GP is trying pressure me into smear test. Is this acceptable?

[Enfys1982]

A fortnight ago I had a UTI which was treated with a short course of antibiotics. It cleared up but then came back again so I was prescribed more AB’s and did a sample, they couldn’t grow a culture from the sample but I did have raised white blood cells. When the GP rang me to discuss it she initially asked if I could repeat the test and we’d take it from there she noticed on my notes that I was a due a smear and said she wanted to check my cervix as well. For reasons I don’t want to go into I don’t want a smear test, but she went on and on me and basically pushed me into making an appointment with a nurse rather than rechecking my wee sample. I didn’t feel I could say no or explain my reasons why, she didn’t ask me why I felt the way I did either.

Honestly I feel much better now. The unpleasant symptoms have gone so I cancelled the appointment and she’s now phoned me up and asked why I cancelled. I said I felt better and I was busy when my appointment was booked for (both true) but she continued to push and implied that she wouldn’t run any further tests until I’d had my cervix examined. Just thinking about it is making me have a tight chest and panicky I really don’t think I could face it unless I was knocked out. I don’t have any gynae symptoms, my periods are normal etc. I had a fucking UTI! Why is she pushing me to have an invasive test I don’t want or need abs which isn’t relevant to what was wrong with me? She’d already asked if I was currently sexually active and I said no.

The more I think about it the more feel angry. I’ve had similar before from other staff at the practice when I’ve gone in for other things not relevant. Do they get commission for every smear they do or something?

*Having

@Beseen22 TY for posting the link to Jo’s Cervical Cancer Trust.
I am passing it on to someone today.

OP, for most women smear tests either don’t hurt at all or are just a little bit uncomfortable but not painful. I’ve had a few and most were totally without any pain or discomfort, one time it was a little uncomfortable. The plastic thingy is called a speculum. They come in different sizes, so they can use a smaller/shorter one if that fits your body better. The nurse slides it into your vagina and then it opens up at the cervix end and kind of holds up the vagina walls around the cervix so the nurse can use a little brush thing to collect some cervical cells for testing. They used to use lubricant to help slide in the speculum, but now they try not to because it can make it harder to text your sample.
If you can’t get a tampon in without pain it sounds like you may be suffering from vagisimus, which just means your vaginal muscles clamp down involuntarily when you try to insert something.
If actually, you would like to have the test and check out your cancer risk, then the person to talk to would be a nurse at your practice who’s does loads of smears. They may have options and techniques to help you. General Anesthesia probably won’t be one of those options though. Doing the test yourself at home (probably without a speculum) or inserting the speculum yourself at the clinic might be an options - although if you can’t insert a tampon sized thing then that may be tricky.
Your Dr isn’t pushing some horrible unbearable painful test on you unnecessarily. She’s trying to get you to take a test that’s generally painless and sometimes slightly uncomfortable to access your cancer risk. You do not have to have it if you don’t want to. But your dr can’t know you have will have difficulties with inserting the speculum if you don’t tell her. If there’s something in your past history that means smear tests are difficult for you mentally then you can tell without telling her details - if you explain you can’t get a tampon in, that would be enough info I think.

Please just push through OP. Lady at my work in her 20s always used to say she couldn't face going to a smear so she never went. Fast forward to last year she is being treated for cervical cancer and has said how silly and irresponsible she was in the past refusing it. I had one last week, they are fine and take about 30 seconds x

Just get a smear test - it’s not fun but it’s not a big deal and can save your life. I think you’re being ridiculous.

@Enfys1982

You posted on Mumsnet and you didn’t think you would get a range of responses?

Riiiiight. You really do need to grow up. Issues aside regarding your smear (sexual trauma etc) to be getting angry with GPs who are already incredibly overstretched just goes to show your ridiculousness and entitlement. If you don’t want one, don’t have one. Problem solved.

She’s not doing it for fun OP, she thinks you should have one.

Good luck with writing to the Gp and asking to be removed from the list. I had a hysterectomy 6 years ago, my cervix is long gone on a medical tray. Yet I still get 2 or 3 letters a year asking/reminding me to book a smear and telling my how important it is that I do so.

I do think though that you have perceived strong encouragement as pressure/bullying.

So from what you have posted @Enfys1982 you have never had a smear.

Is that right?

What age are you now?

This is sensitive but are you a virgin?
Have you ever had a baby?
Has anything ever been 'in there' - you say you can't use tampons.

You are worried about the speculum 'the plastic' thing'.
They can use smaller ones (that they would use on a child/ young girl.)
They use lube.
They do it slowly.
You can shout' ouch' if you need to.

The whole process takes under 3 minutes.

I feel 100% sure that with the right approach from a HCP you will not find it any where near as bad as you imagine.

Unless you intend to go through your life with no test ever, you need to find a way to deal with this.

Is it sheer embarrasment?
Or former trauma?

What's behind your fear?

She shouldn’t be pressuring you. Some people on Mumsnet are very weird about smear tests and get very angry at women choosing to have them. Ignore them they’re idiots. Just tell her you don’t want the smear. I stopped having them because they were so painful.

I can't say I like smear tests but I'm up to date with mine and have had all required since my first 18 years ago.

The nurse (and you can insist on a female one) will ask you to lie on a couch. Feet together knees out to the side. It doesn't matter what you look like down there, they've seen it all before.

She will talk you through what is about to happen. Usually they will touch your leg first with their hands so you're not surprised.

They use water based lube and the speculum will be single use and sterile. This is inserted gently into your vagina. There are different sizes so they can do a smaller one if you want.

The nurse will visually inspect your cervix. This is important and can spot signs of ectropions and other changes to your cervix.

Then they swipe your cervix with a clean, new, sterile brush.

They gently remove the speculum and jobs done.

It's really not to bad.

I have an ectropion on my cervix. I can guarantee the smear test was super easy compared to the camera up there.

Don’t confuse your google search with your GP’s medical degree!

If you are terrified of cervical smears (and that’s very common), then you tell the GP and explain why! Just communicate! They will suggest ways to make it easier for you. Just blankly refusing without even trying to seek help is silly.

@Theluggage15

Personally couldn’t give two shits if other women want to neglect their health. Bit silly blaming doctors though.

Coerced "consent" is not legally valid. It would be assault if they conducted the test under those circumstances.

If an examination is important and medically necessary, the answer is to work with the patient to reassure them, plan a manageable way forward and obtain legally valid consent.

Not to coerce, bully and terrorise with scare stories. Shame on every person engaging in that behaviour.

You can buy a home HPV swab & do it yourself at home, no speculum, just insert the swab & then send it off.

What an unpleasant person you sound.

I think you do need to chat to a GP about your fears and the fact you'd like sedation to have it done. (You said you'd need to be knocked out)

The test for HPV can be lifesaving.

Can you do an e consult explaining there and saying in there what the difficulties are and you'd like an appointment to sensitively discuss it?

I completely get consent and reasons for not wanting it done but if there's a way you could be supported then they have a duty of care to work with you.

You care enough to be unpleasant to someone who doesn’t want one. How weird.

@Theluggage15

I was responding to the blame part in regards to the GP. Do you understand that?

That’s rubbish.
yes the NHS is overstretched.
GP still expect their ox to behave appropriately and not get angry at them when they can’t get seen/get treated.
i expect GP to still behave appropriately too.

Works both ways.
Stretched NHS or not.

Agreed - very full on.

Yes, and I’ve never had a baby. I’m so scared it will hurt or I will make a show of myself.

The GP isn't a mind reader, you didn't tell them why you didn't want one and it's a perfectly reasonable thing for them to suggest both given your presentation and opportunistically. The majority of women with overdue smears it's because they're inconvenient or uncomfortable, not because of the sort of reaction you describe. Lives are saved every year by GPs nudging women to get them smears booked in, it's good practice which lots of GPs probably don't have the time or headspace for right now. It's on you to find a way to communicate effectively with the doctor if there is a particularly serious underlying reason rather than booking and cancelling appointments, she must have had some concern if she was checking up to see if you'd gone.
If you definitely don't want one at the GP, I'd ask reception to put an alert on your notes if it's too difficult to discuss directly, and consider getting a private self swab HPV test if you've ever been sexually active with a male or female partner.