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

Schools in certain countries were very included in the healthcare prevention system

This sort of brings up all sorts of issues regarding consent. Especially regarding the more intrusive medical examinations.

Cancer survival in Europe for Ovarian cancer is higher than the uk, one reason being earlier detection. I think if I was being offered a free annual check for cervical/ovarian cancer I'd take it.

“Found it odd first time but got used to it. Also had the situation where Dr just about to start smear test and his mobile phone rang so I had to lie naked with legs up until he finished his call (it was another patient, not all Drs have secretaries”

I think you should put a complaint in about that. All mobiles phones have cameras for starters .....

This sort of brings up all sorts of issues regarding consent. Especially regarding the more intrusive medical examinations.

Parents signed papers. That was it. I don't remember obgyn at school tbf. That was private I think. We were though encouraged on regular basis in the final year (14-15 age group).
Vaccines were simple. Everyone, unless medical exempt. You couldn't (and I think still can't) be at state school otherwise.

I had a burst ovarian cyst which developed into Sepsis and nearly died. !.(Very rare dont mean to frighten you, This would have been picked up much earlier if I had been to a gyane )In the UK we are governed by costs sadly, and I have a Mammogram every 3 years and smear tests when due.If its free then I would certainly take advantage of this if you can .A short appointment and some checks is a great idea ! Why wouldnt you?

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.

Maybe you should have because WTAF @SympatheticSwan? Why would pubescent girls (who I assume aren't sexually active) need internal pelvic exams every year?

It seems waaaay over the top. How is it justified? Yes a gynaecologist could pick up on things but so could a urologist, a general surgeon, a psychiatrist. Do you go and see them once a year too? No! It’s just revenue gathering

Why wouldnt you?
Because the evidence shows you don't save more people from dying from cancer?
This is because many cancers are either very slow growing (older people die of something else first) or go away by themselves.
If you try to treat slow growing cancers with radiation you cause other cancers.

The only period ive seen a gynaecologist is when I was diagnosed and being treated for fibroids. Once this was all done and I had follow up (had a hysterectomy) I was discharged and never seen one since.

men, I imagine, aren’t going yearly for an examination of their penis, testes & prostate?!

yes they do, but at an older age when prostate issues are common.

OK people need to read: The French system is entirely different from the UK one, it does not rely on gatekeeper GPs. Many GPs in France have never done a smear because this is the job of gynecologists. It's not that complicated really - just two different systems.

NICE does not make public policy decisions with regards to screening and treatment based on epidemiological studies, it makes them based on QALYs. That means that they take a number of factors into consideration including costs. Put brutally they compare things like how much it would cost to screen people for X, prevent Y number of people from becoming ill and costing Z to the NHS, as opposed letting Y number of people present ill when their symptoms become obvious. All sorts of quality of life issues, medical issues, statistics on probabilities and risk, as well as cost are calculated by QALYs.

Yes, of course the French College of Gynecologists makes national recommendations for screening, diagnosis and treatment protocols. These differ from those made by other national bodies, e.g. in France mammograms are offered to women from 40 years old onwards, in the UK the starting age is 50 years old. There is no consensus in the literature over whether screening the 40-50 year old group, on the whole, prevents cancers, or stresses women with false negatives , further investigations and unnecessary procedures.

But this is fairly typical of many public health, screening and diagnosis decisions. Sometimes you have a discovery that is ground breaking and overwhelming, e.g. helicobacter pilori and gastro issues, but most of the time you have to weigh complex evidence from multiple sources on a limited budget.

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.

How can that possibly be justified?! In what world is performing medically unnecessary internal exams on teenagers good healthcare?

@CecilyP

I've been followed by 3 different gynaecologist / obstetricians in France and they have all been independent but have offices in hospitals.
From what I understand most specialists who work in hospitals are independent in France.
So there wouldn't be a referral required.
But in more rural areas perhaps it is different. I've never lived more than a 25 min drive from a hospital.

I am a bit shocked by PP's gynae answering his phone halfway through examination. I have been left midway through a consultation so my gynae could go and deliver a baby but I was fully clothed and sitting on a chair so it didn't bother me.

Prevention? I am with @SympatheticSwan. I started going to mine at 15. I don't understand why people are so horrified here I don't know a single woman who would consider that traumatic. Uncomfortable? Yes. Your legs are up in the air. Traumatic? No. Also age of consent is 15 there so if you want pills you are in that office regularly anyway.

Plus we pay about 13% towards healthcare a month on top of taxes. So we will obviously demand and get more.

Do men get their nads checked annually in these countries too?

It smacks of women being seen as faulty/leaky/icky to me.

It's so weird that there are healthcare systems where some people can't access care for things like cancer because they're uninsured, while there's money for unnecessary fanny gawping.

Pelvic examinations from the age of puberty is a bit much

@SamanthaBrique
For one of my friends it resulted in a discovery that she has two uteri (uteruses?) - well, you can call this a curiosity rather than a genuine health issue, but she was on a special protocol from day 1 of her pregnancy, and for another a nasty STI was caught quite early, at the stage where there are no obvious external symptoms, and she was anyway not experienced enough to know that something is not normal.

Pelvic examinations from the age of puberty is a bit much
I probably was not accurate when I said puberty. I think gynecological exams start at the age of 14, they are just added to the annual health screening for school children. A girl can always refuse the pelvic exam, no one is forcing children on the examination chair by force.

You can't compare testicles and ovaries. It is easier to spot growth on a testicle🤷And yes. They get them checked with the GP during some of their annual "MOT". I think it's recommended every 2 years now.

Nobody straps women down and forces them to have these exams. France is also one of the few countries that has pelvic rehab as part of its standard post natal care for women. If you don't want to do it, just don't turn up, but the fact that the offer is there is not a sign that women are treated as dirty but rather that gynecological health and well being is a priority in this health care system.

I go every year for a smear test. I also have my breasts checked plus ultra sound. I’m a worrier and am lucky enough to be able to afford to get it done privately

I think this is tied into the fact that in some countries if you go to the doctors and come away without having had blood tests or being given a prescription then they are a Bad Doctor who isn’t doing their job. That is just the expectation, whether or not those blood tests are necessary and whether the medication might do more harm than good. I suspect those are the countries where this sort of annual check up is common.

Also I feel like there might be a whiff of misogyny about it. Just the idea that your mysterious lady parts might suddenly malfunction if they aren’t checked yearly by (in many cases) a man.

@corduroyal no it smacks of the health care system taking gynae care seriously.

Also I feel like there might be a whiff of misogyny about it. Just the idea that your mysterious lady parts might suddenly malfunction if they aren’t checked yearly by (in many cases) a man.

🙄