Should the age for first smear test be reduced?

Acilaf

Hi all, going unreg for this one.

A few months ago I started bleeding during/after sex. This has happened maybe 5 times in total. After the first time I went to my doctor, who referred me to Holles St. The gynaecologist there thought it was caused by cervical erosion due to being on the pill. I expected a smear test to be carried out; however, I was informed that due to my age (22), she was sending me for a scan instead. This, I was told, was due to a HSE policy of not performing smear tests on under 25s.

Around 6 weeks later I went for the scan of my uterus and ovaries, everything looked fine, no abnormalities. I then had to wait another month before my final appointment with the gynaecologist, where she told me she was satisfied that it was cervical erosion and nothing to be too concerned about. However, when pressed, she said she couldn't be 100% certain, and admitted herself that not being able to give me a smear test was daft.

I was not totally happy with this treatment- although the doctor was very likely correct in her diagnosis, I think an intial smear test would have been much better- cheaper for them, less intrusive for me. I am now in a position where I feel I should book a private smear test to get 100% reassurance that it is nothing to be worried about.

While I understand the thinking behind a general policy of no smears for under 25s, surely if there are symptoms, such as bleeding after sex, this should be negated?? I feel that the only positive thing I have gained from this experience is the knowledge that yes, our health system is a complete joke, and I will go private in future for any pressing health concerns.

Has anyone else had similar experiences? Do you agree that smear testing should be on a more ad hoc basis, and that a blanket "no under 25s" rule is crazy? Any stories/advice welcome

Nevyn

I think it should be 17 if you are on the pill and/or sexually active.

Dutchess

I think that routine smear tests, the ones that are done very 3 years are fine to start at 25. But if someone comes in with an ailment of any kind, doctors should do what they can to figure out what is going on. They should not go with a different test just because it's not protocol to do another test before a certain age. And although there is no such thing a 100% surety whatever test is done, if a doctor is doubtful whether one test (a scan in this case) gave a definitive answer, they should carry out the test that they think would make this more definitive.

I have private insurance and always will have as long as I can remotely afford it.

iguana

That sounds like an odd policy imo, surely it should be done on a case by case basis depending on the sexual activity of the individual and the type of contraceptive they use? I had my first smear at 21 when I decided to try the pill, it was done at the family planning clinic.

It was ever so slightly awkward though, as the doctor was teaching medical students and asked if it was ok if they watched.

ztoical

I'm very surprised they refused to do a smear if you were bleeding. I know my GP has done smear tests on women under 25 when they presented with issues that called for one.

Xiney

In Canada it is generally recommended to get a smear done yearly from the age of first sexual activity or 18, whichever comes earlier.

ztoical

Xiney wrote: »

In Canada it is generally recommended to get a smear done yearly from the age of first sexual activity or 18, whichever comes earlier.

Ah but Ireland is still ruled by the religious nut brigade and if the HSE put age for routine smears at 17 which is the age of consent you'd have people implying the HSE was encouraging young people to have sex.

jigglywoo

I asked my college nurse about this a few weeks ago because I thought 25 was far too late to be tested.

She told me that anyone who is sexually active carries HPV and your body will clear it within a few years, i.e. by the time you're 25. She said that when younger people are tested abnormal results will appear because of the virus, which in a way is normal, and results in unnecessary treatment. If by the time you're 25 you have an abnormal result then your body probably hasn't gotten rid of the virus and it might turn serious.

That doesn't mean you shouldn't get tested if you're under 25 though, if you feel that it's important or concerned about it then go for it but your doctor will probably tell you the same thing I was told.

Acilaf

ztoical wrote: »

I'm very surprised they refused to do a smear if you were bleeding. I know my GP has done smear tests on women under 25 when they presented with issues that called for one.

This is what I thought too, in fact I was sure when I arrived in Holles St that a smear would be the first thing they would do. In fact, the doctor told me she couldn't do one, she then even went off to check with someone else, only to be told the same thing.

It's absolutely crazy.

By the way does anyone know of good places in Dublin city to book a private smear test? And the approximate cost? Sorry for the questions!

Xiney

it seems REALLY weird that they can't do a smear because you're underage.

I'm not really well versed on the various public/private clinics... is the one you went to public or private? and does the Church have something to do with the clinic? If you went to a private, non church run clinic, would they be able to do a smear?

LEH

I got my first smear at 24, had to pay for it with my gp, but it's free once every 3 years after 25. It cost about €50, and could have paid €30 for a courier to get the sample to the lab, but they said I could drop it up myself as it was only 15 mins away in Sandyford. Don't think you need to go to a private clinic or anything, just go to your GP but you will probably have to pay something. Got the all clear about two weeks later by phone.

I agree that 25 seems quite old as the limit for smears, the reason I went for it off my own bat, is remembering all those teenage magazines like Sugar and Bliss saying how important it is to go for smears from 21, so thought it was well overdue! But the policy is probably for the reasons mentioned above about HPV levels before 25 etc.

princess-lala

You can have a smear test before 25 you just have to pay for it yourself!

ztoical

princess-lala wrote: »

You can have a smear test before 25 you just have to pay for it yourself!

Yes but if your under 25, have a medical card and are bleeding or having other medical issues that call for a smear then they should be able to perform a smear test and have it be covered by medical card. Saying they can't perform smears on any women under 25 just seems very odd.

ztoical

jigglywoo wrote: »

I asked my college nurse about this a few weeks ago because I thought 25 was far too late to be tested.

She told me that anyone who is sexually active carries HPV and your body will clear it within a few years, i.e. by the time you're 25. She said that when younger people are tested abnormal results will appear because of the virus, which in a way is normal, and results in unnecessary treatment. If by the time you're 25 you have an abnormal result then your body probably hasn't gotten rid of the virus and it might turn serious.

That's not actually the case....over 80% of women will get some forum of the HPV virus during their life but the majority will be cleared by your bodies own system. It takes an average of a year, but can take up to three years, for a woman's immune system to control the infection. You are at risk when you start being sexual active and should start getting tested about 3 years after you become active so if a girl is sexual active at 15 she should be getting screened from 18/19 not 25.

iguana

jigglywoo wrote: »

She told me that anyone who is sexually active carries HPV and your body will clear it within a few years, i.e. by the time you're 25. She said that when younger people are tested abnormal results will appear because of the virus, which in a way is normal, and results in unnecessary treatment. If by the time you're 25 you have an abnormal result then your body probably hasn't gotten rid of the virus and it might turn serious.

That's not entirely accurate. It takes 1-4 years for the body to control the virus and while the immune system is fighting the infection smear results can show mild abnormalities. As it's safe to wait for several years due to the slow early progression of cervical cancer it's sensible to wait 3 years before taking the first test. Waiting until 25 makes the assumption that most women wait until 21 to have sex.

Imo, testing should begin 3-4 years after a woman becomes sexually active. If a 21 year old tells her doctor she has been sexually active since 17 she should be entitled to a free test at that point.

Nevyn

Xiney wrote: »

it seems REALLY weird that they can't do a smear because you're underage.

I'm not really well versed on the various public/private clinics... is the one you went to public or private? and does the Church have something to do with the clinic? If you went to a private, non church run clinic, would they be able to do a smear?

It goes back to keeping a young woman's virginity intact, same with the taboo on tampons. A lot of what is 'best practice' in medicine in this country is riddled with catholic mores and a dr can end up being investigated fined or have their lience looked all of which drives up their practice insurance premiums.

I know that family planning clinics will do them every year of a client smokes and is on the pill and every 3 years if they don't smoke.

I had my first when I was 19 I pushed for it and was told by dr and nurses that really I was making a fuss over nothing,
I had been sexually active for 4 years at that stage and on the pill for 2 years and I smoked occasionally.

I had heard that not doing them before 23 was to do with the body not being full developed rather then anything to do with HPV.

jigglywoo

I know what the nurse told me isn't entirely accurate and it seemed a bit vague when she was explaining it but she was just giving a quick summary, maybe she was basing it on old information.

Based on iguana and ztoical having similar info on it I'm more inclined to go for a test in the next few months instead of waiting til I'm 25

ztoical

jigglywoo wrote: »

I know what the nurse told me isn't entirely accurate and it seemed a bit vague when she was explaining it but she was just giving a quick summary, maybe she was basing it on old information.

Based on iguana and ztoical having similar info on it I'm more inclined to go for a test in the next few months instead of waiting til I'm 25

My info comes from speaking to my mum whose a GP and we talked about it for a good bit cus she was pushing for me to get one as I'd been sexual active for about 5 years at the time but it dawned on me that if I did get one she'd be the one doing it as she was my GP and that would be just weird. So I ended up asking alot of questions as to why I needed one and a getting a bunch of info to read on it. Ended up going to a different GP in the end as frankly there are just some things mothers and daughters should not share

ztoical

iguana wrote: »

That's not entirely accurate. It takes 1-4 years for the body to control the virus and while the immune system is fighting the infection smear results can show mild abnormalities. As it's safe to wait for several years due to the slow early progression of cervical cancer it's sensible to wait 3 years before taking the first test. Waiting until 25 makes the assumption that most women wait until 21 to have sex.

Imo, testing should begin 3-4 years after a woman becomes sexually active. If a 21 year old tells her doctor she has been sexually active since 17 she should be entitled to a free test at that point.

lol snap!

iguana

iguana wrote: »

That's not entirely accurate. It takes 1-4 years for the body to control the virus and while the immune system is fighting the infection smear results can show mild abnormalities. As it's safe to wait for several years due to the slow early progression of cervical cancer it's sensible to wait 3 years before taking the first test. Waiting until 25 makes the assumption that most women wait until 21 to have sex.

Imo, testing should begin 3-4 years after a woman becomes sexually active. If a 21 year old tells her doctor she has been sexually active since 17 she should be entitled to a free test at that point.

I don't think that's really it. I think it's that the cervix of young women isn't fully developed and is prone to these mild abnormalities. The reasoning behind raising the age was that there was a huge level of over treatment and anxiety caused in young women.

I don't think anyone assumes that most women wait until 21 to have sex. I actually did, and went doctors hear that they're very surprised. I don't think they hear it often.

MeerKat17

I was ill while on holidays in Holland a couple of years ago (when I was 23) and hospitalised. As soon as I was brought to a room, (which was within 20mins of arriving I might add...our hospitals truly suck!) the doctor asked to do a smear test and asked when I had my last smear. I will never forget the look of total shock and horror on his face when I told him I had never had one, that you don't start them until your 25 in Ireland.

I think the age should be reduced to 18, or as soon as you become sexually active.

MeerKat17

MeerKat17 wrote: »

I was ill while on holidays in Holland a couple of years ago (when I was 23) and hospitalised. As soon as I was brought to a room, (which was within 20mins of arriving I might add...our hospitals truly suck!) the doctor asked to do a smear test and asked when I had my last smear. I will never forget the look of total shock and horror on his face when I told him I had never had one, that you don't start them until your 25 in Ireland.

I think the age should be reduced to 18, or as soon as you become sexually active.

It's weird to think that most of my peers won't have had a smear test. I think I was pretty much in the last group of 20 year olds in NI to be called for one. I've been through countless smears and colposcopies and biopsies and most people my age have NEVER had any sort of internal exam. My sister has been sexually active as long as I have and she has FOUR YEARS to go until her first smear. It does seem kind of crazy.

Charlie.

From what I was told from my GP the age is 25 because abnormalities in the cervix are normal for woman under 25 and carrying out smears would lead to unnecessary anxiety and medical procedures.

At 21 I experienced bleeding after sex a few times and went to my GP who basically said she didn't think it was anything to worry about. I mentioned I was afraid of cervical cancer and would like a smear and she told me I could have one if I really wanted but "it would be expensive" and to be honest I got the impression that she thought I was being silly asking for it! I think it cost 70 something euro. The results came back showing some abnormalities and so I was sent for a colposcopy and biopsy. Thankfully the biopsy has came back clear and so I am going back for a smear in 6 months.

I think it's so wrong that at 21, after being sexually active for 4 years, being on contraceptives and showing signs of cervical cancer, that a smear test was not even mentioned to me by my GP, never-mind encouraged!

Charlie.

Charlie. wrote: »

From what I was told from my GP the age is 25 because abnormalities in the cervix are normal for woman under 25 and carrying out smears would lead to unnecessary anxiety and medical procedures.

Well, that is a valid concern. I essentially ruined my early twenties worrying about HPV and cancer and abnormalities and having to go to the hospital all the time, and they never actually did anything. I'd have been much better off not finding anything out until now. What I knew didn't help anything, just caused me ridiculous amounts of stress and hassle. I've had a lot of people say 'ohh you're lucky you found out.' Why? I would have found out the exact same thing 5 years later and at least got to enjoy a few years thinking I was in perfect health. In my case, I would have been much better off not being checked until 25. I'm aware that some people having anxiety is better than some people having cancer and it being missed but there's two sides to every coin. Perhaps it should be 'X years after you've had sex'. In my case, it was about 5 months after, so my body hadn't had a chance to clear anything on its own anyway so it was quite pointless.

Hannibal Smith

Acilaf wrote: »

Hi all, going unreg for this one.

A few months ago I started bleeding during/after sex. This has happened maybe 5 times in total. After the first time I went to my doctor, who referred me to Holles St. The gynaecologist there thought it was caused by cervical erosion due to being on the pill. I expected a smear test to be carried out; however, I was informed that due to my age (22), she was sending me for a scan instead. This, I was told, was due to a HSE policy of not performing smear tests on under 25s.

Around 6 weeks later I went for the scan of my uterus and ovaries, everything looked fine, no abnormalities. I then had to wait another month before my final appointment with the gynaecologist, where she told me she was satisfied that it was cervical erosion and nothing to be too concerned about. However, when pressed, she said she couldn't be 100% certain, and admitted herself that not being able to give me a smear test was daft.

I was not totally happy with this treatment- although the doctor was very likely correct in her diagnosis, I think an intial smear test would have been much better- cheaper for them, less intrusive for me. I am now in a position where I feel I should book a private smear test to get 100% reassurance that it is nothing to be worried about.

While I understand the thinking behind a general policy of no smears for under 25s, surely if there are symptoms, such as bleeding after sex, this should be negated?? I feel that the only positive thing I have gained from this experience is the knowledge that yes, our health system is a complete joke, and I will go private in future for any pressing health concerns.

Has anyone else had similar experiences? Do you agree that smear testing should be on a more ad hoc basis, and that a blanket "no under 25s" rule is crazy? Any stories/advice welcome

I think once a woman is sexually active they should be eligible for a smear test, regardless of the age. I don't know is the reasoning behind such late screening because of the intrusive nature of the procedure?

Charlie.

[quote=[Deleted User];66042182]Well, that is a valid concern. I essentially ruined my early twenties worrying about HPV and cancer and abnormalities and having to go to the hospital all the time, and they never actually did anything. I'd have been much better off not finding anything out until now. What I knew didn't help anything, just caused me ridiculous amounts of stress and hassle. I've had a lot of people say 'ohh you're lucky you found out.' Why? I would have found out the exact same thing 5 years later and at least got to enjoy a few years thinking I was in perfect health. In my case, I would have been much better off not being checked until 25. I'm aware that some people having anxiety is better than some people having cancer and it being missed but there's two sides to every coin. Perhaps it should be 'X years after you've had sex'. In my case, it was about 5 months after, so my body hadn't had a chance to clear anything on its own anyway so it was quite pointless.[/QUOTE]

You obviously don't have to answer this but did you go for your first smear because you had symptoms of something being wrong or was it just as a precaution as you were sexually active?

In my case I went for one at 21 because I was worried about bleeding after sex. So in my case although I would have preferred obviously not to have went through the worry and stress that I did, I feel my concerns and reasons for wanting the smear were very valid and I think it's wrong that I wasn't encouraged to go for a smear by my GP just because of my age!

akamossy

I had one when I was 19 because my doctor said I had to have one as I'd been sexually active for over a year. I know it's since changed but I definitely think if you are sexually active then you should have to get a smear done.

starburst87

hi, im 23 with a 5 year old daughter and had my first smear at 21, that was fine but i've just got the results of my second smear back saying the test shows a very slight abnormality which is not serious and should not cause you concern, they also recommended i repeat the test in 6 months. i am in a right state over it, i think im going to have to get another smear done in 3 months just for a peace of mind, is there anyone else in this situation? i can't help but worry

starburst87

starburst87 wrote: »

hi, im 23 with a 5 year old daughter and had my first smear at 21, that was fine but i've just got the results of my second smear back saying the test shows a very slight abnormality which is not serious and should not cause you concern, they also recommended i repeat the test in 6 months. i am in a right state over it, i think im going to have to get another smear done in 3 months just for a peace of mind, is there anyone else in this situation? i can't help but worry

A very mild abnormality really is nothing to worry about, especially if it's the first time. They are monitoring it, and if the abnormality persists, they may send you for a colposcopy to get a better look at what's going on, but I definitely wouldn't worry one bit about it now. Just make sure you do go back for the repeat smear and follow all the advice you're given by your doctor.

Pythia

I got a smear test through the Cervical Check thing at age 23. I didn't have to pay or anything. My GP just sent it in, maybe she changed my age on it or something. Weird how no one else seems to have been able to get it...

princess-lala

I had my first smear test 6 weeks ago,I got the first letter in January after I turned 25.

I wasn't overly pushed on going for it but two weeks before it my cousin and myself were talking on msn!

Shes 10 months older than me, only registered late last year for hers and ignored the first letter and then went to have hers.

After 5 weeks she got her results - a letter to ring her doctor. She went and was told shes cin3 (the stage before cancer)

So when I went for mine I was telling my doctor and she was giving out that 25 is too old for the first smear, that if my cousin had a smear 5 years ago it probably would have came back as abnormal or cin1. But because of the poxy HSE here she is in the position shes in.

The hospital shes attending have done numerous biopsys and the results come back the same but they said shes not bad enough to have treatment, she was told recently that she will either return to cin1 or go on to get cervical cancer! They are doing repeat smears every three months and a biopsy in between

princess-lala

princess-lala wrote: »

I had my first smear test 6 weeks ago,I got the first letter in January after I turned 25.

I wasn't overly pushed on going for it but two weeks before it my cousin and myself were talking on msn!

Shes 10 months older than me, only registered late last year for hers and ignored the first letter and then went to have hers.

After 5 weeks she got her results - a letter to ring her doctor. She went and was told shes cin3 (the stage before cancer)

So when I went for mine I was telling my doctor and she was giving out that 25 is too old for the first smear, that if my cousin had a smear 5 years ago it probably would have came back as abnormal or cin1. But because of the poxy HSE here she is in the position shes in.

The hospital shes attending have done numerous biopsys and the results come back the same but they said shes not bad enough to have treatment, she was told recently that she will either return to cin1 or go on to get cervical cancer! They are doing repeat smears every three months and a biopsy in between

What difference would it have made? She's in the same position she would have been in. They don't like to treat women under 25 anyway, so all that would have happened would have been that she spent her early twenties worrying about it, as I did. She would have had to have gone to hospital every 6 months to check up on it and been told to 'wait and see', most likely. It's not until you're 25 that they start taking it seriously.

princess-lala

Lawrence Itchy Soy wrote: »

What difference would it have made? She's in the same position she would have been in. They don't like to treat women under 25 anyway, so all that would have happened would have been that she spent her early twenties worrying about it, as I did. She would have had to have gone to hospital every 6 months to check up on it and been told to 'wait and see', most likely. It's not until you're 25 that they start taking it seriously.

If it was found 5 years ago she could have had laser and be ok now!

princess-lala

princess-lala wrote: »

If it was found 5 years ago she could have had laser and be ok now!

But it's not that simple. As I said, they don't like to treat young women. She probably wouldn't have had laser. There is a risk with the treatments and that's why they prefer to wait and see what happens first. My abnormalities were discovered as mild CIN 1 4 years ago and I'm still in the same position as your cousin.

SugarHigh

No, there isn't the money for it. Campaigning to get stuff like this means you are creating media pressure that will force the HSE into a decision where they will have to take from somewhere else just to appease the crowd, their own information tells them the money should be spent elsewhere.

candy-gal1

Yes it really should be reduced, to 20 maybe.