When I was 21, I received a letter from the NHS inviting me for a routine pap smear – to test for HPV and to check the health of my cervix. Usually the NHS waits until you’re 25 before sending these letters (at least that’s the case in England, Ireland and Scotland), but I was living in Wales and the policy was 21 there. And I’m so grateful that it was.
I remember the smear itself being uncomfortable but unremarkable. I could never have imagined that it would mark the start of three years of examinations, biopsies, surgeries and treatments, after the results showed I had HPV and cancerous cells in my cervix – different to pre-cancerous or abnormal cells. All of which, as you might imagine, would prove to be quite traumatic for a woman in her early twenties.
It might sound weird coming from a sex writer who is literally always talking about sex, but for the best part of a decade, I had a very negative relationship with my body and intimacy. I would have to do months of psycho-sexual counselling and physio to make even thinking about sex possible again, let alone having it. Everything had stopped working. My brain and body were in a state of disassociation and my pelvic floor muscles had become hypertonic (permanently tense). In my mind I saw flashes of the hospital and surgical instruments every time someone touched me. I had to use dilators and had weird nightmares. To say it was rough is an understatement.
The needles, biopsies, surgeries and recovery that followed my diagnosis meant I had to miss vital parts of my university course too and a lot of the fun stuff all my friends were doing. It seemed like the hospital appointments were never ending. But finally after three years, I emerged with half my cervix remaining – after losing the other half to various surgeries and treatments – and a distinct desire to never have my vagina touched by anyone ever again. The healing process was long and although it’s surreal and almost funny to think about it now, I was so alarmed by the idea of touching myself after the surgeries, I had to lie on the bathroom floor with my legs open so my mum could administer the antibiotic cream with a syringe. Not the most enjoyable experience for either of us.
HPV (the Human Papillomavirus) is linked to at least 99.7% of cervical cancer cases, according to NHS data, and is so common that almost everyone who is sexually active will get it at some point in their lives. In fact, the nurse doing my swab told me that most bodies carry it, but the majority of people’s immune systems can fight it off without much trouble. However, it’d later turn out I was just very unlucky with how the virus affected me in particular.
Fast forward 12 years to 2024, and there’s now the option of having a HPV vaccine (which produces antibodies to prevent HPV from infecting healthy cells) while at school. It’s such a powerful tool when it comes to preventing cervical cancer (along with head and neck, anal and genital cancers), that the NHS says there’s a real chance cervical cancer could be eradicated by 2040. Yet, a new report has found one in six girls aged 12 to 13 have forgone the vaccine (it’s most effective prior to becoming sexually active), as have one in five boys. And equally as worrying: one in three women and gender nonconforming people with cervixes still aren’t taking up their smear test invites.
In light of these new numbers, Steve Russell, national director for vaccinations and screening for NHS England has urged parents of those eligible to consent to their children being vaccinated, citing that “500,000 girls and boys have been vaccinated with a dose of protection against the virus by the end of year 10, however, there are over 50,000 girls and over 70,000 boys in year 10 who were unvaccinated against HPV”. If we can shrink these numbers, then maybe nobody else will have to go through what I experienced.
“There are over 100 strains of HPV in total,” explains Dr Aziza Sesay, an NHS GP and women’s health expert. “In the UK, the vaccine is offered free on the NHS to girls and boys aged 11-13 But if you miss the vaccine in school, you can also get it on the NHS up to the age of 25 if you’re assigned female at birth, or up to the age of 45 if you’re a man who has sex with men. If you’re over 25 you can also get it privately from pharmacies and other health centres.”
Jabbed or not, you still need to attend cervical screenings too (I know they’re not the most fun, but they’re over quickly and are so, so important) and going to mine saved my life. As Dr Sesay says, “Cervical screening saves lives – so don’t skip yours. If you’re concerned about the health of your cervix before you’re 25, you can arrange to speak to your doctor who can advise you.”
It’s hard not to think about how I might not be here now if I hadn't gone through everything I did, and how I wish the HPV vaccine had been available to me back then. If I’d had those injections aged 11-13, it’s likely those cells on my cervix wouldn’t have been a threat to my life and I wouldn’t have lost half my cervix or had to go through the experiences that stopped me from having sex for years.
When you go through trauma like that, it can take a long time to unpack and start to heal from it. But this is why I’m so hopeful for the generation receiving the vaccine now. And with any luck, if we all keep talking about the importance of smear tests, hopefully they’ll go for screenings too and their results will come back clear.
My experiences not only made me want to learn more about women’s health and support cervical cancer charities, but they steered me into the field of sexology, sex journalism and coaching women with sexual dysfunction and trauma. Despite other hormone issues, I occasionally have periods and I’ve been told the surgery shouldn’t interfere if I want to try and get pregnant – although miscarriage and preterm birth are more likely if you’ve had your whole cervix or some of it removed. I tried everything to feel comfortable with my body and sexuality again and fortunately, years of therapy, somatic work and sexual wellness practices have worked for me.
The sight of a speculum still makes me very nervous, obviously, but the fact that we might be able to totally remove the threat of cervical cancer by 2040 is incredible. It makes me hopeful that other people in their teenage years and twenties now won’t ever have to go through what I went through. My advice? Get the vaccine, use barrier methods of contraception to protect yourself and even though it can be uncomfortable, go to your cervical screenings. You need one every three years and having them can save your life.
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