date with my smear tests and if something was there then it must have been detected early.

A coloposcopy is a procedure where a doctor or specially trained nurse (a colposcopist) uses a special microscope to examine the cervix, they may then take a biopsy or sometimes treatment is carried out immediately if the colposcopist is confident that the abnormal cells detected by the smear test are actually present. According to the NHS website about 4 out of every 10 women who have a coloposcopy have a normal result, meaning the cervix is healthy. In about 6 out of every 10 women have abnormal cells. This doesn’t mean they are necessarily cancerous but may develop into cancer if left untreated. Less than 1 in 1000 women referred for a coloposcopy are found to have cervical cancer.

So what was my experience? I went along to the coloposcopy out patient clinic back in September last year. The waiting room was tiny and the atmosphere wasn’t very pleasant as you can imagine, with quite a lot of worried faces around the room. When it was my turn to see the doctor I went it to find there was also a nurse and a medical student in the room. I was asked if I minded the student being there (which I didn’t) and after a quick chat we got started. I had to get up on a bed which had supports to put my legs into. The doctor then inserted a speculum (just like they use when you are getting a smear) and moved the microscope into place. The microscope has a bright light so they can see the cervix but the microscope stays on the outside so not too much to worry about there! Some sort of solution was put onto my cervix to highlight any abnormal areas. None of this was in the slightest bit painful, although some people might find it a little bit uncomfortable.

The doctor could see the abnormal cells on my cervix and although she said they didn’t look as widespread as the smear test had indicated she still recommended I went ahead with treatment to remove them straight away. The most common treatment to remove abnormal cells is large loop excision of the transformation zone (LLETZ) which uses a heated wire loop to remove cells from the ‘transformation zone’ which is the area of tissue at the entrance to the birth canal. As I knew we were hoping to have another baby soon I asked whether having this treatment could affect my chances of conceiving or through pregnancy and birth. The doctor advised me that it shouldn’t cause any problems with conception but that depending on how much tissue was removed it could possibly weaken the cervix, but this would be monitored in the later stages of pregnancy if necessary.

The LLETZ procedure was carried out using local anaesthetic which was injected directly into my cervix. I didn’t feel the injection at all, the only minor effect was that my heart rate increased slightly and I felt a little shaky. The nurse explained that this was because the anaesthetic contains adrenaline which helps it to work quickly. The nurse was very good at chatting to me throughout the whole procedure, not only explaining what was happening but also just taking my mind off what was going on in my nether regions! After I was given the local anaesthetic the doctor used a heated wire to removed the abnormal cells. Again, this wasn’t at all painful, in fact I hardly felt her doing anything at all. And that was it. It was all over and done with in about 10 minutes. I was given a sanitary pad and advised there might be some minor bleeding for a few days until the area healed. Actually there was only a tiny bit of bleeding and it had stopped by that evening. The abnormal cells which are removed are then sent to a lab to be tested to see how severe the changes are.

I was then asked to wait in another waiting area and given a drink and a biscuit, just to make sure I was feeling OK and didn’t have any reaction to the anaesthetic. After about 20 minutes I was feeling fine and headed home. A few weeks later I got a letter advising that the cells they had removed had the lowest category of changes (which means they would be the least likely to develop into cancer). All I had to do was return for a repeat smear in 6 months. As I mentioned at the start of this post this smear test has been postponed until after I have had my baby, although there was some confusion about this with the GP saying I could have it done now, but my midwife saying it was best to wait. If this follow up smear is clear then I will go back to having regular 3 yearly smear tests. If abnormal cells are detected again then I would have to go back for another colposcopy and perhaps further treatment.

For me, although obviously the colposcopy and treatment wasn’t something I would choose to go through, it really was fine and I’m happy knowing that any potentially dangerous cells have been removed. I know I was lucky and that the outcome isn’t as good for a lot of women but it just shows how important it is to have regular cervical screening tests. If you do then it is much more likely that any cell changes will be caught early and treated before they can develop into cancer.

All women aged between 25 and 64 are invited for cervical screening tests every three years and I would urge everyone to go for their tests regularly. I hope that by sharing my experience I can set a few minds at rest as to what happens if abnormal cells are detected. Although other women may have different outcomes to me, the presence of abnormal cells doesn’t mean you have cancer and it is usually something which can easily be treated. But please, please make sure you go for your smear tests. Because if it is cancer then catching it early gives you the very best chance of a positive outcome.

 

After writing this post I continued the rest of my pregnancy with Gabe and he was born at home without any complications. Three months later I had my follow up smear test which came back clear of any abnormal cells. For me, as for most women who have an abnormal smear, everything turned out fine. But please, please make sure you go for your smear tests. Because if it is cancer then catching it early gives you the very best chance of a positive outcome.

5 thoughts on “What happens after an abnormal smear test?

  1. I always think going for smears is so important, although not the nicest thing in the world! I’m sure if anyone is going through this same thing that your post will reassure them x

  2. I recently had a letter inviting me for a routine smear, my heart sank when I read it. They have been letters I dreaded, for years even before I ever received my first one. I’m not sure why, I have never found them painful and always come out thinking it wasn’t that bad. I guess this time I’m worried that there are changes since having Eliot.
    Really helpful & informative post! X

  3. I’m glad everything worked out okay for you, and that you were able to give birth at home without complications. I had terrible side effects after my LLETZ procedure, as did a number of other women, but there isn’t much awareness about the 15% of women who lose almost all sexual function after LLETZ. This is my story. http://www.hormonesmatter.com/sexual-trauma-leep/

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