Summoned for a colposcopy

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Hi all, I had my first ever smear just 5 days ago and I have already received a letter summoning me to the hospital for a colposcopy examination.

I am extremely nervous about what to expect - maybe not a good thing reading up on it online. The possibility of a biopsy being required is scaring the sh*t out of me and the fact it is a male doctor isn't helping my nerves. I called today and unfortunately it's only male doctors so I will just have to put up with the embarrassment.

Has anyone else had a colposcopy? Is it as bad as the Internet is making out? What should I expect from it, how long will I be there approx?

Thanks

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13 Replies

  • Posted

    Hi I had my first smear middle of Jan.

    Had my colposcopy today it really wasn't that bad, the worst part was speculum, biopies was fine try not to worry x

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  • Posted

    Hi Rachel

    For a start if you want a female doctor, I'd call back and ask them what date a female doctor is available, stand firm!

    I think many women request female doctors for things like this, hardly surprising, so some places will fob women off and hope they just accept the male doctor. I guess they don't want the female doctors flat out while the males are standing around. But your comfort should be considered, if a male doctor would add to your embarrassment/discomfort, then you should make clear you'll only accept a female doctor. I recall a young woman faced a similar situation last year, she made a stand and got the female doctor. Breast Screen in Australia is staffed entirely by women so the system can manage it if they care and they'll only care if women make clear they have a definite preference. 

    Anyway, having said that: I assume you're 25 so you should understand false positives are a problem before age 30, that's why pap testing does not commence until age 30 in an evidence based program, the sort found in Finland and the Netherlands. (both countries protect their young women and also, make an effort to minimize the risk of over-treatment in older women)

    The Finns have the lowest rates of cc in the world and refer FAR fewer women for colposcopy/biopsy, since the 1960s they've had a 7 pap test program, 5 yearly from 30 to 60. So this is not new evidence. Young Finnish women won't find themselves in your position because they won't be tested in the first place.

    Here is Australia we test from an early age, about 18, and we have huge referral rates for colposcopy/biopsy/over-treatment rates as a direct result. Our program will change in 2016, but excess will again feature in our program. Excess does not benefit women, just increases risk.

    Sadly, not one country in the world has shown a benefit pap testing those under 30, but concerningly, young women produce the most false positives that can lead to unnecessary colposcopy, excess biopsy and potentially harmful over-treatment. I've always felt women don't get enough information about cancer screening and it's always presented as something we must do, we have a choice about these things and the law and proper ethical standards says it should be an informed choice. At the moment you can only make an informed choice, if you do your own research.

    So I'm sure it's nothing, I'd be cautious allowing them to push you into any treatments at your tender age. You should also, know that HPV primary testing is also, not recommended until age 30, this is because about 40% of young women are HPV+, transient and harmless infections that will clear within a year or two.

    The best program in the world for those who wish to test, IMO, is the new Dutch program, 5 HPV ptimary tests or self testing with the Delphi Screener at ages 30,35,40,50 and 60 and a 5 yearly pap test will ONLY the offered to the roughly 5% who are HPV+

    This will save more lives and just as importantly, takes most women out of pap testing and harms way.

    It's a shame you didn't get to this information before you agreed to your first smear. So many young women are put through these procedures, it's all so unnecessary, you have only to look at Finland and the Dutch to see how screening should be conducted...follow the evidence and put the interests of women first. I also, think there needs to be more respect for our legal right, informed consent, too many women feel pressured into screening with no understanding of the risks and benefits and where it can lead, that's unacceptable.

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    • Posted

      As a male doctor wishing to specialise in OBGYN, I find this response quite off putting. For starters, it demeans the commitment of many men like myself who are genuinely committed to women's health issues. From Pap smears to HPV immunisation, were all invented by men. Almost all of our understanding of female reproductive physiology came from the works of great men. Unless Eliz knows better, I am guessing that the drive of many such men was a genuine interest in women's health issues.  Bear in mind that the training pathway for OBGYN in Australia and similar countries is about 8-10 years post medical school. You don’t go down this path to perv on women. In my case, the draw of obstetrics and gynaecology stems from my genuine fascination with the field is because it combines lots of general medicine and surgery. I also really enjoy my work in the area of obstetrics.  It is very renewing. The gynaecological aspects of this field is extremely important from the point of screening, prevention and treatment. I think a small inconvenience in terms of colposcopy even if conducted by a male doctor is a small price to pay relative to warding off cervical cancer. There are also guidelines in Australia for colposcopic referral. Generally, a GP only refers a patient to colposcopy clinic if two pap smears turn out positive. There are also other reasons for referral such as bleeds etc which can get assessed during your consult. 

      I reiterate the fact that the male doctors you see are professionals and their sole concern is your health. 

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    • Posted

      I've had some terrible treatment from female doctors in the past and some great kindness shown by male doctors, but what grates on me in your post is that you say "Pap smears to HPV immunisation, were all invented by men. Almost all of our understanding of female reproductive physiology came from the works of great men". This is very unfair because, historically, women were excluded from these professions until recently, and especially in the 19th century women were actively barred from any careers, medical ones especially. Hardly surprising that men forged ahead in these areas and called it their own. 

      I find it hard to imagine that a woman would have invented the widespread use of smear tests anyway, so detested are these procedures amongst women I know, and indeed, Dr Papanicolou himself had a great deal of trouble in getting his pap test accepted as a tool for detecting early signs of cervical cancer, because the test is highly inaccuarte.  A great many male doctors (Dr Herbert Green?) were and are against this test being used universally on the grounds that while it is a useful tool for high risk groups, it is a huge waste of time on the majority of women.

      What changed the fortunes of Dr Pap, were the realisation by American businessmen that it could be a huge cash cow for private medicine, such as in the US where it was tied in with employee medicals and insurance packages as an essential requirement, resulting in the huge over-treatment rates they have in the US. Business, profiteering and propaganda has been the driving force behind the pap smears success, not medical need, and the reputation of the gynaecology profession is damaged and suspect as a result.

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    • Posted

      The sad part about what you are saying is that if women had been allowed in these professions, research and science, we probably would have made strides a lot sooner in the field of obgyn.  And I have worked alongside of docs in all professions for years, male and female, good and bad, and some male docs go in to the field to perv.    
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  • Posted

    The World Health Organisation doesn't recommend women under 30 years should have smears due to the innaccuracy of the smear test at younger ages and the high rate of transient HPV viruses. It is shocking that so many young women are being needlessly put through screening at such a young age and having to go through colposcopy as a result. 

    If you were living in the Netherlands you would not have had your first smear until age 30. The NHS is wrong to promote such fear in young women, and push them into invasive testing, with nothing in the way of explanation or reasoning.

     

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  • Posted

    Hi Rachel

    I had my first smear and that too came back abnormal. I have a colposcopy booked for Monday 23rd and terrified, fearing the worst. Do you mind sharing your experience with me and what the outcome was for you? I have a 3 year old little boy and keep thinking I won't be here to see him grow up sad

    Thanks in advance

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    • Posted

      Hi Emma,

      My appointment with the colposcopy clinic went fine, it was much the same as the smear only I think he looks through a microscope type thing to get a better look. The worst part is the waiting for your appointment as lots of worries go through your mind, try not to think about it! They may be able to give you your results there and then so you won't have to wait again. 

      If they do find anything your in the best situation as hopefully they will have found it early enough to treat successfully. I've read that if they do find bad cells they burn them away there and then and if they need to take a biopsy it's just an uncomfortable feeling but not painful. 

      Try not to think on the worst outcome, you will make your self ill with worry and good luck for the 23rd. 

      x

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    • Posted

      Thanks for the reply Rachel.

      I hope everything went well with you and you got the results you wanted.

      I hope I do get the results there I don't do so well at waiting for results. It was just a shock that's all and needed to hear from others. Thank you x

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    • Posted

      I know it is a shock, I got my colposcopy appointment through within a week of having my first ever smear and immediately alarm bells began ringing. Turns out my GP had actually referred me as in there (tmi) looked a bit "angry" but really was nothing to worry about. It may be your GP has done the same. I suspect if they have to do a biopsy for you they won't be able to give you the results there and then but your entitled to ask any and as many questions as you want. Anything to give you peace of mind and nothing is too daft.

      Try not to worry over the weekend

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    • Posted

      Thank you. I'll try not to. Glad everything was ok for you smile

      Just to play the waiting game now!

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  • Posted

    Hi

    I have had two cervical cancer scares in the past.

    A colposcopy doesn't hurt. It's as embarrasing and uncomfortable as having a smear. If you don't want a male doctor, you can go to the hospital to the GU clinic and have it done by a female.

    I needed a biopsy both times. If any changes are seen then this is a precaution. Yes, it is uncomfortable. I took paracetamol before I went and then was injected to freeze the area. Unfortunately in my case they did find early stage cancer. I had a loop excision to remove the cells. This wasn't painful.

    For the sake of being embarrassed and uncomfortable for a few minutes, it's worth it! If you can have a smear, deal with the dreaded speculum and stirrups, you can have a colposcopy.

    I'm having one next week. Third time for me. I just want to get it over and done with. Let us know how you get on x

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