To think gynaecology is still stuck behind with the times?

[ThemysteriousH]

I’ve been debating weather to post this for the last few days but I’ve decided too. Apologies it’s long but didn’t want to drip feed

I really don’t want to come across as NHS bashing - I completely understand as both a patient and employee how tough times are now. I fully appreciate the services we have.

I know I should’ve said something but I just wanted to get out of there. I felt embarrassed and a bit shocked so please no bashing about that.

I had a gynaecology appointment Monday finally, not locally due to the wait list.
I saw a lovely endometriosis nurse last July who referred me back to see a specialist as she recommends surgery, something myself and my GP agree with also.
I attended the appointment and saw a Dr who hadn’t looked at the referral or my history, was quite frankly rude and dismissive and suggested the coil (something I’ve tried and made no difference), I also had a very nasty infection from it. I have tried everything.

I used to live in Oxford and had yearlyish laparoscopy’s for my endometriosis for symptom control. I moved back to rural Wales 8 years ago and have only had it once - 5 years ago.
He asked to examine me, I thought he meant abdominal so laid on the bed with my top up and trousers a bit down ready for the examination, he snapped and huffed saying it was an internal one and to undress and put my legs in the stirrups.
It was very uncomfortable and it made me bleed, I got upset, the lovely nurse comforted me & asked was I okay after the consultation.

He’s booked me to have another ultrasound - something I only had months ago, which was abnormal but he didn’t even try looking on the system and wanted an updated one.
I felt like I was being an annoyance and not listened too.

Has anyone else had similar experience? It feels like it’s the one area in medicine that hasn’t updated with the times.

I’m sorry you experienced that it sounds like it’s the Dr who examined you rather than medical advancements. I think you should complain to the surgery.

in my experience the strides they have made in gynaecology have been massive in recent history.

There is a great school of thought that medicine and clinical practice is still sexist in many, many ways.

I have found the difference in private care HUGELY different. I will only do anything gynaecological private. I'm sorry you went through that.

I agree with this. I had a friend who struggled to be taken seriously with a gynae problem. It was dismissed as ‘just your age’ , ‘cannot possibly be that painful’ She died of late diagnosed cervical cancer.
We need better women’s health care.

@PinkflowersWhiteBerries I'm so so sorry about your friend, how awful 😞

@chantelion I think I’m going to have to save for a private consultation. My CA125 test came back positive and that was dismissed. No further bloods requested. My GP has done a whole load and they weren’t looked at.

@SunflowerSeeds123 it certainly feels that way.. I went in with a positive mindset but it was the typical older man not understanding and kind of saying just get on with it. I don’t want to stereotype but it was exactly that.

@Wolfpa that’s really interesting! I did wonder was it an “area” thing. I had a lot better and what felt like modernised care, all those years ago in Oxford.

I've had many male gynaecologists and now gynae oncologists and they were all superb. As with all NHS services you have to advocate for yourself to a degree with your history - you're the lead character in your story that only you know and all that but I've never experienced poor care, rudeness, poor practice etc.

You got a shit doctor unfortunatley.

I would contact PALS at the hospital and say what you've put here - Consultant did not treat you with dignity and did not read the referral. Very upsetting to have an internal examination by a HCP who has already made you feel uncomfortable , hope you're ok.

Years ago we had one large hospital here just for Gynecology and it was brilliant.. my consultant ( male) was well known for being brilliant... hospital is now pulled down.. everything has merged into a huge hospital and it's just not the same.
My daughter saw a Gynecologist who just kept dismissing her..he was nasty... more or less saying " it's womens problems gey on with it"
My friend went private with exactly same condition.. l went to The Spire with her.. when we entered the room to see the consultant it was the exact same one my daughter saw on the NHS... he couldn't have been more nicer.. it was like he was a completely different person..offered her just about everything ( at a price).🤷‍♀️

Wow @Moier that's awful that he treated people so differently when he was getting the £££

Standards of care can really vary by area OP or people can just happen to get a bad doctor.

I personally am glad I live in a large city and imagine the treatment is all better, more up to date and with better facilities.

My mum lives in a smallish place and she had to go to a different town for any hospital visits. Waiting lists seem a lot longer for her and GP appointments harder to get.

I had the worst gynae experience with a a female consultant not much younger than me!

she was the third consultant I had seen in as many years and I said

‘look I have these massive fibroids, I am constantly unwell and anaemic I have had enough now, ablation didn’t work for me, something is very wrong my skin is horrendous, I am hugely overweight (BMI 36), I look pregnant I feel awful please can I have something done to help? I have had 2 Mirena coils - they fell out due to the fibroids pushing them out’

She said:

‘it is hard being a woman, we get spots. Go on a diet. I’m not happy to do any surgery on you as it’s highly likely you could die on the table’

I left and cried and eventually went back to see my GP and she pulled up a letter that said ‘patient chosen not to have any surgery’. I said that isn’t true I didn’t say that! She referred me back I got a really old posh man consultant.

He took one look at my file and said ‘I’m going to just take it all out, this is silly now’ and when I questioned the previous consultant he rolled his eyes and said ‘you will be fine’

when they went to take out my womb the fibroids were so big they had to do an abdominal hysterectomy there were 4 of them between 5cm and 9cm large so I had been just bleeding continually for all those years and I also had a load of ovarian cysts likely causing even more hormone issues. The consultant taking out my womb changed my life I am so grateful he helped me. I’ve lost nearly all the excess weight and have my life back

I've only ever had good experiences but I am sure some Drs aren't brilliant. And endometriosis is one of those conditions where people have to struggle unnecessarily to be taken seriously. And I also find it shocking.

Some of the things I do want to address, though, as someone working in the NHS:

• your GP may have been on board with your surgery but it is highly unlikely they communicated it in their referral. We receive horrendous referrals which either lack detail altogether, only contain a copy of 3 recent GP consultations or, my favourite one - GP ticking the referral criteria boxes and then patient telling me during the consultation that they have never reported these symptoms. GPs are busy, things unfortunately don't get communicated properly.
• Not looking at your previous ultrasounds - depending on where these were done, they may not even have access to your previous ultrasounds. Systems often don't link. Or you may have (inadvertently) ticked the box to decline to share some of your medical records. I had a patient upset with me because I didn't check their latest blood test and I had to explain to them that they didn't consent to sharing outcomes of their labs or details of GP consultations with secondary care services.

It’s dreadful.

I have a gynae appointment soon (I also have endometriosis) and I’m really dreading it because the consultant they keep sending me to (and who did my laparoscopy) is very dismissive and minimises my symptoms. The last time I saw her I left in tears.

I discovered she has an Instagram page which is full of the opposite of what she tells me.

I would agree that it's not by any means a male doc thing to tell you ''It's just women's problems ...''.

One of my DDs (early 20s) recently had a hard fought for appt. with a specialist for her uterine pain, and came back out to me in tears.

The basic script was:

Pain is subjective ....
Pain killers are available ....
Sometimes women get terrible pain ....
If you ever want kids do you really want us doing things in there?

I could have gone in there and punched her.
We'd followed along the line of referals all the way from DDs original GP appt., through a couple of scans and here we were 6 months on and this woman was supposed to be the point at which it got sorted out - and we got that. Crushing.

We'd had better information and empathy than that from the guy behind the counter in Boots a few months earlier !
😡

Yes told surgery was semi-urgent, what that meant was 12 months waiting. If they had been honest I could have asked serious future questions.

I'd jump up and down for joy at a re-scan or anything - instead of that end of this year I'll go to theatre with scan reliance from May 2023!

I do think the nhs play a lot of games and gambling when it's comes to woman's health. The only good thing is I've been able to book in for a smear earlier then I should.

Oh my goodness what a mixed bag of experiences, I’m so sorry to read of your ones that weren’t great 😌

I really wish I’d advocated for myself and will do in future.

I can see I was wrong in saying it’s because he’s male, I did have an excellent male one when I lived in Oxford which I didn’t even think of.

Being 2024 you’d have thought things would be more innovative? Endometriosis is also not often seen on ultrasounds and my last one was abnormal but again I didn’t really get a chance to speak.

I can see from @Catza response that there’s other things I should’ve taken into consideration also.

Ill get back in touch with the endo nurse too and relay how it went I think!

This is scary! So many “social media” professionals now (not that I’m saying they shouldn’t - but at least be consistent IRL too.)

Maybe the (male) gynaes could listen to women.

I had a male gynae ignore me completely when I told him the reason I was at the hysteroscopy clinic to have my coil fitted was because I was an odd shape and it needed the camera to make sure it wouldn't move. He ignored me and just inserted it. 24 hours later it has spontaneously expelled itself (do no recommend).

This sounds awful & must’ve caused what ended up to be unnecessary pain for you 😞

@Somatosensational that's made me cross for you! In preparation could you screen shot her relevant posts and go into the appointment with an overly polite "I was very interested in your social media posts about X symptoms and the options of A B C treatments. In light of this, what is the plan for me?" Obviously easy for me to say, but you could go in with written notes and the attitude that if a doctor has a public social media account where they're discussing gynae conditions, symptoms, and treatment options, they cannot have any objections to you bringing this into conversation.

I might just do that @CurbsideProphet, thank you. Basically, when I met her she was convinced I had stage IV and was absolutely lovely. She operated and found stage I. Ever since then she’s been very dismissive, telling me it’s ‘only’ stage I and it shouldn’t be causing me so much pain. She even made a 🤏 gesture to demonstrate how small my lesions were, which was the bit that made me cry (actually, it made me really fucking angry but I didn’t feel it was appropriate to express it which was when the tears came). Meanwhile, on her Instagram page, she’s stressing how ‘stage does not correlate with pain levels’ as any endo specialist worth their salt knows. I’ve got the rage just thinking about it again.

I had torrential bleeding for a year, just before Covid. Couldn't leave the house without planning loo stops every 15mins to change pads etc. I was badly anaemic and very low spirits.

When I was referred to a male gynae, I told him they'd found fibroids during my first pregnancy, so he did an ultrasound, said there was no evidence I'd ever had one. I told him they'd measured and monitored it throughout pregnancy to make sure it didn't move and block the birth canal. That I'd seen it in scans, that other consultants had marvelled at the size. He dismissed it. Even dismissed opinions of other consultants: 'Sometimes people think something's a fibrous and it isn't'. I was literally scanned every month and seen by different people throughout my pregnancy.

Bleeding did not stop after being put on the pill ... his solution. Also made comments about my age and menopause.

Then Covid happened. I was prescribed brutal hormone medication by him because I couldn't have a scheduled ablation, which was next step, after everything shut down (I can't remember what it is) which affected me in so many ways. GP told me the hormone meds are not recommended to be taken for more than 3 months, and I was on it for entire lockdown. Consultant had told her no alternatives. When he saw me again, he shrugged and said 'It is what it is'.

I mentioned fibroid again. Dismissed again.

Brutally low mood. Went to see GP and mentioned history of fibroids to her again and she firmly said, 'I think that's a red herring' making me think she'd spoken to him.

Then suddenly, the bleeding just stopped. Back to normal cycles overnight. I saw consultant for a follow-up appointment and said, 'I don't understand how it could be so horrifically bad, for so long, then just stop. Why?'

To which he responded, laughing loudly like it was a proper joke, 'Well, there was this thing about a fibroid'.

When I think what he put me through, I could honestly kill him with my bare hands.

@crochetcatsknitting that sounds horrendous, what an awful experience for you & what sounds like gaslighting.
Did you complain? (I’m shy so I know it’s easier said than done)
How are you now?

The consultant has prescribed me progesterone (I think - definitely begins with a P!) to make me have a more “significant” period to give me a good “clear out” to see if that helps. Something I’ve never heard of!

@ThemysteriousH
"A good clear out"?
Is it 1950?
I'm sorry you're dealing with this - and that doesn't sound like cutting edge medical practice

Honestly I’m baffled, I haven’t taken them yet, in the 20 years of having horrendous periods and having an endometriosis diagnosis, if anything I’ve been given medication to help lessen the flow!

I’m torn weather to take these before my scan or after as I don’t know the effects of it.

I am so sorry that the specialist was awful,
I would have been very upset.
I would complain.
Gynaecologists examine 1000’s woman a year…they need to remember that for women it’s a relatively rare and scary thing.
Where I work the hospital gynae service is currently only Operating on women with cancer. If I refer ( I am a GP) then it is declined… women with huge fibroids, anaemia, pain, incontinance …. all declined. It’s a shit state affairs
I know with endo that the feeling is that repeated laparoscopy and excision just creates more pain due to adhesions.
I am sorry that you are experiencing this.
Women are getting a shit deal. Because women basically carry the reproductive burden ( periods, pregnancy, childbirth, injuries from childbirth, mental health effects of all of that) then I always feel that women are due special consideration in regards health… the funders do not agree.
Have you tried transexamic acid for bleeding? Specialist pelvic floor physios can be amazing too.
I had endo … diagnosed late as I saw how shit women treated when they went for help… my reluctance cost me my fertility.