To question gynecologist?

[Pipsqueaked]

After several episodes of bleeding after sex I went to see a GP and was referred to see a gynaecologist, who I saw today. They examined me and advised I had a cervical ectropian and to come back in 3 months if it wasn't any better for a colposcopy.

AIBU to ask for a colposcopy now? From what I've read it's impossible to distinguish an erosion and early stage cancer. It seems colposcopy is standard practice. Or have I got this confused? I'm really anxious and have come away feeling no more reassured. :(

You can ask the GP if you like, but I'm sure the gynaecologist with a decade plus of medical training is aware of the standard practice based on what they found when examining you. They're likely taking more into account than you see online such as age, risk factors, history and so forth.

I’m a GP and wouldn’t routinely refer into gynae for an ectropion so to me the plan sounds reasonable and standard. If you’re concerned, which is understandable, you can of course ask for it sooner. They are trying to avoid you having potentially unnecessary procedures which are not entirely without risk, however.
It probably would have been easier to discuss/arrange if you’d said it during your appointment but I realise you don’t always think of these things at the time... If you want to be seen sooner, please call the gynae secretary directly, don’t go to your GP.

When was your most recent cervical smear? If you are up to date, there is probably no reason for them to be too concerned. Cervical ectropion is really common. I've had it for years. I have had two colposcopies, the first due to an abnormal smear (it was mildly pre-cancerous, removed, and it was fine, no issues in about 10 years) and the second due to a period of really abnormal bleeding (bled for 6 weeks straight inexplicably, that one came out fine, no explanation but bleeding stopped). The cervical ectropion I think was noted in a routine cervical exam (for something unrelated). Gyn wasn't too fussed. It's caused me bleeding in all my pregnancies, but otherwise no problems.

I don't know what the standard practice is, but I didn't have one after they noted mine. I suspect because I was otherwise low risk and up to date on my smear. If the bleeding continues and you have other signs, I would follow up though.

I'm sure he did take those things into account Lemon but people can still get cancer without risk factors and younger than expected. I probably should also mention I had a clear smear 6 months ago. But they aren't always 100% either are they?

Thanks Sally that's really useful to know. I will wait and see what happens and try not to panic. I have found secretary email address online would it be really bad to email them and ask for clarification do you think?

Are you generally anxious about your health OP? Have you ever been preoccupied with the idea of getting ill or dying before, with other illnesses or symptoms?

Yes I am anxious about cancer after watching two people close to me die far too young. It's something I'm working on.

Unsuccessfully obviously

Cervical cancer is very slow to develop. I say this as someone who has had 2 loop excision procedures following from 2 abnormal smears and then colposcopies. I insisted on having smears every 6 months afterwards, despite gp telling me I really didn't need to. I went private and paid for them for 3 years, clear every time. Private gp told me that they were completely unecessary and wouldn't do them any longer. I'm now back to one every 3 years as that's how long it can take to develop. Please try not to panic.

We are only allowed to email patients if they have an NHS email, for data security reasons. We phone patients back if they email. Sounds silly I know... I don't know if everyone is as strict though.
If you phone the hospital the switchboard should be able to put you through.

Please don't try and self-diagnose on the internet, it's a recipe for disaster. Pretty much every single symptom out there can potentially be a sign of cancer if you look into it enough - so step away from Google first of all!

If you're really concerned, go to the GP and insist on a smear. Most are perfectly happy to give you one if you're concerned. I had irregular bleeding a few months ago (it turned out to be hormonal) and I asked for a smear for peace of mind - my GP was more than happy to check everything out for me.

However, please try not to worry! Irregular bleeding can be caused by SO many things and if your gynaecologist has already diagnosed you, you probably have nothing at all to worry about. Remember, they deal with this kind of thing everyday and are used to it.

It's only natural to panic when things seem wrong, but like a PP said, cervical cancer is really slow to develop and if you're up to date with your smears, the likelihood is you'll be absolutely fine. Please try not to worry!

I've only had one smear. I'm not 25 yet.

Do not go to your GP and 'insist' on having a smear. Most will not do it, not least because many labs will not even process the sample outside of the schedule for the national screening programme.

Given that you had a clear smear 6 months ago and aren’t yet 25. I can understood the route they’re going down. I get your worry though, as anyone would be. Have you changed sexual partners? Contraception etc? These are all things that get taken into consideration. Btw OP I’m exactly like you, I even paid for a private smear 2 years after mine (clear) luckily all was fine, it helped massively put my mind at ease. But having seen close people lose their life to the disease, it is always on my mind. I too, am working on it. Good luck and please try not to worry. Request an earlier examination or pay privately

I didn't see you'd had a clear smear six months ago. In that case, I really don't think you need to worry. Please remember your GP and your gynaecologist know what they're talking about - they deal with this kind of thing all the time. The likelihood of you having cervical cancer at 25 after a clear smear test is ridiculously tiny.

I know the chances are tiny. I just hate that I'm/ they can't be 100% sure. The annoying this is, is that the gynaecologist was someone I saw privately through my medical insurance.

But what I'm getting from this is that it develops slowly, so if it was cervical cancer hopefully 3 months wouldn't make any difference? And I don't need to second guess the professionals anyway. Thanks will try and stop stressing.

deepestdarkest. Don't know where you live but our lab rejects samples even a few weeks early, no matter what the clinical symptoms. As they should - a smear is a screening test not a diagnostic test. If you have diagnostic concerns you need a speculum examination (but not smear) +- gynae opinion +- a colposcopy. Just like the OPs doctors have planned.
A normal smear is reassuring but is not a diagnostic test.

No test is 100% pip, even the colposcopy, and they need to balance of potential risk of danger from potential disease (which they've presumably assessed as low for you) against risks of procedures (not as low as you'd think).
It's natural to worry but it sounds like they have a sensible plan in place. I think you're doing the right thing trying to stop stressing :)