What to expect at a gynaecology appointment?

[Newname85]

I’ve been referred to a consultant. I have super heavy and painful periods. Going private as it is really bad. My friend went private for her antenatal care and had an excellent experience with a male Gynaecologist. I want to go to him, but im worried he’ll have to do an internal procedure/examination?
My friend says she only had scans, but her case is surely different?

If anyone here took treatment for heavy periods, did the doctor do an internal on you?

I’d expect a physical internal examination, possibly with a speculum too, and perhaps an internal and external scan. Also some bloods.

Yes. And it's highly likely that most gynaecology appointments will involve an internal examination. The best gynaecologist I had was also a man so please don't be deterred by this. He's seen more vaginas than you've had hot dinners and it will be very professional and matter of fact. Unless you have the German gynaecologist I did in Colombia who repeatedly referred to my vagina as a cunt. That was most strange but has made a rather interesting anecdote! Good luck and hope it's all sorted quickly.

I've always had a male specialist and never feel awkward as they have female chaperones like nurses in the room.

Had an internal and the nurse stood next to him watching what he was doing.

Anyway re heavy periods, you might have to have an ultrasound on your a hysteroscopy/laparoscopy. The ultrasound can see everything as it's part internal and would see anything sinister or cysts.

The latter is done under a general and would see endometriosis and the like.

This! But it really is nothing to worry about and if necessary for your health then surely it's necessary and will be over quickly

What happens if I refuse internal examination? Can they find out the same info with an ultrasound?

I’m really keen to go to this doctor, but I definitely cannot let him do an internal examination. Pls don’t judge, I'm just not comfortable.

I have anxiety about gynaecology related medical procedures from my pregnancy and child birth experiences. My friend had the same too, but this doctor was excellent.

Have you tried tranexamic acid? Changed my life no doubt. I had periods so heavy that green tampon and full nappy type sanitary pad would leak through in the 15 mins it takes to do school run. These are game changer and got from gp. Went for years on and off to different doctors and all said go on pill which i didn't want then one day a young dr prescribed these!!!!

These

Are you saying you couldn't face an internal with anyone or just a man? He wouldn't be doing his job properly if he didn't do an internal.

I went privately for heavy bleeding. First appointment he took a history and then used an ultrasound wand. Not painful. Nurse in room.

You are clearly well within your rights to refuse any medical examination, but it seems like a proper waste of time and money to pay for a private medical appointment only to not allow them to examine you when you arrive.

This really. No point on going to this doctor if you won’t agree to an internal exam. Waste of money. Could you do an internal with a woman doctor? Explore this option if so.

agree With others that the internal ultrasound is the main part and if that’s not portobello for you then it seems like a waste of everyone’s time to go to see the specialist. To get a proper diagnosis they need to be able to run the relevant tests.

Agreed- why are you wasting time and money if you are not going to let them conduct the tests?

You'll have to have an internal at some point if the heavy periods can't be controlled

You might have a fibroid

There is no point paying to see the guy and not allowing him to do what he needs to do

You can have a female with you when he examines you

Or go to a lady gynae

I've got endo and have had all the treatment, but want to start by saying that you do not have to have any treatment/examinations unless you want to.

Gynaes are used to seeing women who don't want internal examinations. It's normal. Some of them have a better bedside manner than others but if you don't want an intimate examination, that's your choice. There are usually workarounds.

The most likely thing they will want to do is a transvaginal ultrasound. They use what looks like a skinny dildo. It's generally not painful and doesn't require fingers in the vagina. It gives them better images than abdominal, but I've been told that it is possible to do it abdominal only (I have young adult daughter with possible endo, they won't perform internal ultrasound on her as she's not sexually active).

Endo can also be seen on MRI (this is how mine is monitored now).

When I went to a private gynae I just searched for a female one, i wouldn't bother making an appointment with this male one. However good he is, if you aren't comfortable, there's no point. Just look for a female one instead.

Do not waste your money going to someone you will not allow to examine you properly.

Don’t assume private will be quicker or better. I have/ had the same condition and I have private medical insurance via work but had it all sorted hysteroscopy (not hysterectomy) and mirena coil within 6 weeks.
However you proceed request a female doctor.

I had lots of investigations for heavy bleeding. More people have looked in my vagina than I care to recall, but you cannot expect a medical professional to treat a body part they aren't allowed to see.

No one can force you to have a procedure. You have to consent to all procedures, so don't worry that you'll be forced to do something against your will. However, I'd suggest that you do your best to have all investigations that are necessary in order to help you as the doctor will just want to treat you and improve your quality of life.

Also, I've had gynae examinations by a male and a hysteroscopy by a male... They suck, but the procedures did lead to outcomes that really enhanced my quality of life, so I don't regret having the investigations and procedures!

Well you won't get a fully effective diagnosis, and that will hamper how you are managed, which will only be based on what the gynaecologist knows.

I only had scans. They found fibroids. I now have a date for a procedure to remove them and fit a Mirena, under a general anaesthetic. Also private. It was swift, within a couple of months. NHS waiting list is 2 years.

You might not need an internal exam, especially at a first appointment

I'm wondering if you've ever had a smear test.

When was this. Hysteroscopy waiting times on nhs in London now 18 months to 2 years. GP suggested if I had a private route I took it (now have appt for procure within 2 months privately.

That’s alarming. About 18 months ago. Via 2 week wait. I’d still advise staying in both systems and being scrupulous about cancelling if you get seen either route first.