Open wide: fascinating article on the smear test speculum

[T1meForDebate]

www.independent.co.uk/life-style/women/speculum-use-smear-tests-pain-women-cervical-screening-sexism-men-a8834771.html?fbclid=IwAR2Tz_c2FlAh-RizAETPr1KX9VhKZ-miAT2r0f-Hyi11QV21AXq_lWOklXI

clicky

speculum

Fascinating (and depressing). I have a retroverted uterus, so quite frequently the HCP struggles to get a decent sample. It's about 50-50 as to whether the HCP knows about sitting on your hands, IME (I owe a big debt to the first HCP I encountered who suggested that one to me). And yup to the pinching experience too, been there.

Interesting article. I like that it highlights how absurd it is that medicine persists in using outdated technology which causes pain to women and tries to intimidate them into attending, rather than fixing the issues with the equipment.

I'm grateful I've just had rather than just about to have one when reading that! I was asked to sit on my hands, but not sure why. They didn't have problems inserting the speculum but did in finding my cervix. It was unusually painful this time but not too bad.

Really interesting article. I’m a female HCP so have been on both ends of a speculum but I hadn’t even considered there might be alternatives. Great tip about offering women to insert it themselves.

I have recently started ordering in a softer and more flexible type of ring pessary for women with prolapse (the standard ones are horrible and really difficult to compress to get past the vaginal opening- so unnecessarily painful to insert). Will definitely look into kinder alternatives to the Sims’ speculum. Didn’t know about him either the bastard. So much of what we are taught is just unthinkingly misogynistic. It makes me angry.

I liked the article apart from the misuse, yet again, of the term ‘gender’. I do not, and never will, believe that a man is a woman if he says so. Room 101, was it?

Fermats yes, the search for the cervix of the retroverted uterus.... It's a bit disconcerting to be told "I can't find your cervix".

Quite a good article, I’m glad there’s someone writing about this as I really don’t like some of the attitudes around smears. You can buy your own home kits for anyone who is overdue for any of the reasons outlined in the article.

It's a bit disconcerting to be told "I can't find your cervix".

Tell me about it! Last smear I went for, we went through more positions than the karma sodding sutra. The bugger was still missing in action at the end of it.

I have had the firking around looking for the cervix too, and AFAIK have the usual sort of uterus.

The speculum always puts me in mind of a car jack. Especially the last time I went

The NHS are trialling self tests for women who miss their smears. About bloody time. Now offer all women this as an option and the countless numbers who hate this invasive, painful and unpleasant test have an alternative.

www.huffingtonpost.co.uk/entry/diy-smear-tests-to-be-offered-to-women-as-part-of-nhs-pilot-scheme_uk_5c9378f8e4b0d952b223f42b

If you have a hard to find cervix what are the chances that you, yourself, from "up there", are able to ferret around down there and get it?

I wonder if some sort of softer device could be produced? I can certainly find my cervix in the absence of a speculum. I used to use the diaphragm as a contraceptive, and you have to feel for your cervix through the rubber membrane to check the diaphragm is in the right place once you've put it in.

I have vaginismus, PCOS, adhesions, interstitial cystitis and understandably chronic pain and PTSD . Have as yet only met two HCPs who understood when I said speculums hurt more than having my wisdom teeth pulled . Most of the time you’re told to grit your teeth and get on with it .

I actually had one spectacularly awful male gynaecologist who told me how I could possibly know that I had vaginismus if I have never had penetrative intercourse? (This being despite the fact that I’ve had regular internals since teenage years where it’s more than evident ...)

His concern was that my unwillingness to have PIV intercourse must be very frustrating for my husband and I really should try to have sex for his sake !

I’m a lesbian - no desire to have sex with a penis ! - but even if I were with a man , why in the fuck should I subject myself to severe pain so he can have a shag ?

Unfortunately most nurses are the same - most I’ve met say ‘it doesn’t hurt at all’ , and then proceed to get annoyed when they can’t physically pass a speculum due to involuntary spasm .

The NHS actually has a policy up afaik when it comes to coil fitting (which I was advised to have to get control of menstruation a bit - apparently you’ve to try a mirena before a laparoscopy for endometriosis) - you have to at least attempt to have it fitted in a standard clinic . They don’t automatically allow any anaesthetic beyond a bit of numbing gel on the speculum , you have to put yourself through severe pain and trauma first and only if you can prove that you can’t cope with the experience at all then they will give you sedation . Whilst berating you for the cost to the NHS ... fucking dreadful . Despite me repeatedly telling doctor I couldn’t cope and was going to black out - no, you can’t possibly be sore , you’ve had some local gel, please take a deep breath and be quiet thank you ...

I have thankfully - after some fab advice on here - managed to secure an appointment with mybodyback , so no male doctors and a kinder environment but if that service wasn’t on offer I’m doubtful if I’d have bothered going for a smear .

It’s like women aren’t trusted to know their own bodies at all or to make a reliable assessment on what they can and can’t handle .

fearofthesmear

Oh my god, I am so sorry I cannot imagine having to have anything inside my vagina with all those issues. The way you’ve been treated is horrendous.

I've often wondered why there hasn't been some better replacement for the speculum. Last time I went the nurse practitioner had a try, then the GP, both excruciating for me - then I was sent to the hospital where a gynaecologist did it (surprisingly painless in the end).

More on re-designing the speculum:

GynePunk, the cyborg witches of DIY gynecology

Women Are Reinventing the Long-Despised Speculum

My local surgery uses plastic speculums now and has done for a few years. They are slightly better than the evil metal ones, and less likely to pinch, however, I agree that it's still a painful and traumatic experience that we are expected to just get on with.

Jessicawakefield I finally managed to submit a complaint about a year ago . Was given an appt with a lovely gynaecologist who couldn’t stop apologising for it all and said whilst I would probably never ‘get over it’ there might be ways to be able to live with it all , if I can access counselling of some sort . But accessing healthcare shouldn’t be something that leaves you traumatised like that . I think it’s the sheer lack of trust afforded to female patients - you’re treated like you’re exaggerating from the moment you walk in ... constantly asked about your sex life (I remember an appt at 17 being grilled over whether I knew how to masturbate ) , disbelieved if you tell them you’ve never had sex with a man and therefore can’t possibly be pregnant (‘oh we’ll just do a pregnancy test anyway, just to be 100% sure’)

I could talk for hours about it - and did once to a fifth year med student who hospital asked me to talk to , so she could gain perspective on living with chronic gynae stuff . She was American and I think I remember her saying she felt they were just as bad if not worse , that it’s often seen as a yearly routine matter to go to gynaecology and have a bimanual, smear, breast exam from puberty onwards - something you just put up with as a consequence of being a woman seemingly .

Whole system of managing women’s health needs a total upheaval to be honest !

apparently you’ve to try a mirena before a laparoscopy for endometriosis

Really? That’s awful. I’ve had to have two laparoscopies for endometriosis (both outside of the uk) - one to diagnose as it’s the only reliable way to do so, and a second to treat it, although it’s not a permanent fix. But nothing in the world could convince me to have a coil fitted. If I’d been in the uk when I needed treatment and kept ending up in A+E with the pain, I’d have been screwed. Then again, when I saw doctors in the uk about it as a teenager they couldn’t be bothered to do anything about it anyway and just fobbed me off with the usual ‘it’s a period, it’s supposed to hurt’ nonsense.

If true, it’s disgusting that the NHS is effectively blackmailing women who are in debilitating pain into having treatment they don’t want, might not even work, and in some cases can cause its own horrible problems? (I know it works for some people, and that’s great, but you usually have to battle with the doctors to get them to remove it if it doesn’t).

What happened to the idea of informed choice and patient consent? Doesn’t count for women apparently.

Having a cervical smear certainly gets more painful after menopause. I have had to use Ovestin cream for a few days before a smear to make it easier. Just putting that in with a thin applicator made me sweat until I got used to having something like a tampon inside me again. One Nurse had me on my side as she said it would be easier. It wasn't and I begged her to take the wretched thing out.
I hadn't realised the design was so old. Actually it reminds me of that horrible film with Jeremy Iron playing the gynaecological twins!

I think it’s the sheer lack of trust afforded to female patients

I agree. I have hormone problems and doctors are extremely unsympathetic and dismissive.