NHS Cervical Screening Programme

The cervical screening programme was first introduced in the UK in 1960. It helps prevent cancer by detecting and treating early abnormalities of the cervix which left untreated could lead to cervical cancer.

Cervical screening has been shown to reduce death rates from cervical cancer in up to 95 percent of those regularly screened.

However cervical screening is not foolproof and up to 20% of early changes can be missed for various reasons and some women with normal cervices may undergo un-necessary investigations and treatment. But overall the benefits outweigh the inconvenience. If you have any questions on effectiveness of screening please discuss it with your gp.

Women are first invited for screening at the age of 25 and the final smear is taken at the age of 64. Between the ages of 24 and 50 a smear is taken every 3 years. From the age of 50 to 64, they have 5 yearly tests. The interval between smears may be reduced if any abnormalities are detected. The age of final screening may be extended beyond 64 if abnormalities have been previously detected.

You will be invited to attend your surgery for a smear by letter, If you feel you are entitled to have a smear but have not yet been invited, please contact your surgery.

The smear is taken by the doctor or practice nurse at your surgery. They will explain the process before the procedure. It involves introducing a speculum into the vagina to expose the cervix of your uterus and taking a sample using a special brush. The sample is sent to the lab for analysing.  You may ask questions at any time during the procedure.

Results take about 2-6 weeks to come back from the laboratory.

You will receive a letter with the results at home. If the results are normal, you will be invited again for routine screening at the usual interval. If there are abnormalities detected on the smear, depending on the severity, you may be invited for an earlier screen in the future or in more worrying cases, you may be referred to they gynaecologist for further tests and treatment, usually a procedure called colposcopy.

Once you get your letter of invitation for screening please book an appointment with the practice nurse or doctor to have the procedure done.

Contraceptive Choices

Your options for contraception are

• natural methods - abstinence from intercourse during the time of the month when you are likely to ovulate. There are kits which help you determine the time you are likely to ovulate and give you an estimate of the time when it not safe to have intercourse. There is a high failure rate from this method and it is not recommended as it is not very reliable.
• barrier methods - like the male or female condom - these methods can help protect against sexually transmitted disease but there is a high failure rate mainly because the condoms may split. It is not recommended for long term contraception. 
• the oral contraceptive pill - the contraceptive pill is usually started during the first few days of your period.It is highly effective in preventing unwanted pregnancies if taken as directed There are two main types of contraceptive pill

The minipill (progesterone only pill) - contains progesterone It has to be taken every day of the month at the same time of day without a pill free interval. If you are on this pill, your periods may become lighter or stop altogether. However in some women, it may cause slight bleeding between periods or irregular periods.

The combined oral contraceptive pill - contains both oestrogen and progesterone - taken for the first 21 days of your cycle with a 7 day pill free interval during which time should experience breakthrough bleeding.

Both types of pill can have side effects - a slightly increased risk of breast cancer and cancer of the uterus, headaches, weight gain, acne. The combined pill slightly  increases the risk of getting blood clots (DVT) and stroke so is not recommended in smokers over 35 years of age or if there is a strong family history of clotting disorders. It is also not recommended in certain types of migraine.

You should have a thorough discussion with your gp before you decide to go on the pill.

• Long acting reversible contraception (LARC)

Long acting contraceptives are effective for an extended period of time and once commenced the user does not have to take any action till near its expiry time.

LARC's are highly effective and some of them are useful in controlling heavy or painful vaginal bleeding.

Currently available long acting contraceptives include

- intrauterine device (IUD)

- intrauterine system (IUS) or hormonal iud

- hormonal implants (nexplanon or implanon)

- depot provera injection

Long acting contraception is a preferred method for contraception by the department of health especially for young people.

All the above contraceptive methods including LARC'S can  be arranged at your  surgery. Please make an appointment with your gp to discuss your various options.