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?

I don't think anyone relishes going for a cervical screening op. I know I don't, but my last two picked up that I have HPV and I am being re-tested annually instead of the 3/4 which is usual. I don't want to have a smear in another 12 months but I don't want cervical cancer even more so i'll get on with it.

It's honestly over so quickly and not painful (for me at least - my coil was but not smears) and the nurses do numerous ones every day, don't bat an eyelid and will reassure you if you let them know you are anxious and stop if you want them to.

It's their job to remind you to get booked in and they will be accountable for trying to ensure as many as possible book in for regular smear tests.

Have you asked your GP practice if self swab tests are available? Could you manage that?

You might be able to go to your local hospital (gynaecology department) to have this done under sedation if you needed to.

Could you briefly explain your issue with the tampon to the GP and request a referral?

It might also be possible to do a self swab if that is available (or it might be possible in near future, ask your GP).

Counselling might also be helpful for your underlying concerns.

I was going to suggest you could ask for diazepam. I had some for endoscopy and it was great and the extreme nervousness I felt disappeared completely.

The surgery get a payment for every one they do I believe.

Just cancel the appointment. If asked why, just say something unexpected has come up, and you'll be in touch to re-book another at some point. They don't need to know that that "some point" is never!

@Enfys1982 my friend has an inhospitable vagina-it closes up when she has to have a smear. Gp gave her diazepam & it really helped.

I'm not a fan of smears at all but struggled to get an appointment for months & last week gp did it. So glad it's done & hope you can get through it..

Bless you OP I do understand, I know it’s embarrassing but it’s honestly a much less invasive procedure now than it was 20 years ago. My first smear was a metal instrument (not sure what it’s called) and a spatula thing & it wasn’t comfortable but the new ones are plastic (not so cold) and a soft brush thing, it’s much better & I can’t imagine how it could cause harm or infection any more.
what happens is they get you to undress from the waist down behind a curtain, you are covered with a paper sheet, they can lube up the instrument (I have the little teenage ones from having a narrow cervix and I am sure if you talk to the nurse she will do the same) then they do the brush thing & it’s all over. You get results in a few weeks.

I missed one because of lockdown. I put the next one off, I don’t know why because they aren’t that bad honestly. But I went in at the start of November & 10 days later I was at the hospital having LLETZ & biopsy because it found severe abnormal changes. I really regret missing the tests because if I’d just had the smear when I was supposed to this could have been prevented probably. They showed me on the camera and my cervix was absolutely covered in these cells there was barely any healthy area, it would probably have been much less invasive if I just had a smear 2 years ago like I was supposed to & caught it early but I put it off & it got to the stage that now I’ve had treatment & couldn’t even have a bath for 6 weeks after! I feel very silly with hindsight but there were no symptoms.

Please don’t be scared & please at least consider having it, I do understand how condescending it feels when the nurses talk to you like that but you are the only person responsible for your health & it’s their job to try & pressure you to have the test. Logically it’s a lot less expensive for the nhs to do a smear than arrange a scan & they probably have to follow a process.

I think it’s your choice as long as you know the risks. Ask to speak to a different GP and explain your reasons. Delighted to read there’s a DIY version! I’m now 51 and have been having regular smears since 20( they used to start at 20 then) and over 50 the gap is every 5 years but I’d much rather do DIY. Thanks to whoever posted that link.

@PoseyFlump

Not really. There’s many (understandable) reasons women are wary of smears. They don’t however start blaming GPs as that is a bit silly. There are also some women who really do just need to put their big girl pants on and get on with it. The GP would have had a lot of contact with women who do indeed have cervical cancer hence the recommendation. Like I said if you’re hell bent on not having one then don’t but don’t then start blaming the HCP who offered you one. Silly to do so.

I recently had my smear test last one was just over 3 years ago, it came back with CIN3 cells which I had to have removed. Not pleasant but better than the alternative. I am 31 yo.

If you can somehow get it done, I would try. It does save lives.

A relative nags us into doing ours, as she works directly with cervical cancer patients. While it's something that I don't relish, and I don't have trauma or anything like that, they are still daunting. I'm glad she nags us though.

Nobody can make you do anything you don't want to do - but I think that you possibly do understand why they are necessary and it's more the fear of the process that's made you panic about them.

I do feel that the GP was genuinely concerned.

In response it would have been far better to explain if you could what your concerns are, plus discuss ways in which an appointment could work for you if you wanted to try - such as a mild sedative and a longer appointment time for you so that they can take it slowly and carefully for you.

@Thea91

Careful. You will be accused of scaremongering soon on here 🫤.

You clearly don't have the maturity to read between the lines reading the OPs reasons. And insulting her is not on. You're just proving her point and making her feel bullied.

@Enfys1982 if you can take a look at the link to the Jo Cervical Cancer Trust web site - www.jostrust.org.uk/information/cervical-screening/cervical-screening-after-sexual-violence. You may find it helpful.

Perhaps you might ring the surgery & ask to speak with the nurse, let her know that you’d like some more information about the process, as you are unsure of what is required. Maybe have an appointment booked for a chat about the procedure.

The whole purpose of the cervical smear is to check for any HPV cells present in the sample & from that outcome, some more checking of the same sample will take place. It is far better to find cell abnormalities earlier on.

Again, you don’t have to have a smear as you have choice.
But I strongly encourage you to find out more about what can be done to help you.

The GP has literally said she wants the OPs cervix to be examined. A home swab for HPV won't achieve that.

OP I find smear tests painful and upsetting due to past trauma. I don't know what the answer is. I still have them, so far.

There's a difference to doing a test "just in case" and a GP suspecting cancer and wanting to have a look though. I'd discuss with the GP or nurse how you can have it because "just doing it" isn't working for you.

The GP isn't denying you medical care. She's saying she's not going to waste NHS money by making expensive, possibly unnecessary, referrals with lengthy waiting times for other things related to raised white blood cell count when she wants to check for cervical cancer as a cause and you won't let her. She's not trying to bully you, she's letting you know that if you refuse the smear test she's not going to investigate your white blood cell count further. ie you could be seriously ill and it's going to go undetected. She wouldn't be doing her job if she didn't inform you of that.

I don’t know why folk keep citing this as some kind of gotcha. Practices are incentivised to administer smear tests because early detection saves the NHS millions and, more importantly, saves lives. It is very likely to be in OP’s medical interests to have a smear test. There are options available to help her if she needs it.

Id definitely speak to them about some sedation or something hun, there may be something they can give you. Totally agree smear tests are awful and up until a year ago I'd agree with you about pushy doctors, but this last year I had CIN2 , a colposcopy(which makes a smear look like a breeze) n I'm now awaiting results from my follow up! I had UTI before my smear test last Feb so my point is you never know what is going on in your body xx

@PoseyFlump

I think it is you who can’t read between the lines. Blaming others for your own choices springs to mind but if you want to go through life feeling permanently victimised from someone who is trying to help you, then yes I do think that person should grow up. Don’t want a smear? Fine but just own it. Don’t start blaming the HCP.

Quick question to anyone that may know: if I’ve always had clear smears every 3 years and have been with the same man for 31 years and HPV free, what is the chance of me catching HPV( infidelity not an issue).

OP a few years ago I had a series of UTIs. Never had a positive culture but they miss >50% of infections as they were designed to pick up infections in patients with catheters so the colony count threshold is very high.
I had about every blood test under the sun and was sent to urology for further investigation.
But one thing they never suggested was looking at my cervix.

You can also buy home test kits for HPV where you administer your own vaginal swab. That's all the smear test does now - they don't examine the cells further if that test result is negative.

what is the chance of me catching HPV( infidelity not an issue)

If you've ever had it in the past it can lie dormant for decades and then reappear so that's why the test are repeated. You might not be aware you've had it either.

Perhaps you should read back your own posts and have a think. No-one made you sarcastically use words like 'riiiiight' etc. You're just not helpful banging your drum.

OP you're in a very common situation, lots of women report being scared/nervous. Speak to your GP about your concerns, they can show you the speculum, and the brush they use. They will give you privacy to get changed and usually some paper to lay over your lap. You can have someone accompany you if you feel safer that way, you could also listen to music, or perhaps take medication as advised by previous posters. Kalms can be bought without a prescription.
Personally my smear was quick and painless. Slightly uncomfortable but less than say a blood test..

I thought that you couldnt get HPV if you were a virgin?

I’ve never had it. Always had smears every 3 years. I guess they didn’t always check for hpv when my tests started. DDs 22 and 18 are fully vaccinated. Will they still need one?