Intimate examination required for HRT

@Marshatessa im so sorry that happened to your auntie. It’s a horrible cancer and often found very late with difficult treatment.

OP I am sorry about your experience which makes this much harder for you.
You didn’t make clear in your first post that you had been examined and diagnosed 6 and 12 months ago, you just said you had been on HRT for ‘a while’. I was assuming a few years. I think you may have had different responses if that had been stated originally.

OP, was the last time you have physical examination when you were diagnosed with vaginal atrophy? Your post wasn’t clear as to when you were examined by your GP.

This happened to my aunty who has since passed away from vulval cancer. I agree that it’s better to be examined. I would however want to be prepared prior that this was going to happen.

Yeah absolutely can rebook in, although if symptoms have changed etc they may want to examine too

You’d be amazed some of the things people try to send photos of!!

I always enjoy when they have carefully staged the child to show the body part/ skin bit really well but forgotten about the background!! Usually a waving child or tormented cat etc

I think if a man went and complained of pain or itching around his penis then he would need to be examined too.

This isn’t a sex issue, it’s someone doing their job properly.

Then booking another appointment with a GP. Perhaps the same one who has already examined her once should be the next step. Would you agree?
Perhaps the nurse (non prescriber) should have offered this as an option.

So yes, you will be unreasonable if you complain. She told you why but you know better, apparently.

The nurse had a quick look at my vulva before giving me oestrogen pessaries because the symptoms I described (general itching etc) could gave been due to a lichen infection. It wasn't and I got the meds.

I think the nurse was just being thorough, OP.

As a PP said, it wouldnt have a been an internal exam..it would have just been a quick look at the vulva tissues to check for inflammation, skin cracks in the groin etc. A 3 second look is all they done with me.

I was examined by my (female) GP before being prescribed Ovestin, yes it’s awkward and I would want to be prepared (fresh pair of knickers!) so can understand you were caught off guard.
However I don’t think it’s unreasonable to have an occasional examination for a prescription - as long as it’s not every time!
It’s not being treated ‘like cattle’ it would be the same for any other condition, DS gets eczema flare-ups and I have to send a photo to get a hydrocortisone prescription, obviously you can’t send a photo for VA!

Although it was embarrassing I felt reassured that I had been checked and that if there were any other issues e.g. LS it would be picked up.

I am on a repeat prescription and I have had to fill in a questionnaire about my symptoms but have not been asked for another examination, I would do it, but would definitely want some warming.

Exactly. And if something was to go awry a few years down the road, OP could be saved from a lot more headache so I don’t see the reason to avoid a physical examination.

I’d have thought that since you’ve already been using the vaginal pessaries then you wouldn’t need to be examine. Although I was examined by the gp to check for vaginal atrophy before they would prescribe Estradiol.

OP, it looks like a lot of people have remained undiagnosed for Lichen Sclerosis so if you weren’t ready for an examination, you could just say that and then reschedule. It’s better to be safe, than sorry.

You are being ridiculous frankly. Also what's the big deal? Things change
My gp won't prescribe pessarries on repeat either.

I don't see that at all in this scenario.

If a woman is having genital discomfort then how exactly can a proper diagnosis be given without actually examining the genitals? It's not a gratuitous examination.

Conversely the OP can self-diagnose and purchase medication online or see if a GP will prescribe without an exam. Those are the choices.

What's the problem being checked out?
I would appreciate her diligence.

What are the symptoms of LS? What pain too?

Depending how you described it she may well be worried re lichen sclerosis as you know.

Imagine she doesn’t offer the exam, and 5 years from now you have vulval cancer but have been treating ‘atrophy’ instead for years. It would be her neck on the line and career.

you can decline the exam absolutely, but our nurses can only prescribe to strict guidelines so she won’t prescribe. As a GP I can go outside these but I’ll damn we’ll be documenting exactly how many times I offered it, the reasons I’m concerned and that you’ve been told in no uncertain terms the risks.

YANBU op, women get treated like dairy cattle, it's shameful.

I was prescribed oestrogen cream for vaginal atrophy - which is a lot more severe than a bit of dryness. GP wanted to take a look before prescribing the cream and it took literally seconds, no speculum, no internal anything, just a quick peek to see what the tissues look like.

I have both lichen sclerosis and vaginal atrophy and was undiagnosed for years and suffered a lot of pain and discomfort.

However, if you don’t have any of the symptoms, it’s unlikely to be LS so I don’t blame you for refusing the examination. 🤷🏻‍♀️