Practise nurse withholding the pill without a smear test? (TITLE EDITED BY MNHQ)

[hoomans]

I've just been for a pill renewal appointment with the practise nurse at my GP. I turned 25 last month so have only just come onto the smear screening radar and she informed me that the new rules mean that she can only supply a weeks worth of contraception until I have a smear test and if I continue without having one they will refuse to prescribe it altogether. Surely they can't do this? I haven't declined and I've booked an appointment to get it done but surely this shouldn't be the case?

You should not be forced to have one. I have never had one and I have been on contraception for over a decade.

I probably wouldn't have gone for the smear voluntarily though tbh if I wasn't being made to . I have had the vaccination , I have only had unprotected sex with one partner and I'm not currently sexually active. I also have sometimes struggled In the past with penetrative sex being painful so I know it's going to be painful .

My risk is probably low but I know that you can never be sure.

It was 1989, the first time I asked a GP for The Pill.

I got the whole no smear, no pill thing then too.

I got my pills with no smear, but I am plenty opinionated and not the least bit shy about sharing.

Personally, I think random HCP's use it, both now and historically, to try and force smear compliance.

I also believe it to be highly immoral in many ways.

This particular nurse also patronised me about drinking alcohol as she asked me how much I drink per week, I said nothing as I genuinely don't, I work 13 hour shifts Saturday and Sunday so I barely Ever get out . She said well I know it's more than that as you're a student, I said very occasionally and she said well that's not nothing then is it .

This sounds very strange although I would add please don't miss your smears , not a particularly enjoyable procedure but very necessary!!

@hoomans

This particular nurse also patronised me about drinking alcohol as she asked me how much I drink per week, I said nothing as I genuinely don't, I work 13 hour shifts Saturday and Sunday so I barely Ever get out . She said well I know it's more than that as you're a student, I said very occasionally and she said well that's not nothing then is it .

what a rude patronising cow I'd be mega complaining

@Maray1967

I was told this in the 1980s when I first went on the pill. Thought it was bizarre then. So my first penetrative experience was with a speculum - lovely.

Similar experience in the 70s, I’d had penetrative sex but just turned 18.

see recommendation by NICE

I had a bit of a set to with a female gp who was being difficult about letting me start HRT without a recent smear (in a very patronising manner as well) - I agreed to the smear (after "being very puzzled because the NICE guidelines don't say that, do they?") but it took two appointments with her and a trip to the "difficult patients" clinic at the hospital before I was able to get it done.

On the plus side, I did discover that diazepam is bloody brilliant stuff - DD3 reckoned I was "good fun" when I got home from the clinic having taken two - but that still doesn't make up for the fact that I felt coerced into a medical procedure I didn't want, didn't especially need (personal circumstances) and certainly didn't need before I got the medical treatment I did actually want and need.

@Gladioli23

*They’re working towards this but currently HPV screening still involves a cervical cytology sample (not just a swab) so not something you can do yourself at home.

Primary HPV screening is a step towards home testing though.*

@Sidge - I am a bit confused by this, because you can already buy a home HPV test online? onlinedoctor.superdrug.com/hpv-test.html?gclsrc=aw.ds&gclid=Cj0KCQiAuP-OBhDqARIsAD4XHpe_WUGYctvSfdS_DD-88ri6uVrjv3FAMun6ZK1uorzWfDjXE90L1uoaAneCEALw_wcB

I always assumed it was just an NHS being slow to implement something/not wanting to implement it for older patients where HPV is endemic.

Yes you can do private home HPV swabs.

However NHS cervical screening is still primary HPV screening, so we take a sample of actual cervical cells (not just a high vaginal swab).

The lab then first look for high risk HPV (HR-HPV). If no evidence of this they don’t look any further as the chance of cell abnormalities is negligible especially without symptoms. That’s a negative result, which is a normal smear result.

If HR-HPV is detected then they will look at the cellular material to see if there are any changes. If so then a referral to colposcopy is done.

The idea is that in time, we will offer home HPV swabs to women and they only need a smear if they’re HR-HPV positive. I’m not exactly sure what the timeframe for this is.

Currently, if you do a home private HPV swab unless you’re due a smear nothing will be done about a positive result if asymptomatic, so limited benefit in doing it really.

That's outrageous blackmail! I would complain, escalating the complaint right to the very top if needs be.
I would also complain about the nurses attitude and approach, escalating that right to the top too if needs be.
Who the hell does she think she is!?!?

What about women who are rape victims? What about women with vaginismus? What about women who simply don't want a potentially painful, invasive procedure?

And what happens if they get cervical cancer. The procedures are going to be a hell of a lot worse and way more invasive than a smear which takes a couple of minutes.

My sister has always refused to have a smear test.
She now has all of the symptoms but won’t go and get checked. She is just going to have to wait until it gets worse which is absolutely ridiculous.

I have to have regular smears as I have HPV/abnormal cells.
I know that if I refuse and I get ill, my next procedure will be a lot worse - painful and invasive, as well as life threatening.

Complain. There is no such rule.

This is what some surgeries do to try to bully women into having smear tests to make their testing quota/get more money in.

This should absolutely be challenged and reported.

Utterly ridiculous. Are they going to make men get a prostate exam before they can have condoms? I would complain to the highest level I could get to.

Hoomans, every time you post I'm getting the Horrors.

I probably wouldn't have gone for the smear voluntarily though tbh if I wasn't being made to

I really, really want people to go for smears but this is not okay at all. It doesn't sound like you had an opportunity to freely consent. I think you need to speak to the lead GP or the practice manager about this.

We don't have quotas or rewards as smear takers as such but there is a minimum number of tests that have to be undertaken in a certain amount of time to maintain competency.

This particular nurse also patronised me about drinking alcohol as she asked me how much I drink per week, I said nothing as I genuinely don't, I work 13 hour shifts Saturday and Sunday so I barely Ever get out . She said well I know it's more than that as you're a student, I said very occasionally and she said well that's not nothing then is it

It sounds like she has judged you or maybe she is against contraception or something. It’s very odd.

I would ring and speak to someone else and check this is the correct information for that practice.

i get mine from the local sexual health clinic for free-they ask quesitons take your blood pressure but you dont have to consent to any procedure

look up your local one

also pharmacys have just started selling the mini pill-dont know how much but could look into that

This doesnt mean you shouldnt make a complaint

My doctors messed me about like this, it was one thing after another. Always a nightmare to get an appointment and they wouldn't give me enough to get buy until I could go.

I now buy it online from Lloyd's online doctor it's £15 for 3 months for the one im on. I can order it on the morn and collect the same day. Saves so much hassle.

I would complain on the principle alone. Absolutely shocking behaviour.
I once missed an asthma appointment (family bereavement, I did ring and cancel the appointment) and when I went to pick up my inhalers the arsey woman at the desk said they were not ordered because I'd missed my appointment. I decided to loudly and sternly advise her that as my 21 year old sister had just passed away I'd been preoccupied, and I did cancel the apt. Lo and behold I got my inhalers.

I think the poster who mistakenly used the word enrich got it right.Isn't it all about meeting targets and receiving bonuses.

The nurse sounds a bit if a nightmare but you need a smear.

It’s usually the drs who are pedantic.

What about women who are rape victims? What about women with vaginismus? What about women who simply don't want a potentially painful, invasive procedure?

And what happens if they get cervical cancer. The procedures are going to be a hell of a lot worse and way more invasive than a smear which takes a couple of minutes.

You sound worse with every post.

@WonderfulYou

What about women who are rape victims? What about women with vaginismus? What about women who simply don't want a potentially painful, invasive procedure?

And what happens if they get cervical cancer. The procedures are going to be a hell of a lot worse and way more invasive than a smear which takes a couple of minutes.

My sister has always refused to have a smear test.
She now has all of the symptoms but won’t go and get checked. She is just going to have to wait until it gets worse which is absolutely ridiculous.

I have to have regular smears as I have HPV/abnormal cells.
I know that if I refuse and I get ill, my next procedure will be a lot worse - painful and invasive, as well as life threatening.

Wow, so because your sister has not had a smear test, you think she should be denied any treatment if she has cancer. Do you really not like her or something?

Yes, people who do not have smears (for whatever reason) know the treatment for cancer can be worse. That does not make getting a smear any easier.