I think anything further I say is only going to to prove the “It’s taking longer than we thought,” part. I’ll just say that I had a pretty horrible experience, am not planning on going back anytime soon (if ever, if I ran the universe) and don’t understand why I’m supposed to go in… what is it, yearly?
- Early detection of cervical, ovarian, and uterine cancer
- Possible detection of breast cancer
- Hi, Opal!*
*Sorry, I just had to do it.
If you had a horrible experience you need to change doctors.
What AlaItalia said. IT really shough not be anything like as ghastly as your experience seems to have been. Change medics or perhspa find a clinic that specialises in women’s health and might have a better attitude or whatever.
http://www.nhsdirect.nhs.uk/nhsdoheso/display.asp?sTopic=Cancerofthecervix&sSection=Prevention
Never mind - it is all over for a little while at least!
Sometimes they also feel for polyps in your colon. Yipes.
At any rate, to expand on what AlaItalia said, the sort of cancers and problems that can be detected via gynecological exams are the types of things that you might never catch on your own. By the time you had outward symptoms, it could be very advanced.
Sometimes those exams aren’t fun (okay, they’re never fun) but the right practitioner can make all the difference. I’ve had cervical dyplasia (found by a pap smear), a LEEP procedure to remove it, and several years of frequent follow-up and coloscopies. And I’ve been pregnant. So I know from pelvic exams.
I prefer the exams I get from the Family Nurse Practitioner.
WHOOPS. I meant colposcopies.
I’ve never had one, and I’m doin’ fine.
:ducks & runs:
I agree with the other posters. Find a new provider. Also, you’ll also get used to it, over time. The first few exams I had seemed just awful. I’d spend the whole year dreading the next one. But I went, dammit, because if you don’t get a pap smear every year, you can’t get birth control pills. It’s a stupid policy. What if men had to have a prostate exam in order to buy condoms? But what can you do?
Anyway, after I moved, I started going to my local Planend Parenthood instead, and found the whole experience much better. The attitude I found at an OB/GYN was all, “You’re here for your own damn good, so shut up and spread 'em.” At PP, the environoment was much different. They admitted that pelvic exams suck and everybody hates them, and they went out of their way to make them as tolerable as possible. Warning: YMMV. Other people have complained about PP, so the care you recieve probably depends on the staff at your clinic. The moral is, shop around until you find somewhere you like.
If you think of it, the actual amount of time involved in the ookey stuff is very small. The worst part, IMHO, is sitting aroud half naked in a cold office for a half hour waiting for the doc or NP . . . but anyway . . . Do it every year. Your reproductive system is a ticking time bomb, in so many ways. Plus, you know, they do all the other stuff, too–it’s a proper annual physical.
Yes, please continue to have them. As others have said, they are your first defense against a number of unpleasant diseases. But they shouldn’t be painful or even awfully uncomfortable.
Having had four children, I can’t tell you how many of the darn things I’ve had. But I do know that some practitioners have a better touch, and it is certainly worth your time to find someone you like and feel comfortable with.
My midwife has a number of little touches that make things more pleasant. She tapes pretty pictures on the ceiling over the exam table to give you something to look at, puts potholders over the stirrups to make them more comfortable, and runs the speculum under warm water to make it less chilly. A good practitioner will accomodate your nervousness and take everything very slowly, telling you what she is about to do at each step.
There are some things you can do, also, to make the procedure easier for you. If your bladder is full, it is likely to make palpating your uterus more uncomfortable, so make sure to use the bathroom right before. Also, tense muscles will make things more painful. So, as much as it makes you feel vulnerable to splay your legs out, if you can consciously relax them and let your knees flop open, it should help quite a bit. Along those lines, do you know about your Kegel muscle and how to do Kegel exercises? One of the advantages of doing them, in addition to having a well-supported vaginal canal, is that you can consciously relax that part of you as well, which will go a long way toward making this procedure less painful.
On a side note: I have just returned from my first mammogram, and I must say that it wasn’t nearly as awful as I imagined. The woman doing it was very warm and friendly and worked very hard to allay my nervousness. And I made a point to relax my shoulder and chest muscles while she was doing the sqeezing, which probably helped as well.
I just wanted to say that as a 29 year old woman, my doctor informed me that at this point, I can safely have a pap smear every two years instead of every year.
And I nearly kissed her full on the mouth. I find that swabbing to be irritating to say the least.
j
In my experience, I’ve had better luck with female practitioners (they remember the important details, like warming up that Godawful metal speculum first), my local Planned Parenthood clinic, and nurse practitioners rather than M.D.'s. Please keep going, but I second the motion about finding someone you’re comfortable with. If you are nervous, you’ll tense up “down there,” and it will just make things way more uncomfortable than they need to be.
I had to start getting pelvics when I was 14 (when I started on the pill to stop the Cramps From The Black Lagoon) and let me tell ya, it’s only gotten easier from that first one. Now I’d rather go to the gyno than the dentist by far.
My tips are to switch providers as the others have said. When I had to get my exam from a ped. who didn’t do a whole lot of the things, it was…not fun, to say the least. Now that I’m in university and can go to the student clinic where the women docs do them constantly, they’re a breeze. Also, if you find them physically uncomfortable, ask if they have a smaller speculum laying around somewhere. That’s what the’d do for me when I was younger, and it was about the only way I was going to get out of there without tearing something. And if they try to use a metal one on you, for the love of God make them warm it up first.
As for the necessity of them, in addition to cancer and dysplasia (which is precancerous, right?) as Cranky mentioned, there’s HPV. I don’t want to preach, and this might not even apply at all to you, but a friend of mine only discovered she had HPV after a pelvic. Unprotected sex once gave her warts on her cervix, and she’d never have known if not for the gyno.
Good luck with them and please go back and get another one within the next couple of years. You’ll get used to them, I promise.
But NEVER pee until they tell you they don’t need a urine sample!
I always forget and end up spending twenty minutes in the bathroom meditating on waterfalls and drippng faucets . . . ugh!
“How necessary are gyno exams, really?”
It depends on your risk of bad things that, if detected early, can be treated.
Cervical, ovarian, uterine, and breast cancer have been mentioned. Chlamydial infection was not mentioned but should have been.
Here is what the U.S. Preventive Services Task Force (USPSTF) has to say:
On cervical cancer: “Routine screening for cervical cancer with Papanicolaou (Pap) testing is recommended for all women who are or have been sexually active and who have a cervix. Pap smears should begin with the onset of sexual activity and should be repeated at least every 3 years (see Clinical Intervention). There is insufficient evidence to recommend for or against an upper age limit for Pap testing, but recommendations can be made on other grounds to discontinue regular testing after age 65 in women who have had regular previous screenings in which the smears have been consistently normal. There is insufficient evidence to recommend for or against routine screening with cervicography or colposcopy, or for screening for human papilloma virus infection, although recommendations against such screening can be made on other grounds (see Clinical Intervention).”
On ovarian cancer: “Routine screening for ovarian cancer by ultrasound, the measurement of serum tumor markers, or pelvic examination is not recommended. There is insufficient evidence to recommend for or against the screening of asymptomatic women at increased risk of developing ovarian cancer.”
On uterine cancer: The USPSTF doesn’t mention screening for uterine cancer but according to the National Cancer Institute: “A routine effective screening test for endometrial cancer has not yet been developed.”
On breast cancer: “The U.S. Preventive Services Task Force recommends screening mammography, with or without clinical breast examination, every 1-2 years for women aged 40 and older.” “The U.S. Preventive Services Task Force concludes that the evidence is insufficient to recommend for or against routine clinical breast examination (CBE) alone to screen for breast cancer.”
On chlamydial infection: “The U.S. Preventive Services Task Force (USPSTF) strongly recommends that clinicians routinely screen all sexually active women aged 25 years and younger, and other asymptomatic women at increased risk for infection, for chlamydial infection…” “Women and adolescents through age 20 years are at highest risk for chlamydial infection, but most reported data indicate that infection is prevalent among women aged 20-25. Age is the most important risk marker. Other patient characteristics associated with a higher prevalence of infection include being unmarried, African-American race, having a prior history of sexually transmitted disease (STD), having new or multiple sexual partners, having cervical ectopy, and using barrier contraceptives inconsistently. Individual risk depends on the number of risk markers and local prevalence of the disease. Specific risk-based screening protocols need to be tested at the local level.”
So there is no simple answer to your question, “How necessary are gyno exams, really?” It depends on you. If you are not sexually active you may not need them. If you are sexually active but with only one, low risk partner, you may not need them very often. OTOH, if you sleep around a lot without the protection of latex, it may be in your interest to have them frequently.
Re: OP.
I’m never going to have one, so there!
In addition to disease prevention, let me also point out specifically something that has been hinted at above: Annual exams may help protect your fertility.
Several gyno-related disorders and diseases (STDs specifically, but others as well) can negatively impact a woman’s fertility, and early treatment and cure of such things may be the difference between whether you can have a baby later on or not. That may not be a big deal to you now (depending on how old you are), but it may be very important some day.
Yes, they’re unpleasant. But they’re also important. So go get your exam already.
Just wanted to add that my NP found a lump in breast at my yearly exam. I’m only 26. Yes, I self-exam… she’s just better at it. It turned out to be no big deal (non-cancerous lump) but DAMN was I glad I’d gone that year.
I third or forth using a female + nurse practitioner vs. male or female + doctor.
How would a condom affect the prostate? Being sexually active hasn’t been proven to increase the probability of prostate cancer. However, sexually active women are more likely to contract HPV, as I’m sure you know.
Sorry for the hijack. I don’t know the intricacies of the Papanicolaou torture, so I can’t say ‘I feel your pain’, but it doesn’t sound like much fun.
I cannot see any reason I would -ever- want to give birth, so I’m not going.
But if a person does care, they -should- go.
Okay, just 'cause I’m slow and wading through a lot of info…
If I’m at a very low risk for most of these cancers, if there is no history of cervical, uterine, ovarian etc. cancer in my family, if I’m not going to be sexually active for quite some time yet, and I am planning on never having children, I cna skip out for quite a few years, right?
Fine; replace the prostate exam with the uncomfortable STD test of your choice. I hear there’s one that involves a small brush inserted into the man’s urethra, which is probably a fair approximation. The Pap smear isn’t an unbearable torture, but it does require the patient to disrobe, the use of a speculum to spread open the vagina, and scraping cells from the cervix–which smarts a bit and can lead to a bit of bleeding.
The point is that men who are sexually active and wish to obtain birth control are not required to go to a doctor’s office or clinic and submit themselves to annual exams which have nothing to do with the birth control method. Why are women?
It made sense to closely monitor women’s health in the early days of the Pill. However, in all its years of use, the Pill has not been shown to significantly increase the chance of breast cancer. Taking the Pill may actually decrease the risk of ovarian and endometrial cancer. The increased risk of cervical cancer associated with the Pill is probably not due to the Pill itself, but because many users of the Pill do not use a barrier method, and are thus more succeptible to HPV. Pill users are advised that the Pill does not guard against sexually transmitted diseases, and so just like anyone else, users of the Pill should use condoms if they are engaging in sexual behaviours that put them at risk for STDs (like HIV, HPV, or the rest).
The only remaining reason to require exams is the paternalistic justification that it’s a good thing for women to have yearly pelvic exam, especially if they are sexually active, so it’s a good thing to force them to have one by withholding their birth control. By the same logic, it would be a great idea to require men to visit a doctor or nurse practitioner and have a full physical exam, including STD tests, in order to get a yearly “condom permit” which would be required for the purchase of rubbers. Perhaps you should have to get a yearly physical and cholesterol test in order to get a “cheeseburger permit,” &c.
A physical exam should be required before you start taking the Pill, to check for any risk factors. The Pill can increase blood pressure so periodically checking blood pressure might be required for renewing the prescription. But just taking the Pill doesn’t mean that a yearly pelvic exam is necessary.
It concerns me that the inconvenience, embarassment, and discomfort of the required yearly exam is probably preventing many women (especially young women) from taking the Pill, and thereby causing unwanted pregnancies.
Sorry for continuing the hijack, and if it goes any further we should probably start a GD thread . . . but this is something that chaps my hide. Women should get annual exams for the sake of their own good health, but they should not be blackmailed with their birth control prescriptions.