Smear tests

Daisy78

That may just do the trick will ring them on tuesday, I just hope its the nice nurse not the crankypants :mad:

Having a nice patient nurse carrying out the test is the trick to it really. And I definitely second the idea of treating yourself afterwards....it always works for me!

dubmum1

I found mine very uncomfortable borderline painful but if its the pain that you are worried about and that is what would cause you to be nervous about getting it then maybe take 2 pain killers before you go in. I know it sounds dramatic but working in the beauty trade I know loads of ladies who would take pain relief before being waxed lol ;-)

La_Gordy

I nearly always burst into tears but at least it's a quick procedure

Ambersky

When the issues that seem to cause discomfort or pain in having a smear test are at least partly caused by tensing up of muscles, it seems logical that a woman would be more relaxed about something she has control of and is doing herself.
Given a choice between inserting a speculum into my own vagina and someone else doing it for me, when I have already had a painful experience from someone else inserting a speculum, I have to say for me its an obvious choice.
The area of the cervix they want to get a sample from can be kind of tilted at various angles but if you can get the speculum into your vagina you are then more than half way there and all the health practitioner has to do is wiggle, not push, the speculum around a little to get a good view.
Learning how to use a speculum http://www.sisterzeus.com/usingspeculum.html

So I have a question. Why do so many women seem to prefer to leave the insertion of a speculum in the hands of the doctor/nurse rather than inserting it in themselves even after having had the experience of discomfort or pain at the hands of someone else inserting it?
Ive been speculating (hmm speculum speculating) that it could be for a variety of reasons so Im running those reasons by posters here.
Is it a throwback to the way women's health has been over medicalised for centuries? You know the idea that all the natural processes of a womans body have been seen as a medical problem even when they are happening naturally. So it would follow according to this idea that women would put their legs up and let the medical professional insert the speculum because only a medical professional would know how to do it properly.
Or maybe the reluctance to insert a speculum yourself is just an indication of how uncomfortable women are with their own bodies especially their own genitals. Have we been so divorced from our own bodies that we would rather go through pain or discomfort having someone else insert something foreign into our bodies rather than have to deal with our vaginas ourselves?
If it was simply a matter of a relaxed personal choice I would expect to hear a sizable percentage of posters saying they too usually insert or try to insert the speculum themselves, particularly those who have found it uncomfortable or painful when someone else was doing it.

Whats the deal with the idea that only medical professionals can insert a speculum.
On the net I read questions from posters elsewhere asking can they insert their own speculum and getting this for an answer

Best Answer - Chosen by Voters
no the doc knows how to do it w/out cutting you and knows exactly how far to open it to get the correct swab

What complete and utter nonsense, granted not from a reputable medical site.
I have had one of the top Gynecologists in the country tell me she gets her patients who are nervous to do this regularly and she said that of course being in control and being able to push it exactly as much and as quickly as you want helps a patient relax.
Yet I have been told by several GPs that no one else has asked to do this. Why? And why was it not part of their training even if the patients arent asking for them to learn how to make nervous patients more comfortable in this way, maybe showing them how and then leaving the room.
The fear of smear test and the refusals of uptake in smear campaigns is a very serious issue. Here is a Guardian article about how upset one women got about something that could save more womens lives if womens fear and discomfort was better understood.

Why I'm never going to have another smear test
For women with mental health problems, learning disabilities or a history of sexual abuse, smear tests can be especially traumatic. Why doesn't the medical profession know this?

http://www.guardian.co.uk/society/joepublic/2009/apr/17/smear-tests-mental-health

Here are the results of a study done in 2005.

AIM:
This paper reports phase II of a pilot study that aimed to determine whether self-insertion of a speculum by women undergoing a pap smear would be more comfortable and lead to an improvement in satisfaction and a decrease in anxiety associated with this procedure..........
BACKGROUND:
Research demonstrates that pelvic examinations are considered by most women to be unpleasant and are routinely associated with embarrassment, apprehension, fear and often some level of discomfort and/or pain.........
PARTICIPANTS:
A total of 198 women attending family planning clinics in Perth, Western Australia, between September and December 2003 were invited to participate in the study. One hundred and thirty-three women agreed to self-insert their own speculum.
RESULTS:
The study demonstrated that speculum self-insertion was acceptable to most women, especially younger women. Nearly 91% of women either agreed or strongly agreed that they were satisfied with the experience of self-insertion and would choose to self-insert the speculum again. This included the women who had not previously had a speculum examination. The quality of specimen collected was not detrimentally affected by speculum self-insertion.
CONCLUSIONS:
The results of this pilot research, while needing to be replicated in a larger study, demonstrate that offering women the opportunity to self-insert a speculum during a routine pelvic examination is an acceptable, innovative, simple and cost-neutral change in clinical practice that increases women's comfort and satisfaction and potentially makes sexual health screening less threatening to women of all ages.
RELEVANCE TO CLINICAL PRACTICE:
Speculum self-insertion may encourage women's attendance at clinics for regular screening. Early diagnosis and treatment will result in better health outcomes for women, families and the community at large.

http://www.ncbi.nlm.nih.gov/pubmed/16164528

Lastly read this article as an example of a medical professional working with a patient and actually involving her in the procedure. It dosent include self insertion but its a far cry from the kind of interaction I have had at any practice I have gone to and I think that is an awful pity.
How Can I Make a Woman Comfortable During a Pelvic Exam? Barbara Hughes, MS, MBA, CNM
http://www.medscape.com/viewarticle/461420

Scruffles

What complete and utter nonsense, granted not from a reputable medical site.
I have had one of the top Gynecologists in the country tell me she gets her patients who are nervous to do this regularly and she said that of course being in control and being able to push it exactly as much and as quickly as you want helps a patient relax.
Yet I have been told by several GPs that no one else has asked to do this. Why? And why was it not part of their training even if the patients arent asking for them to learn how to make nervous patients more comfortable in this way, maybe showing them how and then leaving the room.
The fear of smear test and the refusals of uptake in smear campaigns is a very serious issue. Here is a Guardian article about how upset one women got about something that could save more womens lives if womens fear and discomfort was better understood.
Quote:
Why I'm never going to have another smear test
For women with mental health problems, learning disabilities or a history of sexual abuse, smear tests can be especially traumatic. Why doesn't the medical profession know this?

agreed! they arent all ignorant,some are very understanding,it really differs on the doctor and service,perhaps ireland differs to here as well?


this is own experience of it.am severely learning disabled,and actualy had a 'best interest decision' made about the smear test today by the senior gp,the LD pyschologist of mine, parents,and manager of the residential home am living in.
she is very nice and understands that am not able to access the doctors surgery without a lot of issues and does home visits here.

they had spent a long time trying to teach about the smear test, they brought in easy read information designed by the LD services and went over and over with it, but was still at a to low capacity to understand and was also freaked out and confused over it.

the best interest decision is a official document thing they had to fill in, and it coud have gone several ways,including being forced by law to undergo it under a general anaesthetic, woud have had to spent many months having transitions to the hospital, having photos and video of the exact routes we woud be going, photos of the staff there who woud be meeting,having some of the equipment at home to get used to the feel of it etc;,but this woud have a major effect in many different ways including ability to trust staff.

and at the other end- not having it done.
thankfuly after all their talking they decided not to,because of level of capacity and asexuality, and the amount of risks to those around self/on behavior/mental health from carrying out the procedure as well as the general anaesthetic on top all outweigh the benefits and the actual risk from not having it-which is very low because of circumstances.
she said she is sending a letter to the smear test program to make sure am now going to be removed from it so they dont send out letters every three years but they will ask now and again if woud have it.

athtrasna

Got my results today though letter dated 31 May. Low grade changes, have to go back in six months. Anyone got any tips for not panicking? I know the leaflet says chances are they will return to normal but I'm sure I'm not alone in being more than a little freaked out

Morag

The detection methods have gotten better and so they catch that sort of low grade change, I had the same result and when I went back for the repeat it was all clear.

Gongoozler

I was just coming here to write about my second time back (yesterday), when I had one done 6 months ago

For the first few weeks after they said I'll have to go back in 6months, I was a bit like you, worrying about what it means etc. but then I dunno, I thought I'm sure a lot of people are told there's slight abnormalities. You'll probably just forget about it.

Well for my second visit, I actually asked the nurse what the CIN1 thingy meant, and she explained it to me. It means that when they tested you, there was something a little different. (In my case it was lesions of some sort) She said that things change in there all the time and usually change back, hence the need for retesting after 6 months. She said that if the second test comes back abnormal again, depending on what the result is, I may just have to return in 6 months again, or she might send me to have another smear done by a doctor, but standing up this time with some sort of machine thingy. If anything shows up at that time then they can either take action then and there, or they can do something at a later stage or they might leave it, to see if it clears itself up. but either way, don't panic.

i wasn't panicking at all, I just wanted to be informed about what everything meant. I'm feeling better about it now. Just have to see what my results are in 6-8 weeks now.

hope that helps.

athtrasna

Thanks guys. Have been nervous about this one for some reason so the letter confirming that not all was right was scary. I knew straight away it was them, they're the only ones who ever use my middle name

Try to forget about it seems to be key, I think I might open the weekend bottle of wine a night early.

LegacyUser

Vojera wrote: »

My first smear three years ago was quite a negative experience. I was in college and quite nervous about it so I went to talk to the nurse beforehand (it was free!) and had the whole process explained to me. All seemed grand. When I went for the actual smear, the nurse used the wrong sized speculum and really hurt me. She ended up having to get the doctor to come in, who immediately changed for a smaller speculum and got the job done. When the nurse asked me after about my sexual history I told her I was a sexually active lesbian who'd never had sex with a man she pretty much told me I should never have come for a smear....

I'm a sexually active lesbian who's never had sex with a man...I'm 24 and have never had a smear test. I know it's terrible but I just don't know how I could possibly do it. I have an anxiety disorder and problems "down there"...penetration with even small objects is incredibly painful for me, I can't even use tampons...

Is there any way to do the same health check without a speculum? I just don't know how it's physically possible to fit a speculum to reach my cervix when even using tampons is so painful.

A 50 year old friend also opted out of the free smears campaign because of her history of sexual abuse and never having ever been a sexually active woman.

Vojera

anxiouslesbian wrote: »

I'm a sexually active lesbian who's never had sex with a man...I'm 24 and have never had a smear test. I know it's terrible but I just don't know how I could possibly do it. I have an anxiety disorder and problems "down there"...penetration with even small objects is incredibly painful for me, I can't even use tampons...

Is there any way to do the same health check without a speculum? I just don't know how it's physically possible to fit a speculum to reach my cervix when even using tampons is so painful.

If you're not having any form of penetrative sex then you may not have to go for a smear. Your risk will be considerably lessened. They have a freephone number you can ring to talk to them (1800 45 45 55) to see what they think. You wouldn't be eligible for the free smear until you're 25 anyway.

rainbow kirby

anxiouslesbian wrote: »

I'm a sexually active lesbian who's never had sex with a man...I'm 24 and have never had a smear test. I know it's terrible but I just don't know how I could possibly do it. I have an anxiety disorder and problems "down there"...penetration with even small objects is incredibly painful for me, I can't even use tampons...

Is there any way to do the same health check without a speculum? I just don't know how it's physically possible to fit a speculum to reach my cervix when even using tampons is so painful.

My GP uses an extremely small speculum for it - seriously felt like not much more than 1-2 fingers used. If you can find someone who works like that, then that's probably a good option for you.

Ambersky

anxiouslesbian says
I'm a sexually active lesbian who's never had sex with a man...I'm 24 and have never had a smear test. I know it's terrible but I just don't know how I could possibly do it. I have an anxiety disorder and problems "down there"...penetration with even small objects is incredibly painful for me, I can't even use tampons...
Is there any way to do the same health check without a speculum? I just don't know how it's physically possible to fit a speculum to reach my cervix when even using tampons is so painful.

Ok the general advice is to go and get a smear test, but most sources I have read have also pointed out that women who have never had penetrative sex of any kind are at very low risk. It is controversial but the first source I quote here lgbthealth.org.uk even go so far as to say it might not be necessary in such a case. Medical professionals have to weigh up the costs and probabilities over a lot of health issues and there are an array of tests possible for us all to get but we too decide on some and against having others.
If anxiouslesbian the thoughts of going for a smear test and the experience of penetration, when feel you are not able for it, is too much for you, I think it would be important for you to listen to your body.
You say you have problems "down there" and that penetration even of tampons is painful for you. Those issues may be a better place to start looking into, if you haven't already, than going for a smear test just now.

A good friend of mine who is also a lesbian went for a smear test recently and because they were not able to insert the speculum without causing her great pain the GP made another appointment to look into the issue with her.
Anyway they discovered she had a yeast infection that had gone up into her womb (I think) and she was given some tablets to take. Within days a pain that she had been living with but was now so use to as to take it for normal, simply went away and when she went for the smear test later she felt no discomfort having it done.

What I am trying to say is there can be a number of reasons for problems "down there" and difficulty taking a smear test. Not all of them are physical reasons like in my friends case, some reasons are more emotional, but a visit to a sympathetic and knowledgeable GP can be very helpful. Your GP may recommend you to a Gynecologist who may be more specialised in this subject than the GP. Sometimes through therapy and or exercises to learn to relax, feel comfortable and in control of what is happening, women can learn to experience penetration without pain.

Its perfectly ok to just not like penetration. Not liking penetration is one thing but if pain experienced during penetration is a symptom of something else that may need to be looked into. If it is an emotional issue it might also be good to look into the possibility of releasing that and maybe even learning to experience something new in a positive and who knows even pleasurable way.

All women who have ever had penetrative sex e.g. fingers, sextoys
or with men need regular cervical smears. This includes most lesbian and bisexual women.
For an individual who has never had penetration of any sort, it may not be
necessary. If you have any doubts, discuss this with your doctor.

http://lgbthealth.org.uk/node/49#publications

Should all women have cervical smears?
I've never had sexual contact with a man - am I at risk of developing cervical cancer?
If you've never had sexual contact with a man, you are at low risk, but not at no risk, of developing cervical cancer. It is still not entirely clear what causes abnormalities to develop. Often, it is because a virus has infected the cervix. This virus is called human papilloma virus (HPV) and is passed on during sexual contact.
HPV can be passed on in other forms of sexual activity apart from full intercourse. This applies to heterosexual women, bisexual women and lesbians. HPV is passed on through body fluids. This means that oral sex, transferring vaginal fluids on hands and fingers, or sharing sex toys can all be ways of being exposed to HPV.

http://www.screeningservices.org.uk/csw/pub/info/leaflets/all_women.asp

taramk

anxiouslesbian wrote: »

I'm a sexually active lesbian who's never had sex with a man...I'm 24 and have never had a smear test. I know it's terrible but I just don't know how I could possibly do it. I have an anxiety disorder and problems "down there"...penetration with even small objects is incredibly painful for me, I can't even use tampons...

Is there any way to do the same health check without a speculum? I just don't know how it's physically possible to fit a speculum to reach my cervix when even using tampons is so painful.

I have had a problem with my nether regions for 10years . I'm a lesbian too and have never had sex with a man but I've been sore and had pain in the lower pelvis for a long time. I was called for a smear in april and was dreading it. There was no way 'that thing' was going to up inside me. I was right, it was too sore. The doctor was mystified but i told her of my consistant pain and she did an examination. she said I was constipated and possibly had IBS and a possibly had a yeast infection eventhough i was not itchy 'down there'. She took a swab ( a small cotton bud swipes the opening of the vagina) to test for infection (yeast or bacterial), this does not hurt at all. She prescribed Flucol for the suspected yeast infection and fybogel for constipation. And told me to come back the following week. i took the flucol and all my pain went away in 24/48 hours!!
I went back the week after for a second attempt at the smear test and it was painless. I couldn't believe it. And the swab results came back negitive, but i believe the Flucol table rebalanced the yeast in my gut therefore reducing swelling in the bowel thus taking massive pressure off the uteris.
After a few glorious pain free weeks and a bit of physical activity I noticed a feeling of pain in the lower pelvis again. But it didn't have the same prolonged intensity as before. I went back to the smear test doctor, again she said i was constipated and could feel spasm in the intestine..i.e IBS. I was prescribed colofac (it contains mebeverine, an anti spasm) and fybogel. This time i took the fybogel because i didn't take this issue seriously when she told me first. So now i manage the IBS day to day and feel more in control of it rather than it being in control of me. As for the Flucol (yeast infection tablet) that just worked wonders and took away a long standing pain eventhough i didn,t have an infection. Its so much easier to manage the IBS side of things now.
Go to a pharmacy and buy Fybogel or Fybogel 'Mebevering' which contains Mebeverine the anti-spasm drug in Colofac. If this gives you pain relief then you will know you have a swollen bowel / IBS.
NB you cannot take Fybogel 'Mebeverine' with Colofac as they both contain the same antispasm drug. But ordinary Fybogel that does not contain Mebeverine can be taken with colofac. Talk to your doctor, she will advise you on what to take and what not to take to be sure that medications don't clash with anything you are already taking.
Your problem may not be the same as mine but I would be very sure that the GP or Smear test GP will be able to sort it out with a simple prescription. Go for the smear, tell her everything. It was the best thing I did. A simple tablet called Flucol and fybogel and colofac sorted me out. I just regret i didn't speak to my doctor sooner. My GP is male, maybe that was a factor and the fear of being sent to Gynocologists etc kept me quiet about my symptoms and as it turned out I didn't need to see anyone outside the female doctor who performed the smear test.

LegacyUser

Hi everyone, thanks so much for the kind words and advice!

I know that my risk as a woman who has never had sex with a man, and who doesn't participate in penetrative sex, is very low but I would still like to be 100% safe and get tested. I also, on an off topic note, would of course love to be able to have penetrative sex without pain but that's another issue.

I guess I should go to my GP and talk it through - it's just such an embarassing issue and my GP is male. He's fantastic but I just wouldn't be comfortable discussing it with him. I would love if it was a simple yeast infection or bowel issue (ok - let me rephrase - wouldn't love that but as in if it was something that could be easily solved), but I fear I may have vaginnismus from researching on the internet. So I don't think the issue is going to go away without stringent painful 'training' so to speak.

Anyway, sorry for all my personal stuff! Thanks for the advice and good luck to the rest of you ladies with upcoming smear tests

kylith

anxiouslesbian wrote: »

Hi everyone, thanks so much for the kind words and advice!

I know that my risk as a woman who has never had sex with a man, and who doesn't participate in penetrative sex, is very low but I would still like to be 100% safe and get tested. I also, on an off topic note, would of course love to be able to have penetrative sex without pain but that's another issue.

I guess I should go to my GP and talk it through - it's just such an embarassing issue and my GP is male. He's fantastic but I just wouldn't be comfortable discussing it with him. I would love if it was a simple yeast infection or bowel issue (ok - let me rephrase - wouldn't love that but as in if it was something that could be easily solved), but I fear I may have vaginnismus from researching on the internet. So I don't think the issue is going to go away without stringent painful 'training' so to speak.

Anyway, sorry for all my personal stuff! Thanks for the advice and good luck to the rest of you ladies with upcoming smear tests

If there's a female doctor at the practise just ask to see her, your regular doctor won't mind. Otherwise go to the Well Woman clinic; ime the vast majority of doctors there are women.

Good luck with it, and don't worry about the personal stuff; that's what tLL is for!

FairytaleGirl

Vojera wrote: »

My first smear three years ago was quite a negative experience. I was in college and quite nervous about it so I went to talk to the nurse beforehand (it was free!) and had the whole process explained to me. All seemed grand. When I went for the actual smear, the nurse used the wrong sized speculum and really hurt me. She ended up having to get the doctor to come in, who immediately changed for a smaller speculum and got the job done. When the nurse asked me after about my sexual history I told her I was a sexually active lesbian who'd never had sex with a man she pretty much told me I should never have come for a smear, that I didn't need one and so it was my fault it hurt so much! As ambersky mentioned, it's a myth that lesbians don't need smears and I was pretty shocked that a medical professional would perpetuate that.

I went for my second one last week and it could not have been a more different experience. I went to the nurse at my new gp and explained my previous experience to her and she was really good at taking the time to show me all the different sizes of speculums (specula? speculae?) and taking through the whole process and making me as relaxed as she could. I used a tip I read elsewhere (think about something that makes you feel relaxed and happy - so I thought about my pets!) and it was over before I knew it. The feeling of taking the sample is sort of nauseating (to me, anyway), but I wasn't sore at all after and there wasn't a speck of blood, unlike the last time.

So I would definitely be an advocate of talking about it with the nurse to make sure they're on your wavelength and take ownership of it as much as you can. No one likes getting it done, but last week showed me that it doesn't have to be awful.

Oh dear lord.
Im a sexually active lesbian, and went for my first smear today. IT WAS HORRIFIC. The pain was unreal. I did discuss my sexuality beforehand and asked for a small speculum to be used but her response was that they only used one size for everyone, (which looked huge) and that the vagina was elastic :rolleyes:

I dont have a problem with tampons, or penetrative sex with my girlfriend, but today I was crawling up the bed it was so sore, not at the entrance if you know what I mean, it wasnt too wide? But high up inside, it felt like she was pushing soo far in and it really really hurt.

Never again.

Ambersky

For F**k Sake. Im getting really angry about all this.
This is a serious issue that can save the lives of women and the medical profession are running a campaign to get women to go and have smear tests done, yet they dont seem to have their own act together.
Why is it that women are treated soooooo differently at different practices.
Why is it one woman can be talked with and shown a range of speculums and be given a small one.
And in another practice be told it dosent matter what size you use the vagina is elastic. FFS!
And again why are women not handed the thing and told have a go yourself. I mean do they think women have never put anything up their own vaginas before. For gods sake its not rocket science that if a woman was having a problem with a large speculum being inserted, a smaller speculum and letting her put it in herself might make things a lot easier.
One size does not fit all. They are just being lazy and ignorant not listening to women and perpetuating the idea that some women make too much of it, thinking that if it didnt hurt them. then it doesnt hurt. If you say it hurts, it hurts and if you are bleeding or shouting stop and or crawling away from the thing that means it really really hurts.
What do they think will happen if women have such negative experiences, do they think that encourages us to go again.

Is there anything we can do to educate the medical profession and get better treatment for women.
I feel like starting a campaign of maybe e-mailing this thread to all GPs in the country.

Jesus FairytaleGirl my heart goes out to you.
Actually I think this is an issue that should come up when we have Lesbian Sexual Health campaigns. They use to tell Lesbians we didnt need smear tests. I was turned away initially in my own practice. Then through education and campaigns they realilsed Lesbians should be screened. Maybe its time there was a campaign on how to do smear tests for Lesbians and maybe the education would also benifit women who have never had a child, who do not like penetration, who have an intellectual disability, etc.

FairytaleGirl

I know for a fact if I had have been allowed to insert my own (smaller) speculum I would have been fine. Dismissive cow.

kylith

Would she not let you? When I was in college I had my first smear; all the usual nervous clenching coupled with an injection moulded plastic speculum with a sharp edge. After the doctor was about to give up I asked if I could try inserting it myself. I got it in with some difficulty and go the procedure over and done with.

Ambersky

Who in the name of god do they think they are!
My GP originally said she would "allow" me put the speculum in myself but wasn't sure the Gynecologist she was referring me to would "allow" it.
The femal Gynecologist I went to got women to choose the most suitable speculum "with" her and often encouraged women to insert it themselves.
All this is jut about Control and it should stop. There is no other reason for not allowing a woman to put the speculum in herself. No other reason than not wanting to hand over control. No other reason than wanting to maintain their own position as experts. Its professional ego at the expense of womens health.

How dare GPs and Nurses say they wont "let" us put it in ourselves.
Its our bodies we should have the say in what does and does not happen to it.

I think really and I know it would take some guts, but if a woman is refused the request to insert the speculum herself I think she should simply walk away at that stage. I will in future.

LegacyUser

I've had 3 tests so far. The first one I didn't know what to expect so the lack of knowledge helped! The second one was done by an older nurse who just returned to work and was very painful. I received the letter and then put it off until I received the second one. The most recent one was done by a nurse with years of experience, I was shaking like a leaf, she was very kind talking me through it. She started off with a large speculum but I was very tense and grimacing so she changed to a smaller speculum and it was a hell of a lot better. What got me in the door was reading the cervical check website about the importance of the test. Your health comes first. Got the all clear the other day. I have a friend who has body issues and won't go, the nurses see all kinds of bodies they don't care, my nurse said to me that she had done hundreds of these procedures. If you don't go you could be putting yourself in danger. My advice: tell the nurse you're nervous, request a small speculum, breathe deeply, tense your muscles up very tight and then release them before the procedure.

hedgehog21

FINALLYgot it done, it was actually quite sore. but she had to go off and get gloves which gave me more time to panic now the waiting starts

Morag

I would like to know how smear tests are taught.

I shudder to think that medical students are herded in to practiced on women who are put under for surgery as happens in other countries.

http://www.theunnecesarean.com/blog/2010/1/29/yes-its-true-med-students-perform-pelvic-exams-on-anesthetiz.html

In February, Ubel et al reported that 90% of medical students at four Philadelphia-area medical schools performed pelvic examinations on anesthetized patients for educational purposes during their obstetrics/gynecology rotation. Although trumpeted as proof that physicians are lax in securing permission, the study was not clear on the matter of consent. Caldicott et al reported in January that 53% of students at a single English medical school performed pelvic or rectal examinations on anesthetized patients. Students acted without any written or oral consent in 24% of the exams.

Research in the United States, Canada, and Great Britain has shown that the unauthorized use of women is not confined to 1 or 2 medical schools. Using anesthetized patients before surgery to teach abnormal anatomy “has long been practiced.” Women are also used to teach normal anatomy. As late as 1992, Beckmann found that 37.3% of US and Canadian medical schools reported using anesthetized patients to teach pelvic exams.

Other data in Wilson’s article:

[In 2002], nearly half of Canadian medical students (47%) at the University of Toronto reported “pressure to act unethically” and named as the leading culprit the collision between medical education and patient care. Many were asked to perform pelvic examinations without consent.

Ninety-four percent of Oxford Medical School graduates learned to perform digital rectal examinations using male and female patients, many of whom were anesthetized.

Only 37.5% of teaching hospitals “inform patients that students would be involved in their care.”

Forty-two percent of US students are not forthright about their status when doing pelvic exams on conscious women.

Five percent of obstetrics/gynecology department chairs tell students to introduce themselves as doctors and just proceed.

kylith

That is disgusting. What an intrusion! They must think 'Ah, it's not like we're having sex with her, and she'll never know, so that's ok'.

Ambersky

This is a copy of the Cervical Check Womens Charter.
Its a bit difficult to read the image I have posted but you can have a look at the pdf file by clicking on the link below the image to read the full document.


http://www.cervicalcheck.ie/about-us/womens-charter.85.html

One of the sections of the Womens Charter says the following and I think it would be brilliant if they got a few e-mails from posters here.
The addresses at the bottom are the ones they ask service users to contact with their comments and suggestions.

Tell us what you think
Your views are important to us in monitoring the effectiveness of our services and in identifying areas where we can improve.
You have the right to make your opinion known about the care you received.
If you feel we have not met the standards of this Charter, let us know by telling the people providing your care or in writing to the Programme.
We would also like to hear from you if you feel you have received a good service. It helps us to know that we are providing the right kind of service- one that satisfies you.
Finally, if you have any suggestions on how our service can be improved, we can adopt them to further improve the way we care for you

I have also located a training guide for smeartakers to find out what the f**K they are being taught. If you follow that link it is a long document but the bit on how to take a smear and how to deal with patients in in section 4. Personally I think that advice like "it is best to choose the largest speculum comfortable for the woman" to be all from the medical professionals perspective. The document sounds like it covers all the areas needed but it is still cold and lacking in humanity. Just a few catch phrases, lip service in my opinion, on the human interaction needed to take a smear test, with the vast vast majority of attention paid to the medical detail. They may argue that the medical side is the important side but reducing the stress anxiety and pain for women will get more successful smear tests and will increase the number of successful smear tests taken and will ensure those women will be more likely to return for future testing.
They need more input from women on what they would find helpful, on how they would like to be treated and on how to include women in the smear taking process. So if you feel like doing a bit of informing you now know where to send your e-mails. I think lesbians would have a case for contacting the access officer as well as the main number, having had a history of exclusion from testing in the past and it seems a lack of sensitivity and knowledge about taking information from, assessing the needs of, and taking smear tests from lesbians. Women with disabilities might also consider contacting both addresses.

http://www.cervicalcheck.ie/_fileupload/Downloads/CS-PUB-ST-10%20Rev%204%20Guide%20for%20Smeartakers%20CGarvey%20July%202012.pdf

CervicalCheck -The National Cervical Screening Programme

Freephone 1800 45 45 55

Address: PO Box 161, Limerick, Ireland
Email: info@cervicalcheck.ie

CervicalCheck access officer

Phone: (061) 406 500 or (061) 406 551
Email: access@cervicalcheck.ie

National Cancer Screening Service

Address: King's Inns House,
200 Parnell Street, Dublin 1
Tel: 01 865 9300
Fax: 01 865 9333
Email: info@cancerscreening.ie
Website: www.cancerscreening.ie

BerryBlue

Larianne wrote: »

Doesn't bother me. I know that if I'm nervous and uptight it will make the process worse so I don't let that happen. I just chat away to the nurse or doctor.

It might be painful for some people but I don't think it's bad for everyone. And hearing scary stories puts people off getting them which is bad.

I remember before I ever got a smear, I heard all these horrific stories! My first smear was done by I lovely lady doctor who made sure I was relaxed before doing anything. Was grand.

Get the smear done. It's over in a few seconds. May save your life etc. etc.

EXACTLY THIS

I always find the person doing it wants to make ‘normal’ chit chat at the most abnormal time – I’m like eh, yea, lovely weather for a barbeque! But all I want is silence so I can mentally keep saying to my vagina relax, relax, relax – otherwise its painful & takes longer if you clench!

Not a nice experience, but really, its not that bad either – its over within a matter of minutes – and if you can manage to ‘relax’ it’s over before you know it. NOONE looks forward to this, but isn't great we can test for these things?

Best of luck!

Ambersky

I dont think anyone who has posted that a smear test hurt them, or was actually painful, or could not be done accurately because it hurt them too much, said or implied it hurt everyone.

Im tired of being dismissed with "now that wasn't that bad was it " when it was.
Im tired of hearing its a bit uncomfortable and it only takes a minute as a kind of mantra used to silence those who say otherwise.

BerryBlue says
Not a nice experience, but really, its not that bad either – its over within a matter of minutes – and if you can manage to ‘relax’ it’s over before you know it.

For some women it only takes a minute. For some women it is not that bad and no more than a bit uncomfortable.
It is easy for those women not because they are intelligent enough to "relax" and did something the rest of us couldn't manage or didnt think of doing.
We are not obstinately clenching our vaginas and simply not listening to those women who hop in and out of surgeries perfectly relaxed and able to tell their vaginas what to do. Great if you can do that, absolutely great, and if the vast majority find that that works for them great too.
But dont tell women who find it painful, when you have never had the experience, that they are not feeling pain at all only "a bit of discomfort" or that "it is not that bad" you don't know, it didnt happen to you.
That is being dismissive of other womens experience.

Women who are saying a smear test hurt them are not saying it hurts everyone and to suggest that they should keep their stories to themselves in case it puts anyone off going for testing, is an attempt at silencing other women.

Larianne said
It might be painful for some people but I don't think it's bad for everyone. And hearing scary stories puts people off getting them which is bad.

The women who find smear tests painful have feedback that is just as valid and important to offer, as women who say it is over in a few seconds and is only a bit uncomfortable.
It is the job of the medical profession to listen to women, their patients, and make smear tests as pain free as possible. It is the voices of women telling them what is being done wrong and what could be done to make it a better experience that will improve the service for women who find it painful, not women saying we shouldnt talk about such things. Remember where the positivity thing and we shouldnt talk about the celtic tiger as being anything other than wonderful in case it frightened people got us.

crazy_janey

I had my first smear test today, was super nervous after reading this thread! Luckily I know the nurse very well in my doctors surgery and she explained everything to me and helped me relax.
As for the procedure itself, I found it painless and it was over very quickly. Thank God!