Cervical Screening Epic Failure - Potentially Triggering

[CSEpicFailure]

I dread them but I always go. I try to remember this could be life saving.

Today I went, but I freaked out about 30 seconds in.

I was sexually abused repeatedly (rape) as a young child and I find the lack of control nigh on impossible to deal with. I find it so very hard to even get into the right position, let alone stay there. I tense up. This makes it painful.

So today I got myself all worked up and she stopped and I couldn't continue. And now I feel like an epic failure.

I'm rebooked for Saturday, first thing (rather than a pm appointment like today). She is asking the doctor to prescribe me a valium to take beforehand.

I'm 50. I've been with the same man for 23 years. The risks of having HPV must be tiny? I still have to go back though don't I?

You are not a failure. It was incredibly brave of you to even get as far as you did. You should be proud of yourself.

It is your choice whether you go back or not. And if you do go back, when.

Poor you, OP. Horrible. But please try and go back. My sister was raped at 16 and went 3 times for a smear test but bottled it each time. She died of cervical cancer at 29. I will never forgive her rapist.

No you don’t have to go back, OP.

Hels20 I am so sorry to read about your sister. How awful.

I intend going back. I've just done some research and statistically I'm far from out of the woods yet so I will do it. I've just had a call from the nurse to explain how to take the valium. DH will drive me there and back.

Be kind to yourself OP.

I’m so so sorry op what an awful experience. Well done for going. Hope you can try to go back and maybe ask if you can insert the speculum yourself? Also try breathing out if you can as they take the swab. It’s impossible to clench your muscles in that area and breath out at same time

I don't think I could do it myself at all but maybe I can try. She tried to use the smaller size but started explaining it's the length that's different and that just made me feel woozy.

Thank you for the support. I'm not sure how I'm going to get through it on Saturday but I'm hoping the pills help.

I'm sorry this is difficult OP. Would you feel better having your DH in the room with you? He could be at your side to reassure you. The nurse would agree to this I'm sure. Well done for rebooking it.

Joy we just went for a walk and he did offer, bless him. I'd just feel such a wimp. I hate feeling vulnerable.

Try not to see having him there as you being a wimp OP, but as him adding to your strength. You'll have the lovely nurse, your lovely DH, and the valium to help relax you.

I like to wear long knee length socks so I don't feel completely naked from the waist down, I find it adds to the feeling of control. Could you do something like listening to the headspace or Calm app beforehand, to learn some relaxation techniques, and then wear headphones and play that while you're there?

You're incredibly brave

I'm a few years older than you OP.
I got traumatised by IVF, and smears got mentally worse and worse for me each time.
The doctor signed me off from any more screening tests at about your age, though I did have one last one under GA whilst they did a procedure for heavy periods & fitted a mirena all at the same time.

Interesting Teen. We're they quite happy to do that?

I also had endometriosis, several laser laparoscopes, 2 emergency c-sections and a sub total keyhole hysterectomy. The endometriosis was hideous. I lived on pain relief for one week out of every month. The pain, the amount of blood loss, the clots. Ugh. No wonder if I feel so traumatised by anything down there.

They seemed to be happy.

If this coil has to come out I'll be asking for a GA for that too & another smear, even if I have to go private.

I’m so sorry to hear how difficult this is for you, OP, and the reason why.
I’m a community gynaecologist, specialising in seeing women who find examinations difficult, or where smears/coils are difficult for physical reasons. You’re absolutely right that your gynae history is both emotionally and physically relevant.

Unfortunately, although the NHS will shortly only be processing smears if the initial HPV test is positive (the minority of women), they are not yet offering HPV self-taken swabs. The RCOG are lobbying for this.

It would be worth you asking for a referral to a local specialist in this area, or even considering accessing a private HPV swab. It’s important you see someone experienced who maintains your control, rather than getting frustrated with you. My patients sometimes to prefer to insert the speculum themselves, lie on their side, or have a partner or friend with them.

The often suggested Valium either doesn’t help sufficiently, or actually perpetuates the feeling of loss of control over the examination - it’s a huge over simplification and basically one step further from telling you to “just relax”.

You absolutely have the right to opt out of the screening programme if you wish, but do bear in mind that self-taken HPV will be available at some point, and that screening is now up to 65y - also that cervical cancer is almost always fully treatable if diagnosed early (and precancerous changes fully so).

More info for you

www.jostrust.org.uk/information/cervical-screening/cervical-screening-after-sexual-violence

Hope this works out for you. Feel free to PM me.

It's not a pleasant procedure but please go back op.
I was diagnosed with CC at 51 and had been married for 23 years.
I've been free of cancer for 6 years now but am still having treatment for the life changing damage chemo and brachytherapy caused.

OP so sorry to read your post. You may like to know there's a self test kit for HPV you can source privately from Superdrug online. It's around £50. It's a swab you insert yourself. If you come back as HPV negative you might consider not testing again again unless your history changes.
Cervical cancer is rare . In the UK around 900 women a year die from this cancer out of a total around 30 million and Cancer research UK state your lifetime risk of cervical cancer is just 0.65% less than 1%. Do what's best for you and don't feel pressure into going back

Thank you for the continued replies. I feel a bit sore this evening but not sure if it's all in the mind. It definitely did hurt today and it doesn't usually. I was saying to DH beforehand actually "every time I have one I tell myself to remember that it doesn't hurt, for next time". But today it did.

CS you are not a failure. I never found smears easy (for a variety of mental and physical reasons) and it has been much, much worse since I was raped. But - and this is the important thing for me, I think - that man has taken a lot from me, but I WILL NOT allow him to take my health. Fuck that. Fuck him. I deserve better, my family and friends deserve better. Yes, it will hurt, and be unpleasant, but I will not give him the satisfaction of my capitulation. Not. A. Chance. And I say that as someone who still relies on valium to sleep at night

@quince2figs I sent you a DM a few days ago but not sure if you got it?

I have the valium. Still not sure if I can do it. Going to try.

totally not a failure op
and hats of to you for giving it a go. that really takes guts!

are you having therapy? can you talk this through with the therapist?
would taking someone with you to hold your hand be helpful?

Hey,

I was raped as a teen and this massively started to affect me when pregnant with DD where I was diagnosed with PTSD. My smear after her was normal but my next was HPV negative but level 3 cell changes. If I hadn't of gone this would have developed into cancer. Not all cervical cancer is from the hpv virus only the more common types.
I know it's so tough but remember you are giving someone consent and you do have control over the situation. You can get them
To stop at any time and they have to take it at your pace. You can do it OP hope everything goes well tomorrow x

Hi Op, I understand how you feel. I explained to the nurse about my experience and she was very sympathetic and patient when I tensed.

Another that has had a smear under GA here, I wouldn't say it was something that was easy to arrange but was eventually offered to me on the basis that I have vaginismus and am not even able to have penetrative sex without pain. I had to be referred to a gynae consultant and it went on for some time before they booked it in.

What i would say is that if you can get through it without GA that is so preferable OP and so much quicker. GA requires recovery and an admittance as an outpatient. I won't go into details but I found the GA unswttleing afterwards from the perspective of having been quite literally unconscious/naked etc. In terms of feeling in control it didn't offer me that - but did get the job done and is necessary.

The NHS do offer psychosexual counselling OP, if that would be something you would be interested in, and specialist womens physios for painful sex etc.

Thinking of you

You are not a failure. The fact that you even went after what you have been through is a massive achievement. I found it hard to relax and the gp doing the test told me to ‘grow up’. I stormed out. I had a really good doctor once and I barely felt it, she got me to take a massive deep breath and then as I released it she then inserted the speculum. This method was a revelation as I barely felt it at all. Can you ask about doing this? Remember as well why you are doing it, it’s horrible and unpleasant but so necessary. The nurses/gp’s who do them are very good when you have a history of abuse. Good luck.

Ugh. She tried on my side with the small size, then on my back with the large size, then on my side again with the small. With the last try she got some cells but it hurt and became too much and she's not sure if it's enough so I might have to go back.

She was so lovely though. She said next time they could give me some pessaries that relax everything. What I really want is some gas and air. Would this even be an option?

She said about going to the hospital and having legs in stirrups but there is no way I could do that.

I just remembered that some endo was found on my cervix and lasered off. My cervix never became effaced/dilated in my pregnancies despite being on the syntocin drip for 20 hours and havingcontractions. I've always suspected my cervix is duff. I think that must have something to do with why I find it so hard (on top of the years of abuse from 8 years old including rape).

Not sure what I'm gonna do if I have to go back. And ultimately I will have to go back in 5 years anyway.