To remind you to look after your cervix (cervices?!)

[FourForYouGlenCoco]

I know it's been done plenty of times, but one more won't hurt, right?
So long story short:
Went for (overdue) first smear last year, after DC2 was born. Borderline changes & HPV - sent for colposcopy, they went for 'watch and wait' and asked me to come back in 6 months.
Went back, severe dyskaryosis/CIN III. Back again a few weeks later for lletz under local.

The hospital is an hour+ away. The logistics of it all, organising someone to take DC1 to/from school, trekking baby DC2 back and forth with me - not fun. But I am so so relieved I didn't put it off, so relieved I didn't just assume everything would be alright. In the 6 months between colposcopies, cell changes happened really fast. If I'd left it...who knows?
The lletz was really not that bad either - I was very apprehensive beforehand but it was maybe 5 minutes and done. Minimal pain, minimal bleeding afterwards, and definitely a damn sight better than cervical cancer.

So please, please, PLEASE book your smear if it's due or overdue. Go to your appt, don't bury your head in the sand, don't put it off. I know it's not how you'd choose to spend an hour, but it's really not that bad. And it's so fucking important. So do it.

The reason women are nagged as you say is because they DO avoid reminders. Nagging happens because people ignore invites.

I was removed from a GPs register because I ignored invites. Their attitude was appalling.

After eventually managing to change GPs (which is harder than you might imagine) I still had to jump through hoops at my new (better GP) to get my decision to be respected.

Part of the reason for this, is down to the fact that GPs receive payment for hitting a target for percentage of women who take up invitations. This means GPs have a direct conflict of interest. Some of the pressure applied by GPs is therefore down to them wanting / needing the funding to help treat other patients rather than it necessarily being in your best interests. Its grossly unethical.

The system is fundamentally flawed for this reason as it leaves open for abuse and potentially for women - particularly vulnerable women - to be coerced into having a smear rather than having one based on informed debate.

I find it frustrating when people say this does not happen and if it does its only 'rogue' doctors who do this. I do not believe this given the number of posters on MN who have said they have felt pressured by HCPs. I fear it is much more widespread than people would like to admit.

This type of pressure is a breech of trust between doctor and patient and does lead to people not seeking medical help for other issues, because they fear being harassed over targeted tests (its worth pointing out that smear tests are not issue that is funded in this way). This in itself is a side effect of aggressive promotion of smear testing which does care harm but is virtually invisible because its not something that is measured nor is easy to measure.

Since having a smear is 'for your own good' very few people report GPs for being aggressive over smears. Few realise they even have a legitimate reason to do so, nor are aware of the conflict of interest which makes it unethical.

I certainly didn't at the time, and it was only years later than I realised I could have made a complaint. Even then I'm not sure that I would have either the confidence nor emotional strength to raise such a complaint against the idea that 'smears are good' and the prevailing attitude to women that is contained within the institutional promotion of them.

I am pleased that posts on MN do seem to be much more accepting of criticism of the system and flaws of the culture around promotion of smear tests. It does seem to have improved over the last few years. Threads are by and large much more balanced than they were and there is more of an actual debate than there used to be. It is healthy to ask questions and raise concerns rather than just accept what you are told with regard to your health and any kind of authority.

The important thing is informed decision making and those who would benefit from one are able to get one. That is not every woman and it is wrong to suggest it is. This is why targets are fatally flawed as it ultimately makes the assumption that not achieving the target is a 'failure'. That's not woman centred care. That's target driven care.

I've never had one because the idea of anyone fumbling around down there makes me squeeze my legs together tightly.. I had c-sections because of this. If I could be put to sleep I would! I consider myself low risk for HPV as I first had sex at 24 and have only slept with one man who was tested clear before we slept together. I know I could still get it but I can't get past the pain aspect.. I wouldn't be able to keep my legs open. I have no problem with sex (never been fingered though) Wish I could be brave! I can get anything done at the dentist or other medical procedures with no worries or nervousness though so I have a good general pain threshold/can put my big girl pants on when it is required at other times..

...and by 'identify women' I mean carry out a routine urine test to detect HPV.

The uptake of that would be so very much higher than the current smear testing regime, it would be cheaper and would enable cell changes to be caught at a much earlier stage.

My treatment was also carried out privately and it was truly eye opening how differently things are done when the pressure of financial targets/HNS policy is removed from the equation.

I do understand why people are of the opinion of the OP, the NHS is a very influential body in the UK. I just hope the paradigm shift that is on the horizon comes sooner rather than later.

The uncomfortable truth is that cervical cancer is an STD, the sooner we become comfortable with that fact, the sooner we can mount an effective defence as a society.

open Why the reminder of cervical screening only?
Colon cauner kills over 40 people a day in the U.K. But no one ever tells anyone to look after their anus. It is our country's second largest killer but I have never seen a thread telling other women not to forget their screening.

Horrid "How only you can make the appointment they cant force you. "

no, but they can give you the impression they will strike you off as a patient if you don't have one. Also, saying to someone literally in a suicidal breakdown situation "how about you have one quickly now" is pretty appalling.

I do just bin the letters but it is appalling to be pressured by a GP when actually in there for other reasons, particularly mental health - in fact I'd say that's a deliberate thing because they probably thing "she's in such a state, she'll do what she's told".

I feel like very few posters have any interest in Dying's experience btw which is the really pertinent post on this thread.

someone else mentions it being unusual to find a smear painful. I think there's a reluctance to talk about it in case it it puts women off going.

I mean, reluctance to say "I found it horribly painful and had problems after".

But no one ever tells anyone to look after their anus

The overwhelming majority of anal (and vulval) cancer is also caused by HPV strains 16 and 18, so early detection of these cancers would be an added bonus to rolling out HPV screening.

Bowel cancer is something rather different though.

Perhaps she can suggest some help for you to accept that other people not agreeing with 'you must go for a smear' and 'it's not that bad' doesn't equate to having 'something wrong with them'.

What are you promoting you sound very defensive its your business if you don't want a smear test no one else's. No one is forcing you to get a smear test.

To read comments like that upsets me. People who have had a diagnosis after having a smear test are thankful they picked it up.

I know someone who is terminally ill and the doctor told them that if they went to see the doctor earlier to get checked, not smear its something else, they could have treated it.

My daughter who is gay has never been for a smear test, why would she do so? Her cervix has never met sperm.

Also she has never had the vaccination because of this. She's clever and doesn't want to have penis in vagina sex.

Most abnormalities of the cervix disappear and resolve. Some do not.

I mean, reluctance to say "I found it horribly painful and had problems after".

Sadly this is a symptom of a bigger issue in women's health. Not ok to speak negatively of smears, or bad birthing experience, shouldn't openly talk about miscarriage as it makes others uncomfortable, endometriosis sufferers being minimised, the endless issues of contraception being aimed mostly at women, the list goes on and on. There really is a culture of 'women are expected to suck it up, get on with it without question or complaint'.

agree it is everyone's choice to get a smear or not. After something like 20 years of annual normal Pap smears, I've just had my first abnormal, followed by a colposcopy finding cin II. That's faster than I would have imagined since you always hear cervical cancer is slow growing. If I had skipped this year, I can only imagine what my diagnosis would be next year...
Leep (lletz equivalent) scheduled in a couple of weeks. Glad to hear it's not too bad pain wise and recovery.

Slimthistime

That's disgusting have you reported them. Its your right to refuse I have never experienced what you have gone through. In you situation I would change surgeries.

I've pushed out 4 children and had a forceps delivery nothing worries me anymore. I have a baggy vagina. My last smear test was very quick, I can understand if some women feel uncomfortable about it. When I first had it done it was painful, they are opening you up and then sticking instrument in there.

elendon - afaik it's irrelevant of whether sexual activity is between members of opposite sex. From what I've been able to see from various cancer and hospital and health service websites, Cervical cell abnormalities are for the most part caused by hpv. Your daughter doesn't have to have had sexual activity with a man to catch it, she could potentially catch it from anyone who has been exposed to it, man or woman. It's nothing to do with sperm.

HorridHenryrule, firstly, I never said I personally wouldn't have a smear. I have had one - purely because 'it's what you do'. I wish I had been more informed beforehand as I would have probably waited until I was done having children. I haven't yet decided on whether I shall have one in years to come, but if I do/do not, it will be based on my own research and not because 'it's what you must do silly woman'.

As for To read comments like that upsets me - do you not think it is upsetting and rude to say to those who found 'negatives' in the opening post 'must have something wrong with them'. I'm still unsure what you were insinuating, but it wasn't polite regardless.

I know someone who is terminally ill and the doctor told them that if they went to see the doctor earlier to get checked, not smear its something else, they could have treated it.

Please read Dying and other posts to see how wrong this is. Don't blame a person for getting ill, it may or may not have been caught earlier, despite what the doctor said.

What's your definition of forced horridhenry?

Because I don't think there can be many, if any women who've been held down kicking and screaming (notwithstanding that some women do report having had smears taken without their consent when having other gynae procedures or checks). But some of us think the bar should be set a bit higher than that.

So what of the women who are threatened with or experience deregistration from GPs, or access to contraception, who then comply? What about women who aren't told it's optional or, worse, who are told they need to get it done, and comply? What of the poster upthread who presented at her GP during a MH episode and was offered a smear when she was there, would that have been meaningful consent had she agreed? There are elements of coercion in some of these, and even where there's not, there's a huge problem with respect for autonomy.

Also, with respect, you being upset reading opinions isn't a reason for people not to post them, nor does it invalidate the opinions. I imagine many women would be upset by your comment that nobody is being forced.

Dear OP - a simple thanks from me.

I had the same as you when I was 25, the colposcopy and eventually the LLETZ and cone biopsy.
I now have a 1 year old. I had to have a stitch put in in wk 16 of pregnancy because my cervix was left in a bit of a state.

Before getting pregnant I had lazily put off my smear. I eventually got my act together after I gave birth only for an incompetent doctor to bugger up the test and be called back to get it redone. I had put off making that appointment for 6 months and after reading your post phoned and booked in.

I have absolutely no objection to someone reminding me how shit it felt thinking that you may have something life threatening wrong with you. You have given me a kick up the arse that I am grateful for x

There really is a culture of 'women are expected to suck it up, get on with it without question or complaint'

You have the wrong attitude this is to do with your health. Your entitled to your opinion and I'll leave it at that.

I had laser treatment following a CINII and whilst the abnormality was resolved, I had a massive bleed afterwards (like my 12 weeks miscarriage). My vagina had to be packed to stop the bleed. It isn't always plain sailing.

I've never had a mammogram either because my mum never did. I don't do smears either. I'm post total hysterectomy (at 46) and in my 50s. After the hysterectomy I got numerous letters requesting me to go for a smear, it took several phone calls to convince them I didn't need a smear test because I didn't have a cervix. I was terribly upset about this as I did eventually successfully sue the NHS for the removal of a totally normal uterus, fallopian tube and cervix.

That's not true Expat. Not true at all. Not with a 14 year old. She did the research and decided that for the duration of the length of the validity of the vaccine, she was fine. Her decision. Her choice.

Looking after your cervix doesn't mean you have to be subject to invasive procedures throughout your life. It's ridiculous and expensive. If you think you may be at risk or you wish to proceed with it then go onto a database. To require this of every woman of childbearing years and after is a step too far.

Because I don't think there can be many, if any women who've been held down kicking and screaming (notwithstanding that some women do report having had smears taken without their consent when having other gynae procedures or checks). But some of us think the bar should be set a bit higher than that.

Then they should be struck of you have to give them permission to do that. You cant allow doctors to bully you find another doctor and report them.

YANBU OP :) seriously there are some ridiculously argumentative people on here. In no way is OP "demanding" or "bossing" and if that's what you take from this you need to seriously relax. Thanks for reminding people OP, it really is a life saving test!

I've never had a mammogram either because my mum never did - huh?

You have the wrong attitude this is to do with your health.

I genuinely can't believe you typed that entire phrase and didn't see the irony there.

Also, to spell it out, having a smear can be bad for your health. And the lower risk you are otherwise for cervical cancer, the more the balance is tipped towards risk and away from benefit.

HorridHenryrule, I like how you cut out most of the post you quoted me in your last post. It's fair enough if you disagree with what I said, but at least put it in its full context.

I don't take my health lightly, I've had a couple of episodes of being very ill, and something has come up in my family history that has made me reevaluate certain matters. That doesn't mean I have to jump every time my health care tells me to.

MissBax My mum is 92 she's never had a mammogram in her life.