Womens Gynae is still barbaric

Switzerland do still have regular screening as do Canada - this appears to have been a viral social media post that spread misinformation.

I had a mammogram on Thursday and a breast ultrasound yesterday. They weren’t the worst I’ve had and I put that down to it being day 6 after the start of my period. I was told I would only be allowed it between Day 5-20, as a peri menopausal woman that’s like throwing a dart at a board but luckily I was Day 6 and I think that might have helped. The Doctor told me that women were now being refused private healthcare if they did not have this screening every two years (I live overseas). She also told me that for every 10 mammograms, one woman would have cancer which seemed outrageously high but perhaps not if they’re identifying cancers that the body would naturally get rid of.

I could cry and rage reading your stories it’s awful As someone who has had very painful smears and a vulva biopsy there is no space for complaining We are treated like whingers, moaners and children and are meant to be grateful and just shut up - well fuck that.

I really wish I hadn’t read this. Iv been sent for a colposcopy a week on Monday. I certainly won’t be looking at no screen. I’m in so much pain down below just now so hoping to get answers. I’m hoping I get pain relief.

I’m so sorry this happened to you - I had the same . It felt medieval x

I'm not in the UK and we can now do our own smear tests if we want, but at the GP's surgery. I decided to give it a go, even though smears don't bother me, and it was a piece of cake.

@ellie09ask to be done under GA for LLETZ procedure. They will try and down play it but you have a right to have done under Ga 💖

@ellie09 you and ALL women deserve better.

I read a book and listened to an interview by a physician who was lamenting exactly your point, too much of gynecological care is still based on misogynistic practice. It's unacceptable. We should be enraged women are still treated this way.

I'm going to try to find the interview/book and will post it here.

In the meantime, please know you can request GA for this. It's very rarely offered as an option. It is an option. Please if you feel strong enough feed back to both the team & the clinic/hospital. It takes many many voices for change. We must not accept this is women's health care in 2025.

Hugs to you

Last time I was at the nurse getting repeat contraceptive pills she asked if I wanted to get a coil. I said no, I’d heard it was sore, and she agreed and said that’s why she’d never get one but they were forced to suggest it. I hate this sort of patronising clap trap. Why not give us the facts instead of just pretending.

I had a hysteroscopy recently. The consultant who booked it for me said “you’ll be fine” so I assumed having had 2 children it would be nothing to worry about.
on the day of the procedure I was offered a local but they said because of where it needs to be administered this can be painful in itself so I decided as it would be relatively quick I didn’t need it. during the procedure they did offer me gas and air as could see I was in a lot of discomfort. I declined because I just thought I was making a load of fuss. I have to say the staff were all very kind and considerate I just wish I’d have known beforehand how uncomfortable it would be and I don’t know why I had the attitude just to suck it up and be brave.
i genuinely would advise anyone having the procedure done to ask for/accept pain relief

Thank you for your support. That was me.

I am very well informed and have done my research and have weighed up my risks and made an informed decision based on this.

The smear test. I am extremely low risk for hpv. I will take an at home hpv test occasionally.

I have decided that the risks to my health from having these invasive, unnecessary (for me) procedures done is higher than without. There are concerns in recent studies and research that the actual stress of the mammograms, the radiation and the effects of the breast tissue being compressed under so much weight can actually CAUSE damage.

As a few others have pointed out there are also serious concerns raised over mammograms and false positives. It’s called over-diagnosis. Too many ‘cancerous’ lesions are found that would never develop into cancer or anything problematic. Lesions that women are having removed for no reason that their immune systems would just deal with naturally. A tipping point where the harms outweigh the benefits have been identified by many experts. Switzerland have ceased regular screening and I believe Canada. So many women go through unnecessary stress and even operations because of these.

I won’t have a mammogram due to false positives and thankfully don’t need smears as had a hysterectomy
I have to have regular urological surgery and when I first had it done was GA and 2/3 night stay - now it’s day case and no anaesthetic!
I find it incredibly painful and always ask my GP for a sedative eg diazepam to take the edge of this
The tiny dose they offer for someone of my body weight is almost negligible and does nothing - Dcat who weights less than 3kg was on a higher dose after his last urinsry obstruction!
I dread it immensely and have nightmares before and after

For my last gynae procedure, they were testing out a new machine. There were six people in the room! However, one of those was a nurse, whose sole purpose appeared to be checking that I was as comfortable and pain free as possible all the way through. She checked in with me constantly, as well as just chatting to try to take my mind off things throughout. There are definitely some people at least working in the field who are very thoughtful and caring.

I’m very sorry that not everyone gets the same level of care.

Sorry to read this. I had the same a year ago. The pain was awful, and I struggled to walk back to my car which I’d parked half a mile away.

Thanks this looks interesting

Posted in error.

I had to have a general in the end because my cervix spasmed and I fainted. It’s unbelievable really. And no one warns you either so you don’t know to insist on local anaesthetic or premed (Valium or the like).

McCartney's other observation about screening is does it extend your life?

Her point is that for many there is a point at which your body just fails. So you will die of SOMETHING at that point.

But screening research will sometimes only look at whether someone died from the issue they were screening for or not. And it's important to separate studies like these from others.

The argument is that for screening to really be a success you have to work out whether it prolongs your life OR whether it just stops you dying from a particular cause, but you still die at that point anyway from something else.

This matters because sometimes the treatment for a particular condition can be awful in its own right and affect quality of life. And are you better, spending your last days enjoying them as best you can or undergoing invasive treatment which isn't actually going to make you live longer? This is where more information can change behaviours.

So again the way you present data to patients matters.

I think one of the themes from all this on that whole, and going back to the OP is how doctors actively can and do withhold information in various ways to get patients to behave in a particular way that is often in their interest in some way (to keep budgets down or because it's less paperwork or because it's quicker). And this might not necessarily be in the best interests of the patients themselves and if the patients are made aware of these things they will behave differently.

Notably it's women who get the shitty end of the stick with this most, because of poor attitudes and because women are less likely to challenge or question a doctor because that's the way they have been socialised.

Barbaric.
I was sent home the day after c section with paracetamol.
And had a hysteroscopy with zero pain relief.
it wouldn’t happen to the men.

Appreciate your informed posts @RedToothBrush.

I think the mammogram statistics are shocking, this is from the NHS

This adds up to about 4,000 women each year in the UK who are offered treatment they did not need.

Love how they say 4,000 women each year are “offered treatment” as if anyone is going to turn down treatment when they’ve been told they have cancer, that “treatment” is mastectomies, chemotherapy, radiation, life long medication all of which they didn’t need, absolutely shocking.

https://www.independent.co.uk/life-style/health-and-families/features/why-i-m-saying-no-to-a-smear-7577967.html

And this interview is interesting:

https://www.sefap.org/2014/09/24/interview-with-margaret-mccartney-the-waste-and-harm-of-overdiagnosis/

-M.M.: This is the “popularity paradox”. The worse a screening test is, the more false positives there are; the more false positives there are, the more people are led to believe that a screening test saved their life. So the paradox is that the poor screening test becomes more popular, as people are led to believe that they have been saved, not harmed, by it.

She's saying that screening is driven a lot by peer pressure and people coming along saying 'you should have your test, my test saved my life'.

Except the paradox is that lots of these people, didn't have their life saved. They had unnecessary treatment. But they will never know their treatment was unnecessary because of how this works. They just believe their life was saved rather than understanding they might have been one of those who had actually been harmed by screening.

It's a difficult thing to get your head around. Its's an uncomfortable thought that many of those who are 'walking adverts for the success of screening' are actually the unwitting unaware victims of harms done by screening. Certainly no one who may have gone through that will want to consider they've potentially been harmed rather saved. Psychologically it doesn't compute.

Her point is that some of these numbers when assessing risk are massively off.

If the risk across the population as a whole is 1 in 2000, this isn't an evenly spread thing. Certain conditions are very much part of a pattern of family history. So if you have a family history of a certain cancer your risk is actually much higher than that 2000, but the reverse is also true if there isn't that pattern. And this massively distorts 'the risk' you are presented with.

Thus if you are armed with this knowledge about risk not being evenly spread, you might make different decisions. People with a family history might take it much more seriously whereas other might go, actually that risk is really really small, is it worth taking the risk of harm because that's actually a lot higher for me all things considered and I also might wish to consider the impact of the actual procedure itself to my mental health.

Thus being MORE informed can lead to patients deciding they don't want to consent in certain situations.

The whole discussion around presentation of risk is a fascinating one. I do recommend reading up CAREFULLY about what she says in full. Everyone should read the Patient Paradox even though it's now quite an old book now - it's still hugely relevant today. It's one of those books which is hugely important (Ben Goldacre's books are better known about big pharma and science more generally, but it's the same principle).

She talks a lot about the misogynistic nature of the promotion of screening programmes to women too and how they are potentially very unethical and rely on coercive techniques and the infantilisation
and patronising of women which doesn't happen in the same way to men.

It's a fascinating subject, and I really can't help feel we haven't moved on at all since she wrote it.

Thanks

That poster is an adult and has made an informed decision on her own health, stop treating her like a 5 year old.

She wrote a newspaper piece explicitly on smears which I read. In her book she doesn't go that far on a personal level which she does in the article, but she certainly is critical of some screening.

In the book she talks more about bowel cancer screening commenting that during trials they realised that there was a point where there was almost a point where patients were 'too informed' and didn't comply with the 'desired behaviour' of providers instead opting not to take up the offer.

She was also very much not into pressuring women into cervical screening / advising about weight because of tick boxes because it can reduce healthcare engagement as a side effect. Thus if they have symptoms about something completely unrelated, patients will leave it longer before seeking treatment because they are worried that they will be scolded about non compliant behaviour for the box tick. This could put their health at risk - and they were never at risk for the issue relating to the box tick.

I'll have a search and see if I can find the article online but I'm not sure I will be able to find it.

It was from some years ago and she was very straight talking with it. But as I say she had the big caveat that symptoms were not the same as participation in screening programmes.

Yes you’re right it would have been traumatising no matter how it was performed. I was given the option of medical management or ERPC. As I was 13 weeks with a MMC they did stress the surgical management would be the “easier” option and tbh I just wanted the whole thing done. My MC was diagnosed and I was in 2 days later.

I’ve luckily never had to have a colposcopy and reading here I’m so glad of it. It sounds at best uncomfortable and at worst utterly barbaric

Same here 🙏