Pap smears and other gynaecological concerns

[Ace-of-Blades]

I've never had any kind of pelvic or pap-thinggy. Never had it explained to me, or anything : /

[Aravia]

my friends daughter is 16 and has (had) cervical cancer. so things can definitely go wrong that have nothing to do with sex. i know it will be so hard for you, but finding a more holistic new agey type doctor/nurse might help.

a pap just uses a long qtip to take some cells off your cervix. it's over very quickly. the speculum to hold the vagina open is just like pressure too. i had lots of pelvic exams done while pregnant.

too bad your fiancee can't do it for you.

[ItsJustEmily]

Pretty much my first appointment when I was 18 went like this:

Doctor: Are you sure you want to have this procedure done?
Me: Um...yes?
Doctor: Because if not, it is like rape.
Me: Did you just compare this exam to being raped?
Doctor: Well... essentially yes. It can be like rape.

Cue my panic attack.

Another time I went to another doctor (I was out of state for school) because I had a rash. While filling out paperwork it asked why I was visiting the doctor and if I had had a pelvic exam done. I checked no in that box.

Doctor comes into exam room: Okay, are you ready for your pelvic exam?
Me: I wasn't sure we were doing one today...
Doctor: Oh, but you checked that you hadn't had one yet.
Me: Well, yeah. I haven't. But that's not why I am here.
Doctor: I assume that's your boyfriend in the waiting room?
Me: Yes, but...
Doctor: So then you need a pelvic exam.
Yes, because a 20 year old with a boyfriend just can't possibly be a virgin...

Me: But I am here for my rash.

Doctor: Oh. Okay. We can do the exam after.
Me: I didn't come here for a pelvic exam.

Doctor: Are you sexually active?
Me: No.
Doctor: Oh. Well, I guess we can hold off on the exam.

Turns out the rash was just eczema. As I was paying out for the appointment, she asked if I wanted to schedule an appointment for a pelvic exam in a few months when "we" - my fiance and me... - were ready.

The next time when I did try to get an exam, the doctor was so rude. She was really frustrated with me and had no bed side manner what so ever. She kept saying, "It'll just take a minute if you'd just relax!" Yes, because I can relax with someone yelling at me. It didn't help that the nurse was standing off to the side rolling her eyes. And as I was crying after the doctor finally gave up and left, I heard them laughing in the hall. It was mortifying. And my mom (who's gone with me to most of these appointments and who waits in the waiting room) yelled at me all the way home about me being immature and how I'm selfish because its something every girl goes through.

Its like every time has been horrible for me. I am at a point where I do not know what I can do anymore.

Thank you so much for your advice. I'll take your words into consideration - look up doctor reviews, ask about muscle relaxers and anesthesia. I just hope one day we won't need this outdated procedure.

[Ace-of-Blades]

Pretty much my first appointment when I was 18 went like this:

Doctor: Are you sure you want to have this procedure done?

Me: Um...yes?

Doctor: Because if not, it is like rape.

Me: Did you just compare this exam to being raped?

Doctor: Well... essentially yes. It can be like rape.

Cue my panic attack.

My advice: Ditch the doctor.

[MadRat]

Your problems sound like vaginismus and your doctors are fu*king unsensitive amateurs! You should try to find more understanding doctor who would check you different way, for example with sono.

I think it is NOT necessary to be checked this invasive way and doctors who claim it has to be done do it because they can get more money if they do more pap smears.

I´m 28 and I´ve never been to gyno and I´m not going there until I will have some REAL reason to go, like weird bleeding, pain in "down there" and stuff.

We don´t go every year to colonoscopy to be checked for cancer in intestines, we don´t go every year to X-ray to be checked for lungs cancer, so why the fu*k should we go every year to gyno?! It makes no sense.

My general physician knows I don´t go to gyno, while she also knows I´m quite paranoid when it comes to diseases because I came to her from my previous (very lame) doctor with many serious health problems - I was afraid I´m dying. But I told her I´m not going to the gyno and I have no reason to go there. I don´t know if she thinks I´m not sexually active. I think she probably assumes I have sex but she knows that pap smears are not so extra important like some money obsessed gynecologists try to convince us they are.

I think it is more dangerous to be checked with this big stuff than never to be checked. Nothing is 100% sterile, so there are higher chances of catching something through exam then catching it from nothing.

And there are higher chances I will die in car crash, or I will be eaten by shark, than chances that I will die for cancer of my female parts. The risk is so low it is technically nonexistent. On the other hand, trauma which I would suffer through pap smears would be so deep it would probably cause me hard depression and suicidal thoughts.

Almost no risk vs. serious trauma, with high probability of suicide. What is more dangerous?

[RoL34]

Look, you don't have to go every year if you're not sexually active, but you don't want to wait until there's an actual problem before you go to the doctor either. My buddy's girlfriend found a lump that was pre-stage one cancer during a routine breast exam, and breast cancer doesn't even run in her family.

You're not being stupid or immature, you can't control panic attacks, not without help anyway. People are like that for the dentist too, and they have dentists that specialize with anxious patients, I don't see why you can't find a gyno who's the same. Before you actually make an appointment and waste yours and everyone else's time, explain to your gyno exactly what you've been going through and what she suggests you should do (If she says grit your teeth and bear it, find a new doctor).

[Kagon]

I thankfully have a doctor willing to work with me on these, as I also have panic issues. I have past trauma, and I just kinda lose it when I go in for the exam. I can get through it with Xanax, and that is prescribed for me before the appointment, but as I am not and have not ever been sexually active I don't have to get this done every year.

I had my first one done by a gyno who was NOT understanding or gentle, and it was terrible. And at that point, I was supposed to go back yearly....and, well...didn't. Then, I started seeing my current doctor. She insisted on another PAP as it had been years since my last one (its unlikely, but there ARE other things than STD that can cause an abnormal PAP), which I got a prescription for the appointment and was sent to a gyno who is experienced in dealing with trauma\vaginismus for the exam. After that came back with a negative result, my doctor is now only requiring I get tested every 5 years, which is apparently the baseline for "long term monogamous couples" which is as long as she can let me go between my PAPs (I'm on birth control for PCOS treatment, so she does have to have them pop up in my medical record from time to time).

The key is going to be to find a doctor who is willing to work with you, and work with you respectfully. If they don't, find another doctor. If you haven't had one yet it's a good idea to, but you shouldn't have to hold to a yearly schedule.

[Guest]

Guidelines and studies recently done show it is not needed yearly and many of these exams can return false positives and false negatives. There are other tests for some of the things they use pelvic exams for that are more accurate. That being said.. your doctors suck. A doctor should never yell and should never pressure. Find a doctor that is used to working with sexual abuse victims, your reactions won't be abnormal then and they will understand how to help you relax enough to get it done.

[freemouse]

I have learned a lot from reading these comments, so thank you for posting the question and all who commented. Also, I hope you find a solution that will help you feel comfortable about your health, your doctor, and not traumatize you.

[Silmaril]

Not much I can add to the many comments on this topic. But for what it's worth, as a medical scientist I tend to agree with MadRat on this issue. Pap smear screening for cervical neoplasia isn't really that crucial if you have low/no risk factor to begin with. The vast majority of cases are triggered by HPV infection, so if you're a virgin (or have entered a strictly monogamous relationship with another virgin) you're not likely to catch one in the first place. Most low grade lesions either resolve themselves in time or turn out benign anyway. It's when you have high risk behaviour (e.g. multiple partners, unprotected intercourse, poor nutrition) coupled with strong family history that you need to be more vigilant with your screening, because of course it's best to catch the neoplasia early and whip it out before it turns into full-blown malignancy and/or metastases. And needless to say, even without these risk factors, if you ever experience pain or bleeding down there (or anywhere!), get it checked quick smart.

I'm a virgin in excellent general health with no family history of cervical and uterine cancers. Never had a Pap smear and see no medical need for yearly screening, not to mention I find the procedure invasive, and I really sympathise with Emily's dreadful experiences. Talk about a terrible trio: scolding mother, callous doctor and contemptuous nurse! Yikes.... Getting back to the point: IMHO the very first step should be finding a doctor with whom you feel comfortable. Then you'll feel more open about discussing your medical and sexual history, both past and current, to help determine how often you actually need to be screened. Having the procedure explained with more sensitivity may also improve your understanding and lower the anxiety a bit. I'd definitely stop going with mum for a start. Sounds like she's creating an extra medical problem: high blood pressure!

[Whofan York]

Is it too late to add my opinion? I'm in the UK, and had an experience similar to Emily's when I was 18. I applied to be taken off the list for regular recall letters (here, we get recalled every 3 years as standard and yearly if you've had a problem) and now I'm 31!

This topic plus my mum's nagging eventually freaked me out enough to ask the doctor what my needs were when I saw him again this afternoon. I'd been panicking about the answer he might give since I got up this morning. I don't think he believed me when I said I was a virgin, but he said that the test was not crucial for me because I was a very low-risk case.

I literally melted. The relief! It was like finding AVEN in the first place, like being let off the death penalty (well, nearly!) Of course, this is one example of medical opinion in the UK, and things could be different where you are, but I just wanted to throw it out there. The way I'm going I've got a higher risk of heart disease or stroke. So - I'm off to celebrate with wine!

[Amedot]

I don't think it's necessary for a woman under 30 to have a pap smear, unless she is sexually active, or on hormonal birth control, or smokes cigarettes, or has a history of uterine cancer, or has any problems/pain down there.

Are you risking your health? Yeah, kinda. Once you start feeling the symptoms of cancer, it's often already too late. At the same time, it takes years for cancer to develop, and it normally doesn't happen under the age of thirty. Hormonal birth control can decrease your chances of ovarian cancer, but increase your chances of uterine cancer. Cigarettes and tanning beds obviously increase your risk of cancer. HPV (STI) can cause cancer. Understand your risks, and you make the decision yourself.

My doctor kinda verbally abused me during my first pap smear... So I don't think I'll ever have another pap smear for the rest of my 20s, unless I have another sexual partner. Is that taking a risk? Yes. Is it my right to make that decision? ABSOLUTELY.

During the exam, I couldn't relax and the doctor again got frustrated. She actually yelled at me. I was sobbing. She gave up on the exam and slammed the door as she left me in the room to dress. As I was dressing, I heard her and the nurse laughing about me in the hall.

Your doctors sound absolutely unprofessional and rude and terrible (seriously, my blood is BOILING reading this...). And you are NOT immature for experiencing what you did when you tried to have a pap smear. I think you were really, really brave for having the courage to try TWICE and endure both experiences... Braver than me!

Find a doctor that is used to working with sexual abuse victims, your reactions won't be abnormal then and they will understand how to help you relax enough to get it done.

Serran, you are so smart, this is a great idea for anyone who has hangups about pap smears. As I was reading the OP's story, all I could think was, 'What if she had been raped? How dare they treat her like this??'. A facility that is used to working with sexual abuse survivors should be more understanding, comforting, and empathetic. I don't have any experience with sexual abuse facilities, but I noticed the doctors and nurses who worked in the mental health facilities were always more gentle and caring towards me than the average doctors and nurses.

[Aravia]

wow, i'm so glad the ob/gyns in my health suite are all so wonderful. i've never had an unprofessional doctor. i would really recommend asking friends/neighbors/random people who they go to and if they are recommended. cuz damn. i would definitely go to one of those doctor rating sites ad be like yo, this bitch was rude and whatevz.if a doctor ever treats you poorly, just walk out. there is no reason for it.

[Squeakbox]

UGHRAHHHGGGGUH!!!! This is why I don't want sex... I'm going to have nightmares now.

Seriously, that's not right to force you into that. You have to be your OWN advocate, screw your mom. She had no right to pressure you into that exam. You should have the option of going on your own terms, not your mother's, that way you can be better prepared for the test/exam.

[Seele]

I think it might depend on the doctor. I've had some doctors tell me I needed to have one done reguardless of whether or not I've had sex before, and other doctors tell me that as long as I've never been sexually active then I didn't have to have a pap smear done. I can honestly say I've gone with the latter doctors opinions and haven't gotten one done yet. The thought of it actually terrifies me.

The doctors you saw though, that was terribly unprofessional. I would of walked out there and yelled at them for laughing at me, and probably threatened to sue. People like that shouldn't be a doctor.

If your family, however; has a history of cancer that involves testing with a pap smear, then it might be recommended for you to have one done. Again, it just depends largely on the doctor, family history, and of course age.

[Guest]

Pretty much my first appointment when I was 18 went like this:

Doctor: Are you sure you want to have this procedure done?

Me: Um...yes?

Doctor: Because if not, it is like rape.

Me: Did you just compare this exam to being raped?

Doctor: Well... essentially yes. It can be like rape.

Cue my panic attack.

My advice: Ditch the doctor.

Wow, I get what your doctor is trying to say but wow I don't know if your doctor is either really insensitive or completely clueless. But it brings up a good point

**Trigger Warning**

If a doctor, any doctor proceeds with a procedure (even if you agreed to it beforehand or they think its in your best interest) after you've told them to stop or your uncomfortable don't tolerate that get out and then report them!

This describes what a pap smear is and what to expect **trigger warning for brief gendered language** http://www.mayoclinic.com/health/pap-smear/MY00090. But going to a doctor for sexual abuse survivors is a good idea too. You could call planned parenthood (or just go to one for a pap smear) and tell them you experience panic attacks and ask them if they could recommend a good doctor that deals with that or you could look up abuse survivors in the phone book and ask them. And also if possible try to go without your mother it sounds like she might mean well but isn't being extremely helpful. Hope you find an understanding doctor!

[Silmaril]

I think it might depend on the doctor. I've had some doctors tell me I needed to have one done reguardless of whether or not I've had sex before, and other doctors tell me that as long as I've never been sexually active then I didn't have to have a pap smear done. I can honestly say I've gone with the latter doctors opinions and haven't gotten one done yet. The thought of it actually terrifies me.

Speaking from my own professional experience in cytopathology, around 90% of patients coming in for routine screening produce a negative smear result. Of the 10% who return some form of abnormality, the majority show cellular changes caused by HPV only, which is a viral infection and not cancer, with the rest showing low grade squamous neoplasia that (as I previously mentioned in an earlier post) tends to resolve itself or is simply benign. Going by my local stats alone, on average we see only about 1% of patients in routine screens returning CIN II or III (which is when you actually ought to worry). So really, you can totally get away with not having a Pap smear if you're in general good health, not sexually active and have no relevant family history. For what it's worth, I absolutely practice what I preach in this regard, but of course you must make your own decision based on what your doctor tells you.

[Feathers in Motion]

I'm sorry to hear about your troubles :( I agree with serran she had fantstic advice on finding a doctor who works with sexually abused victims.

I'm 22 and I have never had a pelvic exam and I'm terrified of the thought of it. I never plan to have sex, but it makes since you would want one one day. Maybe when I'm 30 I'll do it if they knock me out with drugs first because I will not be capable of getting one when awake.

[Guest]

Here is some helpful info for survivors of sexual abuse/people with anxiety with going to the dr.

http://pandys.org/forums/index.php?showtopic=78864

http://www.pandys.org/quickinfocards.html

http://voices.yahoo.com/how-handle-going-gynecologist-have-5114281.html?cat=72

http://www.pandys.org/articles/grounding.html

[LadyWallflower]

Hello. I would just like to say that you are not the only women terrified of PAP smears. This year I tried to have my first one done. I started trembling in the office and downright sobbing. I was histarical. The doctor could not perform the test.

However, she told me it wasn't because I was crying that she couldn't perform it. Some women's vaginal openings are smaller than others and less stretchy. As a virgin, and someone who has never used tampons, my vaginal opening had never been stretched, and was too small to do the test. She said since I am a virgin I am a low risk, so we won't worry about it for now. She says that they may have to have surgery on it to make the opening wider so I can have pap smears, and have sex more comfortably in the future. Of course, I didn't tell her this, but I don't plan on having sex, so I am bitter about having a surgery (a very mild one), just so I can have pap smears. I guess they feel it is necessary because of cancer.

But I understand. Pap smears terrify me. I was tramautized for days afterwards.

[Qutenkuddly]

The topic 'Are Pap Smears/Pelvic Exams Necessary if You're Asexual?' has been merged with this one.

Qutenkuddly,
Asexual Musings and Rantings Moderator

[JustcallmeRiley]

I wouldn't get a pap smear.

[Silmaril]

Hello. I would just like to say that you are not the only women terrified of PAP smears. This year I tried to have my first one done. I started trembling in the office and downright sobbing. I was histarical. The doctor could not perform the test.

However, she told me it wasn't because I was crying that she couldn't perform it. Some women's vaginal openings are smaller than others and less stretchy. As a virgin, and someone who has never used tampons, my vaginal opening had never been stretched, and was too small to do the test. She said since I am a virgin I am a low risk, so we won't worry about it for now. She says that they may have to have surgery on it to make the opening wider so I can have pap smears, and have sex more comfortably in the future. Of course, I didn't tell her this, but I don't plan on having sex, so I am bitter about having a surgery (a very mild one), just so I can have pap smears. I guess they feel it is necessary because of cancer.

But I understand. Pap smears terrify me. I was tramautized for days afterwards.

Have a Pap smear and 100% chance of being traumatised, or don't have a smear and 1% chance of missing a high-grade abnormality. Speaking for myself only, the choice is obvious.

[wordforger]

Yeah... Being a virgin, I probably will never go in for a test since the risk is extremely low for me. I think it would be a seriously traumatic experience because I get nervous enough in hospital situations as it is without having someone poking around down there. I'd only do it if there was actually a problem or a large probability that there is a problem. Otherwise, it's an unnecessarily traumatizing procedure.

It's the same reason that I didn't get the meningicoccal vaccine when it became policy in Texas to make all college students that will be living on campus get the shot. While I know that it's a good thing to have, I had a much higher risk of having a bad reaction to the shot (my aunt has one of the diseases they mention in the risk chart) than I did of ever coming in contact with the disease they would be vaccinating me against, especially since everyone else had to get the shot. The doctor informed me about the risks and then handed me a note to take back to the housing people. If I had taken the shot, I might have been perfectly fine, but with the increased risk of having a nasty reaction that would leave me partially disabled for life, I decided that I'd much rather leave it be because I could always get it later if I changed my mind. The doctor was very nice at explaining that to me.

Getting a PAP smear, it seems to me, has a larger chance of causing me unnecessary discomfort than of actually preventing anything bad happening. Since I'm a virgin, my risk of getting a disease that would only show up on a pap smear is next to nil. And if I don't do them now or regularly I can always do them in the future if something changes. But why should I subject myself to regular embarrassment and discomfort right now if the risk of cancer is less than 1% and the risk of trauma is close to 100%?

[Quinoa]

And my mom (who's gone with me to most of these appointments and who waits in the waiting room) yelled at me all the way home about me being immature and how I'm selfish because its something every girl goes through.

If my mom did this to me, that would definitely be the last time I let her go with me to a doctor's appointment.

[Batman's Ace]

And my mom (who's gone with me to most of these appointments and who waits in the waiting room) yelled at me all the way home about me being immature and how I'm selfish because its something every girl goes through.

If my mom did this to me, that would definitely be the last time I let her go with me to a doctor's appointment.

I'm not sure I'd stop at never letting her go with me again. I'm pretty sure it would become a very major argument with both of us breathing fire, and continuing to smoke at the ears for days. Not that I think my mother would say something like that, though.

[rh1985]

If you aren't sexually active, and have never been, I really see no reason to get one. I avoided them until now, and I am almost 28. I still don't need one, but it was a requirement before I could use donor sperm. The doctor could tell when he did it that I wasn't lying and he felt bad how much it hurt. I wish I could have been knocked out for it. I'm seriously NEVER having one again, it was dreadful. I'll be no more at risk than I was before, since I'm having IVF. I suppose it may hurt less after childbirth if the IVF works, if I don't end up needing a c-section which has already been mentioned as a possibility by my regular OBGYN. But she can't tell yet if it's from being a virgin or if I am just abnormally narrow. If your doctor is pushy about the pap smear I recommend looking for a new one. My doctor has always been fully supportive of my choice not to have one.

[matfama]

Hi all.

I'm kind of freaked out. I'm 26, asexual virgin female and I need a pelvic exam. I know it's a part of female life and I've done a lot of reading on the procedure, but it still makes me feel extremely uneasy. I don't have health insurance so I can't even go to my familiar doctor to get it done... a stranger will do it at planned parenthood or something similar. I'm just looking for input from other asexual women, especially virgins... is it something to dread? Is it as painless (yet uncomfortable) as they say, in your experience? I have no idea if I'm physically sensitive or not, as I've never had one, never had sex, don't masturbate and don't use tampons. I'm considering using tampons on my next period just so I can get accustomed to having something in my vagina...

Halp. :(

[5_♦♣]

I'm not a virgin, though it's been a long time (7 years) since I had sex. I had my first pelvic exam just a few months after I had sex, so it wasn't so bad. The following year, it was painful as heck. Still haven't had one since.

[Neither]

They are uncomfortable, but painless if you relax your pelvic muscles. If the vaginal muscles are relaxed, they will "suck in" without effort any eventual object the doctor might use and it will be painless.

When I have pelvic exams, I try to relax and thing of something else, like what I'm going to eat for diner or something like that, and just wait for it to be over.