By Izzie
HPV awareness day is March 4th, and while the day has passed it’s never a bad time to talk about our sexual health. When you’re trying to practice safe sex, knowledge is power. So if you’re a curious cat looking to learn a little more, or you’re worried about your first cervical screening, you’re in the right place.
THE FACTS
The Human papillomavirus, or HPV, is a group of very common viruses of which there are more than 100 types. HPV infections are usually symptomless, and most people don’t know they have one, unless they are tested for it.
Some types of HPV are high risk because they stay in the body, and over time can turn into cancer if left untreated. These include: cervical cancer, genital cancers, and cancers of the mouth, and throat. Other types of HPV cause genital warts, which is an STI that results in small growths on or around the genital or anal area. Gential warts are the most common sexually transmitted viral infection in the UK.
HPV is very common and can be caught through any kind of skin to skin contact with another person who already has it. This means you dont necessarily need to have penetrative sex to catch it, and condoms do not necessaily prevent transmission as the virus can infect areas that are not covered by them. That said, condoms greatly reduce the risk of passing on HPV, so suiting up is always safest. 80% of people will get an HPV infection at some point in their lives and their immune system will flush it out naturally, without treatment in 1-2 years. But, some people will get infected with a high risk type of HPV, which the body won’t be able to clear on its own.
THE VACCINE
The NHS has a HPV vaccination programme which uses a vaccine called Gardasil. Gardasil protects against 4 types of HPV: 6, 11, 16 and 18. Types 6 and 11 cause 90% genital warts, while 16 and 18 cause most cervical cancers in the UK (roughly 70%).
The vaccine is usually offered to both boys and girls in year 8. The vaccine requires 2 doses to be taken, and both are important to ensure you are fully protected. If you missed getting the vaccine in year 8 you can still get it for free on the NHS up until your 25th birthday. But, if you get your first does of the vaccine at the age of 15 or over, you’ll need to have 3 doses. Studies have shown that the vaccine protects against HPV infection for at least 10 years, but it is expected that protection lasts for much longer.
It’s important to remember the vaccine does not protect against all types of HPV that can cause cervical cancer, so it’s important that anyone with a cervix also has regular cervical screenings from the ages of 25 – 64. Cervical screenings are once every 3 years, and after the age of 50, once every 5 years.
MY FIRST CERVICAL SCREENING
Cervical screenings, also known as pap smears, or smear tests, are the name for a procedure where your cervix is swabbed for a tissue sample, which is then sent off to a lab for testing. For my first cervical screening I received a letter in the post, and a text telling me to book an appointment with my GP. I got this notification while I was still 24, as the first invitation is sent up to 6 months before you turn 25. I booked my appointment for the following week because I wasn’t expecting to be on my period – which is pretty much the only time you can’t do the examination. I was informed on the phone that the nurse doing the test would be female, but if the sex of your practioner is not mentioned you are able to check while booking. If having a practitioner of a certain sex or gender will make you more comfortable, you can request one for your appointment.
Once I was booked in I decided to Google the procedure, to try mentally prepare myself. I saw the video on the NHS website of what exactly will happen, and it made my vagina quiver in fear. Seeing a speculum open the vagina up reminded me of when I had my IUD removed, and all I could think about was how painful that experience was. After that, I began reading blogs about other people’s tests, which really just made me more anxious, because most spoke about the pain and discomfort. While knowledge is power, you need to know yourself, as well as when enough is enough. If what you’re learning isn’t making you feel more confident, or empowered it’s generally a good sign to stop. This was an examination I knew I needed to have for my own safety, so there was no point in scaring myself out of it.
Fortunately, my initial feelings of worry were unfounded. When I walked into the room for my appointment, my nurse introduced herself, then gently instructed me to disrobed from the waist down, and put the sheet provided over my stomach and vulva. I read that some people prefer to wear dresses and skirts to feel more covered, however this wasn’t something I was overly concerned with.
Once I was situated my nurse put her hand on my knee, looked me in the eye, and said she would be gentle. And you know what, she was. The test took no more than two minutes and before I knew it I was back out the door. I experienced some discomfort a bit later on in the day, but I was lucky the examination itself was pain free. While these are registered professionals doing our examinations, every experience will be different. It is a good idea before your examination to speak to the practitioner and let them know any relevant information about your sexual and medical history, for example if you have never had sex before or you have experince sexual trauma. This will allow the practitioner to make adjustments, like using a smaller speculum, or letting you insert the speculum yourself. If you do experience any pain or discomfort during your examination be vocal about it. This will allow the practitioner to make further adjustments like asking you to change position. There is no need to rush the procedure so take all the time you need for this to be done right.
Following your screening, your results will be sent to you in a letter. The letter will explain our results and what they mean. If you’re negative you will be invited for your next appointment in 3 years. If you’re HPV positive with no abnormal cells you may need another check up in 1 year to see if your body has flushed out the virus, and then again 2 years later. However, if you are HPV positive and have abnormal cells, you will be invited to a colposcopy. A colposcopy is another examination where a senior doctor takes a look at your cervix to identify any cancerous cells. My results told me I needed a colposcopy.
MY COLPOSCOPY
The booking process for my colposcopy was done for me because this was a referral, so I just waited for the letter telling me about my appointment. This appointment was also during the pandemic, so I also had to do a Covid swab before the appointment and self-isolate. The appointment was in a gynae clinic at my local hospital, and the examination was done by a consultant gynaecologist, while a nurse assisted. The gynaecologist was really nice, she introduced herself and gave me a brief overview of what would happen. Then, the nurse helped me with getting me set up in the chair, drawing the curtains for me, and even did some deep breathing with me when she could see I was anxious.
I probably should have said this earlier, but I am a hypochondriac; as soon as I saw the word abnormal on the letter, my mind went straight to the worst possible scenario. Now, I know you’re probably thinking that it’s normal to be a little worried since they said I had abnormal cells, but my letter explicitly said that my cells were low risk, and that most abnormal cells found are likely NOT to be cancer. And honestly, I should have listened, but again, I am a hypochondriac so I was ready for a death sentence.
Safe to say, was I wrong. Similar to the cervical screening the speculum was inserted, but this time, instead of a swab camera was inserted bringing up an enlarged image of my cervix on a screen. I had the option to look away, but was actually pretty fascinated by it. My consultant then dabbed some dye on my cervix and took a look around. She told me she was looking for cancerous cells but couldn’t see any. She then told me I had a healthy looking cervix, and whatever cells they may have found before were gone. Afterwards, I sat with my consultant while she explained that I should be virus free in a year or two, and the only thing that would slow this process down is if I started smoking again (I was two days smoke free at this point). I felt some discomfort after the appointment, but it didn’t last longer than an afternoon.
Overall, this monumental experience was a good one. I enjoyed learning about my body and getting to see new parts of it up close. But most of all, I am grateful I got a check up that could save my life. The most effective way to treat cancer is to catch it early. While good lifestyle choices are important for good health, none of us are totally immune. We don’t all have good cervical screening experiences, but that doesn’t mean we should avoid them all together. Your sexual health is as important as your general health, and knowing your status can help it protect yourself and others. Remember, you have a right to tailor your healthcare experience, even when it is free. Positive sign off!
Resources:
https://www.nhs.uk/conditions/human-papilloma-virus-hpv/
https://www.nhs.uk/conditions/vaccinations/hpv-human-papillomavirus-vaccine/
https://www.nhs.uk/conditions/cervical-screening/
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