Maybe I should just declare this Gynuary?

[oursin]

Because reproductive and sexual health seems to be a bit of a theme at present.

Noted lately in the paper: Young women put off smear tests due to feelings of embarrassment and concerns about being hurt, a survey suggests i.e. the 'Pap' test for cervical cell abnormalities.

At first, misled by the descriptor 'young', I wondered whether this was a cohort which had received the HPV vaccine in pre-adolescence and therefore felt themselves to enjoy a happy immunity to the worries that might lead women to be meticulous in taking up the opportunity to been screened (entirely free under the NHS). But in fact one discovers that 'Almost one in three women aged 25 to 64 have not had a smear test within the timeframe the NHS recommends', which is only barely within the demographic to which routine HPV vaccination would apply.

I'm also a bit bewildered by the issues expressed about shame and embarrassment in the context of medical examinations, which - or maybe not? one might anticipate women might undergo in other routine contexts of healthcare.

I guess that whole 70s self-help group thing of 'let's get hold of a load of plastic speculums and examine our own and each others' cervixes' has really gone the way of the dodo, eh?

Repeats the - well I think it's hilarious - anecdote of the nurse who was doing an internal exam (not actually in this particular medical context) and said 'o dear, I can't find your cervix'* - great temptation to say, 'well, I brought it with me - maybe I left it out in the waiting area - ': BOOM! BOOM!

*Apparently some of us have what is known as a pinhole cervix. ?TMI?

Comments

[sara]

I brought Herself with me to my last annual exam on the principle that if she'd seen it done, it would be less frightening...and she found it so upsetting that she threw up in the sink in the exam room.

I guess at least she made it to the sink but I found the experience a bit discouraging.

[thornsilver]

I don't find it "frightening" but on the scale of unfortunate medical procedures, I'd rather have a root canal.

[sylvaine]

*cackles* Oh my goodness, what a fantastic anecdote. xD

That self-help group you mention is certainly not anything I'd ever heard of!

I do find going to the gyn a tad painful every time, but - well, it is what it is. Honestly, I suspect if I hadn't done All Of The Research about sex and sexuality and gender and sexual health as a teen, I probably would never have gone to the gyn, or would have put it off until I realized that going on the pill would help with the monthly pain (and mostly get rid of the fucking bleeding, halle-fucking-lujah). Because it felt like a weird and uncomfortable thing to me that I didn't want, but I Knew It Was Important, and that mostly propelled me over my reluctance. But most people my age never seemed to care much about that kind of thing and if they went to the gyn, then mostly to get the pill. Which is one way of getting people to get tested!

Urgh, that HPV vaccine. I got the first one but then I had to find a new gyn because the old one retired, and my new gyn is not convinced yet of the efficacy of it, so refuses to vaccinate people with it. It's not been acutely relevant to me yet, and who knows if it will ever be (and at any rate I am now too old for the health insurance to pay for it, and it's a pricey one), so for now I'm just endlessly waffling about whether to find somewhere else to get it or nah.

But also, 65 doesn't seem like it would qualify for "young" for most statistics? O.o

[nineveh_uk]

which - or maybe not? one might anticipate women might undergo in other routine contexts of healthcare.

I would say 'not'. I've certainly never been offered such examinations outside the context of a smear test (obviously I have never been pregnant!).

[serriadh]

I hadn’t had any routine healthcare by the time I was 24 either. Went to the GP for the pill but that just involved checking my blood pressure. Apart from yearly pill renewal I never went to the doctors (I am lucky in having good health but not that unusual?).

Even when I was pregnant the first examination of my cervix/anything in that area was when I had a sweep at 39 weeks.

[nou]

I tried to book myself a smear test last year, but the GP receptionist said no because it had only been 2 years and 50 weeks since my last one.

I tried to book another one today, but they can only book them within the next 4 weeks, and I'm already completely booked up until March.

I emailed the local hospital to ask if I can get one done there, and if not, could they tell me where else I can get one done, and they replied “no” to the first question and ignored the second one.

I wonder if there might be reasons other than embarrassment for the low uptake?

[ankaret]

Yeah, I've had the 'no, you can't book a smear test until you have a letter' runaround too. It seems like an unnecessary layer of bureaucracy that benefits no one.

[nou]

The worst part was that they’d actually sent me a text notification that I was due for one, which is why I phoned them up immediately instead of waiting for it to pop up in my schedule. Turns out they’d accidentally sent notifications to every patient on their books (including my cis male partner).

[white_hart]

Last time I had a smear test the nurse remarked on my colourful socks and then said "oh, you're the knitting lady!" as she remembered a similar conversation from the last time. I suppose it's better to be recognised by my socks than my cervix?

[movingfinger]

An experience or three with someone clumsy with the speculum can put a patient off them for life. It doesn't matter if the thing's warmed, it's still uncomfortable to painful. Ditto shame and embarrassment---perhaps a culture in which women's bodies are disdained if less than perfect isn't the best context for encouraging women to care for said bodies.

[kore]

Yeah, my very first experience with a pap smear was painful AND triggery and not helped at all by my bursting into tears and the (woman) doc going right ahead with the exam.

[kore]

Ditto everyone else, not so much shame or embarrassment as the first time ever it was done with an ice-cold metal speculum and the feeling of being pried and held open and then scrape, scrape, scrape ("Almost have enough now!") put me off getting another one for years. At least with a root canal you get anaesthetic!

(I apparently have a 'tilted cervix' and I heard "I'm having trouble making it pop" and yyyyyeah)

[lexin]

I have a tilted cervix, too.

Every smear test I've ever had done has either hurt a little (a good one) or hurt a lot (a bad one). I do sometimes wonder why I carry on going.

Still at my age (56) they are done every five years rather than every three. Score. Not due another till 2020.

[antisoppist]

At my last one they said "what a pity you're 50 next week. If you'd waited a bit it would have been five years but it will still be three now"!

[lotesse]

When I was a college student in Illinois, the state-subsidized health clinic required regular paps at set intervals to continue receiving lower-cost contraceptives - it might have been every 9 months? I found it onerous, but endured.

[cesy]

It was so painful and I was pressured to continue despite the pain, against my wishes when I asked for a break, and that's really not a good headspace, I'm not volunteering for that again anytime soon.

[ankaret]

I'm really sorry that happened to you. There's a real unwillingness to hear 'No, that hurts too much, I need to breathe for a moment / can we try something else / STOP' in a medical context, and it sucks. I think it stems from a basic lack of empathy.

[ankaret]

I had several experiences with kindly, experienced nurses before I started encountering incompetent baby nurses who were Very! Determined! to assert that They Were The Professional In This Scenario. If it had been the other way round I probably wouldn't have gone back.

[antisoppist]

I've gone the other way and now have the cheerful practice nurse who says "this is where you can swear if you need to, don't mind me, whatever makes you feel better about it".

The worst was the family planning clinic inserting my IUD where one of the women took offence at me saying "ow" and told me I'd had three children so it shouldn't hurt. That made me cry all the way through the rest of it* and the other woman kindly held my hand throughout.


*childbirth no. 1: "it shouldn't be hurting yet, stop making a silly fuss, you can't have pain relief yet", I produce a baby.

[themis1]

I've never had a problem with them, not embarrassed, quite relaxed. But the last time I went for one, the nurse managed to shove the implement in so hard she draw blood and then said she couldn't do the scrape because, gosh, I was bleeding. I decided that at the grand age of 60 I would eschew any further attempts to damage me. I reckon if men had to have the said test, they'd have found a much less painful and embarrassing way of doing it by now.

[mrissa]

Yeah, I mean...I see "afraid it will hurt" and think, yep, sometimes it will, and that's even aside from assault history. I have gotten mine religiously, annually until they changed to every three years, but honestly training and procedure needs to be WAY better.

[notasupervillain]

It's so goddamn short-sighted. Last report I heard, the USA military is stretching its troops thin, not giving enough breaks between deployments, not enough home leave. When you've got competent people who want to serve, why do you care about anything else?

Though. I just thought of research that showed that people who served in mixed race units tended to be less racist. Maybe the religious right is terrified that military folks (one of the only institutions in America that's still respected) will become less transphobic. It's a more logical argument than they one they're making. No less revolting, but at least logical.

[notasupervillain]

Probably tmi, but I'm one of the people who pap smears hurt for. Like, they make me bleed. Doctors feel obligated to tell me that it's okay, which I know because it happens every time? But yeah. I dread it.

Plus, in my younger days of giving a fuck, I used to worry that the doctor would judge me based on how much hair I had or didn't have. Like, what if the doctor thought I wasn't cool?