Oh good, it's smear test time again

I've got to be really careful here. The act alone of talking about smear tests is tricky. Just revealing what's involved may put off those who've never had one before.

And because of its personal nature, it's highly subjective. No two women will have the same experience. That said, from what I've read, and from what women friends and relatives have told me, it is a procedure which they have come to view as a mundane non-event, no big deal and nothing to worry about. Which is how I too have come to view it.

Kind of. The truth is I'm writing this here in order to work through my own issues with smear tests. I've just had a letter from the regional NHS Cervical Screening Department, inviting me to make an appointment for one.

I knew what it was before I opened the envelope. It wasn't just that the envelope said NHS on it, but I knew it was about time again (3 years have elapsed since my last), and the NHS has never written to me about anything else before.

When I saw it, my heart sank. Just the thought of having a smear test, if I'm honest, does not fill me with joy. In fact, it makes me feel a bit sick.

While my rational mind tells me that it's not supposed to fill me with joy, that fear and dread are illusions, and that the thought is worse than reality, it's one thing to be told to 'relax', and another thing completely to have to do it enough to allow your vagina to loosen up to allow access to your cervix.

How does one relax in such a situation? When I first started having smear tests, the advice I was always given – and which is given in the leaflet accompanying the letter – is to take slow, deep breaths.

This works up to a point. It works if I'm in a stressful situation with work, for example, or when I'm meditating. Returning to the breath can be helpful in concentrating the mind on a particular task, and when trying to be mindful in everyday situations.

And it can help in the waiting room after arriving at the practice for my appointment. It can help on the walk from the waiting room to the surgery, and it can help when the doctor or nurse tells me to undress from the waist down and lie on a couch, knees up.

It can help while I'm lying there and the doctor or nurse is preparing the equipment. But when they turn round and approach me with a speculum – an instrument which, quite frankly, my brain splutters at the thought of being allowed to go anywhere near my fanny – relaxation suddenly seems impossible.

I mean, in the throes of having sex, the vagina is relaxed enough to allow an erect penis to enter. But there's more to getting sexually aroused enough for penetration than taking a few deep breaths. And for many women, it can take a lot longer. How am I supposed to fool my body into feeling a similar level of relaxation when a strange woman (it's always been a woman in my case – not that it would make any difference if it were a man) is coming at me with a speculum?

This may seem like a silly comparison to make. But I've also tried to tell myself that it's no different from inserting a tampon. Except, it is of course a lot different. I've always put my own tampons in (not that I use them much these days).

It was because of my inability to relax that my first my first smear tests were traumatic. At that time the nurse told me that my cervix was in an odd position, which made her struggle to access it. "Oops!" she exclaimed. "Your cervix is hiding from me!" I was not relaxed enough to respond but in any case, who could blame it? It took three separate visits before a successful smear could be obtained.

And it wasn't deep breaths which helped. In the end, what did help a bit was to remember why I was having the test in the first place. The leaflet says, "Cervical screening is not a test for diagnosing cervical cancer. It is a test to check the health of the cervix, which is the lower part of the womb (often called the neck of the womb)."

The leaflet continues, "For many women the test results show that everything is fine. But for one in 20 women, the test shows changes in cells that can be caused by many things. Most of these changes will not lead to cervical cancer."

So the test can offer reassurance and peace of mind. Trying to hold this thought – to look beyond the test itself knowing that I'd feel a lot better afterwards – helped me through a procedure which, I would also remind myself, only takes a few seconds. It is a small event with a potentially life-saving impact. It also helped when I found out that nurses now use disposable plastic speculums, instead of the old steel ones.

The best piece of advice I ever had about smear tests, however, was something which suddenly occurred to me. After once noticing that having a bloody good shit could sometimes help bring on a period, I discovered that if I strained my muscles in the same way, tampons would fall out of their own accord without having to pull the string (which was handy if the string ever snapped, which it sometimes did).

The same principle applied when a condom once got lost inside me. How to get it out? Strain as if doing a number 2.

So I decided to try the same strategy during a smear test. Just lie down with knees together and strain your muscles as if having a poo (it's probably best to have actually had one beforehand, to avoid any accidents).

And do you know what? It worked. The nurse was able to access my cervix and take a sample with no fuss. I couldn't believe how much easier it was. And I didn't even have to take any deep breaths.

This is stuff no one ever tells you (well, no one ever told me). But since I got that letter the other day, I've been practising, which also helps me feel better. I feel I'm taking control of a situation which would otherwise control me.

Which, according to Germaine Greer's devastating dissection of the national cervical screening programme in her book The Whole Woman, is what they're partly designed to do. "Screening is many times more likely to destroy a woman's peace of mind than it is to save her life," she claims.

"Women are driven through the health system like sheep through a dip. The disease they are being treated for is womanhood."

This is a view I'm sympathetic to. All the same, I can't help wondering what the alternative would be. No one claims that smear tests are pleasant. Being subjected to an invasive medical procedure in one of the most sensitive parts of the female anatomy – often followed by a breast examination – can be undignified. But despite everything, I keep coming back to the same thought: I'd rather have a smear test than not have one.

Because none of it is as unpleasant as dying from cancer, or the feeling that if I ever got cancer I could have done something to prevent it, but didn't because I let negative emotions overrule my common sense.

Part of being a grown-up means sometimes having to do things I don't want to, and keeping things in perspective. It would be irresponsible of me to publish anything that could be construed as scaremongering. Smear tests are things that all women should be encouraged to have.

"Just scrape my fanny and piss off!" yells Ben Elton in The Man from Aunty. They may be biologically inaccurate, but I think those words may well be ringing through my mind.