AIBU to think I don’t need to go to the gynaecologist every year?!

[Watchagotcha]

I live in France but am from the UK. I was out with some friends last night - some French, mostly Brits who’ve been here a lot longer than me. We got talking about various medical issues, and it transpires that pretty much all my friends go to see their gynaecologist every year! I’m not sure what for: smear tests, when they are due; breast exams; and just “making sure everything is okay”.

Is this really necessary? What kinds of conditions might they be picking up on that I wouldn’t notice and go to the dr with myself?

Do I need to see a gynaecologist yearly?
YABU = yes you do, the gynaecologist might find something that needs treated
YANBU = no, don’t be daft, go to the dr if you need to and get regular smears when they are due

I go every year, but that's standard in the US. I also go for an annual checkup with my primary care physician, also typical here.

It's the same in the US. I don't get the point myself.

We are in Germany and I go every year. Brits have a very strange attitude to health and I say that as a Brit.
Why wouldn't you go annually sapwood you're not paying for it.

It’s standard to go every year in the US because it’s a good revenue stream for gynaecologists not because it’s medically necessary.

This really depends on your age and if you are TTC, going through menopause or something else???

I lived abroad where they recommended smear tests every 2yrs, whereas UK its every 3, which I'm told is purely down to lack of NHS funding! I'm TTC, so would have liked seeing a specialist MUCH sooner in our journey.

It's the same in the US, and annual smear tests. For most patients it is unnecessary but it's how doctors make money.

Oops should have said I’m 48, youngest child is 9yrs, probably perimenopausal but still regular. I’m due a smear, which I will get done, but that’s it really.

I also live in Europe and would choose a combination of answers - go to the doctor when you need, and get regular smears when they are due, which here is once a year (and is fully covered by insurance so not a case of pay per view as in the US). Yearly MOT also includes transvaginal ultrasound to check ovaries and uterus, not just 30 second smear.

I think there are many things that a gynaecologist could pick up on that you wouldn't necessarily have symptoms for, and the sooner they're picked up on the better, no?

I've never had an appointment with a gynaecologist and I'm 57 and have had 2 children. My smear tests have been done by my GP or practice nurses, my antenatal care by midwives and GP, my 2 delieries in hospital by obstetricians. Never had any sort of routine gynae appointment and don't see the need for them. What are they actually for?

I've never been to a gynaecologist, I'm 59 and have had 3 kids. I have my smears done by the practice nurse at the GPs.

I agree it could be to do with revenue, especially in the US. Also I’m not sure how all the healthcare systems work in countries where this is common, but perhaps there aren’t alternative sources of help for the most common problems. I’m thinking along the lines of heavy/painful periods, trouble conceiving, contraception etc, where in the UK your first port of call would be your GP.

I don’t think it’s necessary though and I was actually pretty shocked recently to learn that yearly gynaecologist visits in the US begin as a teenager, and that they regularly carry out internal exams from that age even if there are no symptoms that would make that medically necessary. It seems over the top and potentially damaging, not least in terms of over-treatment.

I have gone every year or so in the UK, and have done since age 16 - but that’s because of long term gynae problems (suspected genetic syndrome) and usually just monitoring of things, scans to check ovaries and blood tests . I did have internal exams before then and agree it is damaging/traumatic if nothing is wrong - if it’s not needed why put yourself through it .

I don't know how the French healthcare system works so can't really comment. Obviously here in the UK most screening programmes are delivered via primary care, so it seems odd to us to visit what would be a secondary care specialist here, for routine stuff. But if that is how routine things are done there, then yes, you should go.
I do find it weird that a gynaecologist would do breast examinations though. If I wanted an expert to check my breasts I would see a breast surgeon. All the gynaecologists I know would look at you as if you were mad if you asked their opinion on a breast problem. Though again, maybe things are different in France.
I would tend to go with whatever the norm is for the country you are in at the time as that will be what the staff are trained to deliver. If you get your smears from a gynaecologist there rather than a GP or practice nurse, then go along with that. It isn't necessarily better, or worse, just different. Unless it is a pay as you go system that is, then I would be very sceptical. I think a lot of unecessary investigations get done in systems where the requesting clinician, or their employer stands to make lots of money that way. And investigations are not always harmless.

What do they do? As far as I can tell my friends have some or all of the following done:

Check your breasts for lumps
Do an external check of sexual organs (when you lie down and they palpate the area)
Do an internal ultrasound with a wand or an external one with the scanner thingy
Check your pelvic floor and prescribe physio if you need it
Check the skin of your genital area for any lumps / bumps etc (turns out most of my friends regularly go to a dermatologist as well, for a skin check - they do the whole body except the genital area)
Quiz you about your sex / reproductive life - are you planning at (more) children, your age, any fertility issues, menopause etc.

In one way it sounds great to have all these things done, in practice It feels a bit excessive. Appointments are quite hard to get but I guess my friends book a year ahead. They are almost fully reimbursed by the state healthcare. I.e. I pay the fee then get reimbursed by the government.

Oops and as I said, they do smear tests which are yearly / 2- yearly here. There doesn’t appear to be any reminder system (presumably because all the women except me are trotting off to the gynaecologist every year!)

If you are from the UK you must know that, certainly in England the vast majority of women don't have a gynecologist never mind see you regularly unless they have specific need to.

Regular checking would be impossible I'd say, surely there simply wouldn't even be enough of them to do the work and would be a huge unnecessary cost on an already underfunded NHS.

But whether you go annually in a different country is entirely up to you.

I'm from the UK and have been referred to a gynaecologist for a specific reason. It took a 6 week wait to get an appointment and that appointment was over 8 weeks away. So I can't imagine that we'd be offered annual gynaecology any time soon.

I wish I could afford private health care, I'd love yearly checks

Annual checks where I am from as well ("third world", so not very well financed at all). But only in my family it had caught two cancers at a very early stage (breast and cervical).

I'm in the uk and I see the nurse when I'm due a smear test. The results come through the post. The dr wouldnt refer us women to a gynecologicalist unless they suspected something was wrong.

I go once a year as it is the done thing in Italy too. I probably don't need to go but my gynaecologists is very popular and I don't want to lose my slot! She is quite helpful.

I did have internal exams before then and agree it is damaging/traumatic if nothing is wrong - if it’s not needed why put yourself through it
Why is it traumatic? I am used to having internal pelvic exams annually from the age of puberty (being delivered as a part of school health programme and then transitioning to adult clinic), I never thought twice about it. I found it weird on moving to the UK that there is no such screening here.

I knew you would be in France just from the title of your thread

Don’t have anything else to add, except that I was surprised about this yearly gynae thing too- not entirely sure it’s necessary but I guess it doesn’t do any harm.

Do men get the equivalent checks and quizzing every year?

The level of care doesn't feel "excessive" to me. My gynaecologist doesn't do breast exams though (that sounds a bit weird for a gynaecologist, who's specialism is surely the reproductive system?).

How is a quick smear once every 3 years supposed to pick up something like cysts - which you'd only know about if it got so big it was causing pain, ruptured, or you were having a pregnancy related ultrasound (further complicating treatment)?

I'm sure any examination by a doctor can be embarrassing for teens, but hardly "traumatic". Why should it be traumatic? Surely less traumatic than cancer treatment...