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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

To not want to have an STI check in order to get a referral? (Possible TMI)

44 replies

ThinkingOfAUsernameIsTough · 21/08/2014 17:19

Since having DS 10 months ago I have been experiencing very bad pains when having sex or using tampons. It has taken quite a lot of courage to get to the doctors as I had a very traumatic birth with DS. I had the appointment last week to get checked over and the Dr said she would have to refer me to the hospital for more thorough testing, so I thought I was getting somewhere with getting this sorted out.

I received a call from the doctor yesterday saying that she can't refer me until I have had an STI check. I feel this is unnecessary as I have been with DP for 6 years, both of us were tested at the beginning of our relationship and neither of us have been unfaithful. She has booked me in next week to have this test done. I am really upset as I do not want to have it as I don't feel it is needed. I know it sounds dramatic but it has been triggering bad memories from when my son was born, in particular when it looked like I needed an intervention I asked for a section instead of forceps and they said no (although I didn't have forceps in the end thank god) but it just makes me feel like I have no control over my own body and I am dreading having to go through with a test that I don't want or need. I am also pissed off that having this test done will put my referral back a few weeks as I need to wait for the appointment to have the test done, and I will need to wait for the results.

Is there anything I can do? Are they allowed to demand this?

OP posts:

FreeSpirit89 · 21/08/2014 17:22

No they are not allowed to demand it. They can recommend it, speak to a second GP.

I would state that you know there is no concern and just want the referral.

Sidge · 21/08/2014 17:27

Gynaecology may well request that a patient has swabs for bacterial infections, chlamydia, gonorrhea and candida before seeing you. It actually makes sense really because when you have an outpatient appointment with gynae they can then see there is no infection reason for your pain and can investigate accordingly. It shouldn't delay a referral as the results will be back within days.

If an infection was the reason for the pain it could be dealt with by your GP and there may be no need for a referral.

I appreciate you are worried due to your previous trauma and experience and whilst you may be confident there is no possibility of infection it is always best to double check just to ensure you are getting the most thorough care and investigations you deserve.

RevoltingPeasant · 21/08/2014 17:28

OP if I were you I'd cancel the appointment and book in with another GP. I'd explain everything as you have here. You could even print out your post (maybe slightly cut down) and have it with you if you think you are too nervous to be coherent.

You are not being overly dramatic. People who have not had traumatic gynae experiences often do not understand how difficult simple procedures can be, and I expect you will get a lot of people piling in to say, YABU, the dr is just ruling out a potential cause.

But there's no good reason to think the cause of your pain is STI-related and the exam would be distressing to you. So say no. And they ought to refer you without.

RevoltingPeasant · 21/08/2014 17:30

Although OP, is there any possibility it COULD be due to an infection, not an STI but another kind of vaginal infection?

What would you do if a second GP wanted to rule out that?

I think it is also easy on some level to feel a bit insulted when drs suggest STI tests when you know you have been careful. Is that part of your reaction, too?

Brabra · 21/08/2014 17:32

They have to rule out STI's though. If your pain is caused by one and you didn't have the checks then you would be having a whole load more invasive and possibly unnecessary tests.

HermioneWeasley · 21/08/2014 17:34

I am sorry you had a difficult birth, but I'm not sure why you're against this? If it's the opinion Of the gynae that this is useful why wouldn't you want to do it. It's about sexual health, not STI s necessarily. In any event, I hope you get it sorted.

Laurel1979 · 21/08/2014 17:38

It may be policy to do this before your local gynaecologist will accept a referral. Your symptoms could be due to a bacterial (non sexually transmitted) infection. If you feel the examination will be upsetting, an option would be a self-swab that you can do yourself.

Finola1step · 21/08/2014 17:38

I do see your point OP.

But from a medical point of view, I think it's reasonable that they want to rule out infections before any further investigations take place.

You can't be forced if you really don't want to take the test. But for completeness, I can see why it's been requested.

It's not the same but I had a whole range of tests for an ongoing medical condition. Turns out the cause was something I would never have expected. My GP decided to order this particular test (along with others) to get the complete picture. I'm so glad he did.

BarbarianMum · 21/08/2014 17:40

You can seek a second opinion. You can ask for a referral without the tests. But, sooner or later, you ^are going to have to have these things ruled out.

I do understand why you are finding it difficult and you can explain that you find it difficult to the person doing the test and they should try and make it as untraumatic as possible - extra gentle, extra checking you're OK with things each step at a time.

Did you explain to the doctor about finding this sort of thing difficult since/because of the birth? It may be that you'd benefit from some port-birth counselling. Did you get a chance to go through things with your midwife afterwards?

Original poster

ThinkingOfAUsernameIsTough · 21/08/2014 17:42

Thanks for your replies. I probably should have mentioned that she did take swabs for other infections just not STIs so this appointment next week is just for STIs, so I will have to go through unnecessary pain, embarrassment etc in order to get this referral.

I don't really feel insulted about it, I know they have to ask, but I don't want to be forced to have one.

OP posts:

RevoltingPeasant · 21/08/2014 17:43

OP Laurel makes a good point.

I am pg and recently needed to have a swab. The nurse didn't want to do it in case she harmed the baby so she asked me to. She told me where to swab and I did it myself.

Can you attend the appointment and ask if this is a possibility?

People who are saying why would you be against it are really missing the point. When you have experienced a traumatic event there is an automatic fight-or-flight style response. Plus, the doctor has not handled it very sensitively, by implying she needs an STI check (rather than to check for any infections) and by making the appointment rather than checking first.

allisgood1 · 21/08/2014 17:44

What is that you aren't ok with? Is it the procedure itself or what they are testing for?

Onesleeptillwembley · 21/08/2014 17:44

They need to rule out the obvious before referring you.
And whilst you know you've been faithful, you know your dh/DP has been faithful, the doctor can't just take your word for it. And I'm absolutely not saying this is the case, but people that are sure they're in a monogamous relationship have been wrong very many times. Look at the relationship boards on here. So the check prior to referral is an obvious step.

Original poster

ThinkingOfAUsernameIsTough · 21/08/2014 17:45

Sorry cross posted. I have only really told the doctor that it was a difficult birth, I just don't feel comfortable enough to talk to a gp about it

OP posts:

MrsTerryPratchett · 21/08/2014 17:45

I'm sorry to say but it is very often the case that women get STIs from partners. I know you are sure that your DP hasn't cheated but the GP can't know that. A lot of medicine isn't, "it is definitely this" more, "rule out this, rule out that". This is just a rule out.

Your medical anxiety is understandable. Maybe talk to the doctor about this.

Onesleeptillwembley · 21/08/2014 17:45

Sorry missed out last but one sentence;
So the doctor would be failing in their duty if they just took your word for that.

MrsBoldon · 21/08/2014 17:48

Some STIs can cause the symptoms you describe. I'm sure you and your partner have been faithful but lots of people have thought that and sadly been wrong.

Depending on where you live, gynae waiting lists can be long and any obvious potential causes need to be ruled out first so they only have people on the lists who have problems that can't be easily dealt with elsewhere.

I know it's now nice but it'll be over quickly and then you can be seen by the specialists you need.

Original poster

ThinkingOfAUsernameIsTough · 21/08/2014 17:49

Sorry cross posted again! It's more the procedure than anything else, I find it painful to use tampons atm so a speculum (I think that is what it is called) is absolutely excruciating, I also get very anxious being in a medical environment. I probably wouldn't have minded quite so much if she had said this in the original appointment and I could have had everything done at the same time, it's the fact that I have to go back.

OP posts:

RevoltingPeasant · 21/08/2014 17:52

Hmmm OP if you have only said you have had a difficult birth, then actually, I think you need to be more explicit. The doctor can't know if that means 'I get a bit flustered before smears' or 'I go into full-blown panic mode'.

I have recently come to the conclusion that it's worth having the extent of your distress at past traumatic procedures on record. Even if it's difficult talking about.

steff13 · 21/08/2014 17:53

A gynecologist is going to use a speculum for his exam, though, probably. Is there a reason why the gynecologist can't do the STI tests? Can you go directly to a gynecologist without a referral? If I were having these symptoms I wouldn't have gone to my family doctor, I'd have gone directly to my gynecologist.

SpicyBear · 21/08/2014 17:54

I'm not at all unsympathetic. I haven't given birth but have had a traumatic gynae op and I don't doubt for a second that this is bringing up real and distressing feelings.

However, if you can, try to depersonalise the situation. As other posters have said, unfortunately doctors can't just take your word for it, because they do not know you or your DH. It is a sensible standard step to have in place in this scenario.

It really might be a good idea to get some trauma counselling to look at this anxiety. It's completely understandable, but if you need medical treatment in the future you may well be in the situation of having tests that you do not want and that are triggering. If you address this now then you are protecting yourself.

SpicyBear · 21/08/2014 17:56

steff13 in the UK GPs are the gatekeepers to specialists. You have to be referred by a GP to access a specialist through the NHS and often even if you are paying privately they will only accept referrals.

Laurel1979 · 21/08/2014 17:56

I would recommend speaking to your GP beforehand, you don't need a speculum exam to have an STI check, it just involves 2 swabs (which loom the same as a long cotton bud) which you can do yourself if needed. Some labs will also accept a urine sample, although this is felt to be less reliable than the swabs.

creampie · 21/08/2014 17:57

Just to add STI stands for sexually transmissible diseases. ie diseases that can be caught from sexual contact but that don't have to be. I don't think you can completely rule them out as a cause without the test.

If it is the cause, they are easily treated. If you skip this step you may find yourself having all sorts of more invasive investigations for nothing.

Laurel1979 · 21/08/2014 17:58

look not loom

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