The stirrups… the speculum… the jelly that your gynae never seems to get totally cleaned up.

Yeah, Pap smears are a (somewhat literal) pain, but cervical cancer was once the number one leading cause of cancer death in American, according to the Centers for Disease Control and Prevention.

Now, thanks to Pap smears, which can identify issues before they become cancerous, it doesn’t even crack the top 10.

“In fact, one of the biggest risk factors of getting cervical cancer is not having had a Pap smear within the past five years,” says Dr Eloise Chapman-Davis, a gynaecological oncologist at Weill Cornell Medicine and New York-Presbyterian.

However, she notes that you shouldn’t just rely on a Pap smear to flag any issues. It’s also important to watch out for cervical cancer symptoms, which can develop in cases of more developed cancer growths.

Translation: If you spot any symptoms of cervical cancer, it’s worth talking to your gynea and getting checked out as soon as possible.

Read more: Here’s what you need to know about cervical cancer screenings

1. Abnormal vaginal bleeding

“One of the most common symptoms of cervical cancer is vaginal bleeding, whether it’s in between your periods, after sex or after menopause,” says Dr Taraneh Shirazian, a gynaecologist at NYU Langone Health. Abnormal vaginal bleeding is generally a symptom of advanced cervical cancer, because it means that a tumour on the cervix is spreading to affect nearby tissue, Dr Chapman-Davis adds. Call your gynae immediately.

2. Extremely heavy periods

This isn’t about your period lasting a day longer or suddenly seeming a bit darker. “Rather, it’s your period all of sudden lasting two weeks instead of four days, or having two periods in one month,” says Dr Shirazian.

But to play it safe, it you have any changes in your cycle that last for at least two cycles (heavier, lighter, whatever!), it’s worth talking to your gynaecologist, she says.

3. Unusual vaginal discharge

Discharge is totally normal, but the type of discharge you experience could be an indicator of a number of different vaginal health issues.

“With cervical cancer, you might notice a discharge that’s foul-smelling and pink, brown or bloody, potentially with chunks of tissue, or what we call necrotic material,” says Dr Shirazian.

And because “masses and tumours secrete fluid, that could contribute to a continuous, watery discharge that seems to occur for no reason,” says Dr Chapman-Davis. Go ahead and give your gynae a call.

Read more: Your IUD might lower your risk for cancer in this surprising way

4. Pelvic, back or leg pain

Pelvic pain could be an indicator of changes to the cervix, but advanced cervical cancer can even spread to the bladder, intestines, or the lungs and liver, says Dr Chapman-Davis. “Then you might have things like back pain or leg pain,” she says. “But that’s typically associated with very advanced cases because the cervix isn’t really affecting a lot of nerves.”

Talk to your primary care doctor to rule out cervical cancer as well as other potential nerve causes.

5. Major fatigue

Because most cervical cancer symptoms don’t come along until it enters more advanced stages, it does share some symptoms with all cancers.

“Fatigue is definitely one of those symptoms,” says Dr Shirazian. One reason why: Abnormal vaginal bleeding, one of the major symptoms of cervical cancer, can actually lower the amount of red blood cells and oxygen in the body, causing you to feel utterly exhausted all the time, usually with no other explanation.

If you are dealing with chronic fatigue, your doctor will likely check your iron and red blood cell levels.

6. Feeling like you’re going to vomit – all the time

A persistent feeling of nausea or indigestion can be a sign of cancer, and that includes cervical cancer, says Dr Shirazian. That’s because, when advanced, cervical cancer can cause the cervix to swell into the abdominal cavity, compressing the gastrointestinal tract and stomach to cause or even acid reflux, she says. Since nausea can be a sign of cervical cancer as well as other issues, talk to your primary care physician before opting for gynae input.

Read more: The 411 On why you shouldn’t delay your pap smear screening

7. Out-of-nowhere weight loss

The same factors that can cause cervical cancer-related nausea can cause unintended weight loss, says Dr Shirazian. (Think: a compressed stomach that can’t hold very much food.) Plus, if you’re constantly feeling nauseated, you probably aren’t going to even want to try to eat. If you lose up to 5 or 10% of your bodyweight over the course of six months without trying, go ahead and call your primary care doctor.

^{This article was originally published on www.womenshealthmag.com} 

^{Image credit: istock}