Gyn. Pelvic Exam - Feel Violated
 

Can anyone give me a good reason why we really need an annual pelvic exam?

My point:

1. The primary reason is supposedly to detect cervical cancer, which is almost always caused by the HP virus.
2. All of the other stuff that they do, i.e. feeling and probing and checking every single part of the female-specific anatomy, has nothing to do with detecting HPV. So, why do they need to do it?
3. HPV is a sexually transmitted disease. We don't have annual testing for HIV, or any of the other lethal STDs, so why do we need special annual procedures to detect HPV?

My theory #1: Most women will do anything a doctor tells them to do whereas most men won't see a doctor unless taken to one in an ambulance (yes, this is hyperbole but you get the point).

My theory #2: We don't really need this. In the old days, it was an excuse for doctors to fondle women in every conceivable way. Today it's "the way we've always done it", i.e. a practice blindly followed by doctors, including women doctors, because it is part of standard medical practice.

Take a look at the following link, which describes the "procedure" for doing a pelvic exam. It explains each of the procedures involved. Most of them are "checking" for abnormalities. What kind of abnormalities are they looking for and do they *really* need to do this every year?

http://www.medinfo.ufl.edu/year1/bcs...vic/index.html

I have not had a "routine" pelvic exam since I went off the pill. I absolutely hated them and only had them done because the doctor would not give me an RX for the pill unless I had a pelvic exam every year.

Now that I am not on the pill, nor any other form of birth control with my husband, I can't be easily blackmailed.

BTW: When I have sex with anyone other than him (or when he has sex with anyone other than me), rest assured, we practice safe sex. Any risk I have of cervical cancer would also translate into a risk of AIDS and, as I indicated, no doctor has ever suggested that I get an HIV test every year.

Can anyone give me a good reason why a doctor should have to fondly my labia, clitoris, ovaries and uterus to see how tender they are?

Why do I care? It has nothing to do with pain or discomfort. In fact, it would be easier for me if they would stop trying to be so gentle and careful. If they used a cold speculum coated in sandpaper (sterilized sandpaper, of course), it would at least give me something to focus on so I cold ignore the feeling that I'm being raped.

The gentle hands and probing fingers, especially at the beginning of the exam feel *way* too sexual for my taste. It also doesn't help to have a woman doctor, since women are not a sexual turn-off for me. Getting fondled by a woman is no less of a sexual act than being fondled by a man.

I also hate it when they tell me to relax and move my knees apart. It just feels like, "Lie back, spread your legs really far apart and let me fuck you with this nice metal expanding dildo.

(Note, btw, in the medical procedures that the doctor is supposed to touch my inner thigh before touching my anywhere else. The idea is to make it easier for me. Exactly why would I want somone lightly touching a major erogenous zone unless the purpose was to get me off?)

If I had my druthers, and if it really needed to be done, I would have my husband do it. Then I *could* relax and let it be sexual. I wouldn't mind it if hubbby fondled anything he damn well wanted to fondle... He inserts things in there on a regular basis. He could be nice and gentle and I could even get turned on by it.

OK, I know that I'm venting here but am I being that unreasonable?

All I will say is this:

If it weren't for the annual pelvic exam, the cervical cyst that my doctor found could have become cancerous if left untreated. No, cervical cancer does NOT run in my family. No, I have never had any STD's or VD's or HIV etc... You may feel violated, you may feel that it's not necessary. But I assure you that there are hundreds of thousands of women who feel otherwise.

There is nothing sexual about the exam. Exam procedures vary from doctor to doctor as well. If you were uncomfortable with your doctor, you should have found another one. I had gone for four years without going for my annual visit, and I got angry with myself for doing so. After hearing about friends of mine who were found to have breast cancer, uterine cancer, and ovarian cancer, I vowed to never miss another year again.

It's your body, do what you want. But from my understanding, neither you nor your husband would be able to diagnose a cancerous cyst on your cervix. And these cysts can happen without being sexually active.

You asked if you were being unreasonable. My answer is, "Yes, you are." Take the time to find a physician who you are comfortable with, one whom you can talk with about your concerns, fears, what makes you uncomfortable. There are good doctors out there.

I'm with Jadzia on this one - cysts, fibriods and tumors can develop without any extrenal symptoms. The pap smear detects signs of cervical changes which can signal the development of cervical cancer. HPV is not the only cause of cervical cancer.

For the last year I have had to have paps every 3 months because I had level III dysplaysia( the last step before cervical cancer), and had to have part of my cervix removed with laser surgery . If I had skipped my annual I would most likely have developed cancer by now.

I feel as uncomfortable about breast exams as you do about pelvic exams, but I am very lax about doing them myself, and I am never sure just what it is I am feeling (besides the obvious) but I have the exams because I am rather fond of my breasts and I would hate to lose them.

Thanks, Jadzia, for saying what needed to be said in firm enough terms to be effective without crossing the line into being harsh.

I think what I'm asking is for you and the others here on TFP to help me get past the anger, frustration and other emotional stuff so that I can make some kind of rational decision.

So, please take me with a grain of salt on this issue. Most of all, if I sound like I'm angry at you or anyone else, please filter that out as you read this post. I'm really not. I just can't talk (or write) about this without getting angry and needing to blow off steam every other paragraph. I've tried. (Perhaps I haven't tried hard enough but I have tried). I've been to five different doctors for pelvic exams (one before going to college, two at college, two since).

When I was in school, I couldn't get a doctor to talk to me seriously about much of anything, especially about this.

I tried talking to my most recent MD about how I felt. Having been out of school for a while, I felt like I wasn't a kid anymore and finally had a right to my own opinion. Even then, I could not get her to take me seriously. I couldn't get her off of "why are you concerned about this" and onto "why is this even necessary in the first place". It's as if they're not to be questioned; their judgement is absolute. Us ordinary women aren't owed an explanation of what's happening and why.I guess I would feel better about it if it weren't for the fact that most breast cancers and especially most ovarian cancers aren't caught by physical exams, they're caught by mamograms and/or women finding lumps in their own breasts, or in the case of ovarian cancer, they just don't get caught all that often. I guess that's part of the problem. When I'm in a doctor's office, it doesn't feel like it's my body.OK, that remark I made about my husband doing the exam was not intended to be serious (I hope I didn't sound like I was being serious at that point). I was blowing off steam and trying to express the feeling of frustration.Is this true? If I could get a straight answer from a physician about whether HPV can be transmitted non-sexually (i.e. is it similar to a yeast infection) it might go a long way toward my feeling like there's a real purpose.I'm perfectly willing to admit that I'm being irrational. Having said that, I wish I could get a doctor to *be rational* instead of dogmatic and patronizing.How do I find one? How do I find a doctor that will treat me like a thinking intelligent person rather than a lab specimen?

Thanks for listening and putting up with my temper tantrum. :crazy:

That is the most important sentance I've seen so far, and it's very true. For some reason you are under the misguidance of HPV being the ONLY cause of cervical cancer. Cysts happen (much like shit does).

Finding a doctor that you are comfortable with can take a lot of time and patience and interviewing. Not just jumping right into an exam. I'm not saying it's easy. The first step, however, is asking friends and family about the doctors they go to. Asking about the good and bad. Then make an appointment to speak with one, not necessarily for a pelvic exam, but to sit and talk. Sometimes this eases fears.

I don't know where you are located in the world, but if you were in my location, I would have a handful of OB/GYN's to be able to send you to. And I could guarantee you wouldn't feel like a piece of meat on the slab.

This is one of the main things that drives me to choose any doctor or dentist (or even my hairdresser, believe it or not). If you, as a professional, cannot tell me what you are doing while you are doing it (or just before) and why, then you are not going to be doing anything to me at all. I like to be informed, and I will question whether something is totally necessary. Imagine my doctor's surprise when I started questioning her about the coloscopy... but she told me beforehand the entire process, and then during it she explained everything just before it happened. It really did put my mind at ease.

This is the type of cooperation you need to find in a doctor. I found it. Other's have found it. You can find it, too. Seriously, don't skip these types of exams. You won't realize how important they really are until it's too late.

pelvic exams are NOT fun, but neither should they give you the feeling of being violated and raped. i think, mayhap, a change of docs would be a VERY good idea... I go to the health center at my school, and while it's no fun, i've never felt like the women with their fingers in my pussy were doing it for any other reason than that was their job and they were concerned for my ongoing health. With a LOT of cancer going back on both sides of my family, i have to echo galaxygirl with the sentiment that although the exams are a pain, i am fond of my body and would not like to lose part of it.

edit: or, at least, lose a non-vital part. i'd rather go 1-boobed then w/o a stomach, like they're about to do to my grandpa. :|

OK, let's set my emotional issues aside for the moment (as best I can).

I may be mis-interpreting what I am reading, but as I understand it, HPV is, in fact, an STD and does cause "essentially all" cervical cancer. I encourage anyone who has any doubts to read further at this web site and the American Cancer Society web site for themselves. I added the orange color for emphasis and all text within the [] brackets is mine also. I'm not particularly happy with the word "essentially" and will try to find a reference that clarifies this.

Also this is only a partial page from an extensive web site on the subject. I would encourage anyone reading this thread to visit the site and read as much of it as your "dry reading tollerance" will allow. This next part put a ray of sunshine in my day (even this late at night)...The ray of sunshine is due to the fact that I am 28 years old and will, (assuming the test proves negative) be able to get by with a test only every three years.

I don't like it BUT I would have rather have a pelvic exam anyday then go to the DENTIST.

I hate the dentist.

maybe i'm just a sheep here, but i always just figure find a doctor you really like and then trust them on it. i work as a cashier, and as bad an comparison as this may be, it always pisses me off when customers don't trust me on stuff. i understand why some might be hesitant, but it's my job, it's what i do anytime i'm not in school. i know my groceries. so, yeah, bad comparison. but i kinda figure it's the same type of thing. they go to school for such a long time and most have some experience clinically, and i figure they're just trying their best to keep me at tip top shape. my doctor right now is sooo kind and thourough in everything she does and i totally feel like she is looking out for me. but i understand that it may be hard to find a doctor that you can trust in that way. i wish you the best of luck.

I don't know, I've never felt violated during any physical or medical examination. It just all seems so routine to me, and I tend to think that it's all for my own good and personal well-being, so getting regular check ups for anything is okay by me. My physicians never treat me like a lab experiment, so I guess that helps me feel more comfortable. Surprisingly, the only thing that makes me uncomfortable is when my gynecologist (a woman) asks me about my sex life, and I don't usually share those with anyone (despite posting on TFP on ocassion).

LOL, yeah, I dread those questions "are you sleeping with more than one partner" lady, my answer to this question for 3 years now, has been no. so... no.

You and me both girl! I also prefer a woman OB/GYN

Hi folks...

I feel better now.

Please read my journal, entry #19. It will be painful to read but I think it will be a good cathartic exercise.

I would like Jadzia, Cheerios and Galaxygirl especially to read it. My thanks to you for replying so quickly and skillfully Thursday night.

Thanks to the rest of you also who have contributed to this thread.

Shannon (and anyone else interested in this topic), please read entry #20 in my journal: http://www.tfproject.org/tfp/journal...72&action=view

You are welcome. I read your journal and was tuched to be mentioned, and I'm sure I can count on you to bitch slap me into shape when I need it. :)

Oh, yeah... yup, I got my palm all nice and warmed up and ready to go any time you need it...

Let's see a bitch slap is with the palm and a pimp slap is with the back of the hand... right?

For now, hows about I give you a nice big hug...

I do not think every MD thinks it is sexual. However, I *DO* understand how it gets there when you are the one on your back with your legs open and the BRIGHT light really warms you up down there!

I do feel for some general practicionars though. You no longer can go to an oby-gyn, your GP can do it. Well most GP's are men and they have to have a nurse present to make sure they do not assult you. I am actually more uncomfortable with the nurse there!

I get this exam done if on the pill or not. My best friend had breast cancer at 33! My GP found a lump in my breast when I was 34 and of course I almost went thru the roof. I couldn't find it till he pointed it out.

I go annually to make sure I don't miss anything.

Just so you all know, my issues are getting resolved...

I'm going away in a few days to be alone with my husband and tell him about it. Having done that, I'm quite sure that he will make sure I do what I need to do... and get me through it... and help me get past something that should have been resolved years ago...

Thank you all for being there...

More info in my journal: http://www.tfproject.org/tfp/journal...ournalid=27572

Entries 19, 20 and 23

i know its 2007 and i'm definitely not sure if you are still an active member but i agree on the violation...i get so pissed at this procedure...and honestly i think guys should be tested too for those diseases that might make us women so vulnerable...i don't know whether we should accept things just like that by science (not like im super religious) but honestly tapping mother nature might not always be good either..i wonder what women did centuries ago? also its so annoying having someone stare at you in your privates unless its someone you have chosen

What did women do centuries ago? They died of female cancers that went undetected. Cervical cancer is not the only female cancer that a woman needs to be concerned with, there is also Uterine and Ovarian (in case there happen to be be additional misguided women out there)

It absolutely stupid in this day and age for a woman not to have her yearly exam....from the time that you start having sex until you die (pretty much) My great grandmother got ovarian cancer when she was 70 and died from it, my other great grandmother got breast cancer at 80 and died of it. \

Dont like your dr? go find another one, and another and another and another until you find one that you can deal with.

No this is not something any woman enjoys, I dislike having to time having intercourse around it and then waiting a day or two to have it afterwards because Im sore. I dislike having to lay on that table and "scooch my butt to the end" I dislike realizing I didnt shave my legs completely and laying there with my feet in the stirrups realizing I have hairy knees...but you know what?....

I'd dislike being dead a whole lot more and Im sure my hubby and my daughter would too.

Got an issue with a male dr? there are PLENTY of female doctors that do gyn exams, and guess what? THEIR hands are smaller lol

Its what? an hour once a year (as long as the test comes back ok) to insure the well being of your body......why do you want to become a cancer death statistic?

There are also plenty of female nurse practitioners who specialize in family planning practice and do annuals. I've been getting mine from LPNs for the last four years via a program called the Family Planning Project (via state funding, they cover exams and family planning services, including birth control, for low-income females) for free.

Every woman should get her annual exam. It's just part of being a woman and having all of our sexual organs on the inside. How many women look at their vaginas on a regular basis? Not many, that's who. When was the last time you looked at your vagina? Do you even know what your vagina should look like when it's healthy? How will you know if it looks abnormal if you don't know what it looks like normally? THAT is why we get annual exams. We don't look inside of our vaginas or check our cervixes ourselves on a regular basis, so we should have a doctor or nurse practitioner check for us once a year. It's key, as Shani said, to early detection.

Additionally, it's a great opportunity to talk about your sexual health with a health practitioner, and learn about new advances in contraception or other sexual health products.

Hmmm...angela146 becomes a "loser", but angelana2 renews the same thread?

Feeling violated from a pap? Sheesh, grow up. I doubt guys are thrilled about the "cough" test either.

I so agree with you on this!!! From the time I was in grade 5-7 I was constantly seeing dentists, orthodontists, and periodontists (braces, funfun). I would much rather get a physical than have to spend any more time in a dentist chair.

I don't much LIKE getting a pelvic examination, but I went just this week and the actual time spent down there was seriously only a few minutes. In my opinion it's worth the time to check things out. If you're uncomfortable with it and don't like getting it done that much, don't. It's your body and if you hate it that much, who cares if you don't get it done? Personally, I will continue to get them done as I don't mind THAT much and find the potential rewards to outweigh the temporary discomfort. As for it being in anyway sexual, I think for 99.9% of doctors, it is anything BUT sexual. They look at body parts as just that, body parts. If they don't, then I think there is something wrong. I don't think there are many doctors out there that would consider a pelvic exam/pap smear to be sexual.

I love my doctor. She has saved my life twice so far. SInce my abnormal pap last month, she may indeed be saving my life again. Hell, we talk the whole time she is doing her peek and poke visit. First name basis, laugh and tell jokes, catch up on family situations. She even made me promise to bring in pictures from the wedding and honeymoon.

You think a pap is bad, wait til you have a kid. Its a regular crotch carnival, especially delivery.

Do whatever you wish, we can not talk you into doing otherwise.

Yeah, I thought this was fishy, too.

The bottom line is that annual pelvic exams are for YOUR protection, not your doctor's jollies. They detect a lot more than just HPV or cervical cancer (as has been discussed to death above), but just for the sake of beating the dead horse, here is a list of things that doctors are looking for in a pelvic exam:

A pelvic exam may be done:

* As part of a woman's regular physical checkup. A Pap smear may be done during the pelvic exam. For more information, see the medical test Pap Test.
* To detect vaginal infections, such as yeast infections or bacterial vaginosis.
* To help detect sexually transmitted diseases (STDs), such as chlamydia, herpes, gonorrhea, trichomoniasis, or human papillomavirus (HPV).
* To help determine the cause of abnormal uterine bleeding.
* To evaluate pelvic organ abnormalities, such as uterine fibroids, ovarian cysts, or uterine prolapse.
* To evaluate abdominal or pelvic pain.
* Before prescribing a method of birth control (contraception). Some methods of birth control, such as a diaphragm or intrauterine device, require a pelvic exam to make sure the device fits properly.

(from women.webmd.com)

Look, nobody's making you do it. It's your choice to do it or not. If your emotional issues are such that you don't feel comfortable with it, don't do it. But know that you are choosing to accept the risks of not having an exam. If you would like to have the added security of having an exam done, then grow up and get over your issues, which surely are not limited to this venue.

P.S. Quit acting like a victim.

I agree with the original poster, even five years after she posted. I admire her fortitude in going against the mainstream mode of thought and daring to question this age-old practice of female examination.

I agree that if it wasn't for pelvic exams, some women would have serious health problems or even be dead. In those cases, the exam was a helpful, lifesaving tool.

Most modern women don't realize the centuries of history involving examination of their genitals, and they were not all pleasant or with ethical treatment to say the least. Modern women also need to realize that just because one individual does not perceive the exam to be invasive does not mean that other women should feel this way.

The history of gynecology is a seedy one; furthermore, this history is not common knowledge to the average woman. Couple that with individual sexual perceptions and experiences, and the by-product is a woman who feels adamant about exposing what is private and sacred to her to a total stranger. This is perfectly understandable.

I feel violated, too, regarding this exam. To me, it is an event which has very, very socially-charged and sexually-charged mores that are expected to be left at the door in the name of good health. If you personally don't feel violated by this, that is fine, but then this discussion is not for you, either

If you feel "violated" then I would suggest getting another, and a female, doctor or PA.
At my last exam, the conversation went something like this:
She: Yep. The vaginal walls are thinning and there's some dryness.
Me: Well, that's just because I'm not thinking good thoughts at the moment
She: *chuckle*

I truly doubt I could have that exchange with a male doctor.
And because my doctor is older than me, she's been there, done that and understands the phases she's seen me in these last 15 years.
If you go in with dread, you feed the dread. Some things have to be done and you shouldn't feel "violated" or fearful when doing them. We all have a personal obligation to our health and well being.

A woman I once worked with had a baby and less than two years later, her "periods" wouldn't stop. After a few months of constantly bleeding, she went to the doctor (she too hated being examined) and was found to have a large fibroid tumor that had broken thru her uterine wall. Considering this occured in less than 2 years, what would have happened had she waited even longer? And, had she gone for her yearly, more than likely it would have been found before the damage was as extensive as it was.

Please, and I ask you respectfully and politely, do not tell me how I should and shouldn't feel: "You shouldn't feel violated." I'm not insisting that you should feel violated. I realize that not all women perceive this procedure to be invasive, and that is fine, but invalidating others' feelings is not constructive.


Though the exam may have a greater purpose in spite of the unpleasantries, it still doesn't change the fact that some women are experiencing what they perceive to be invasiveness of their sexuality. Perhaps they were sexually abused -- even by a doctor. To them, the end justifying the means is highly questionable because the exam is causing as much or more damage as the disease itself.

You misread the intent. "You shouldn't feel violated" because, well, no doctor should do anything to make you feel that way, not as a dismissal of your emotions. "Shouldn't HAVE to feel" might have been better wording.
If you or anyone else has been personally violated then that's an issue that needs to be dealt with. The vast majority of medical practioners don't see you as a sexual being-they're just doing their jobs to keep you healthy.
Having trust in your medical practitioner is part of the process and if you don't have that trust, then you need to look elsewhere.
I don't see it as anything sexual any more than I would see a mammogram or teeth cleaning as sexual. It's a process in health maintenance.
This isn't 1908 when doctors used to think that orgasm would cure a woman's "hysteria" or that removing her reproductive organs would make her sane.

I've actually studied the history of sexuality closely in university, and I have to say that when it comes to the practice of medicine, specifically the field of gynecology, you're right in one thing--yes, there is a "seedy history" there, but you are doing modern doctors a disservice when you imply that they are somehow equal to those quacks because of that history. Quite frankly, the implication is offensive. The field is now more regulated than it was then, for sure.

Furthermore, there is no need to go to a gynecologist or ob/gyn to get an annual done. My last annual was completed by a young female PA who specializes in family planning. It was a great experience--we laughed and joked the whole time, even while she was "down there" and my feet were in the stirrups.

If you perceive some kind of power struggle between yourself and your practitioner, and that your physician, PA, or LPN is treating you as if you don't know anything about your body and don't need to be educated about your body, you need to get a new practitioner, period. The exam, when done correctly, should never make anyone feel violated, and it should never make anyone feel ignorant, either. It should make you feel like you have a partner in taking care of your body. Ideally, your practitioner will use the visit as a time that isn't just about the exam, but about discussing your sexual health and your family planning practices in general. If that isn't happening, again, find a new practitioner.

As a PA in training, I can tell you that we are especially trained in performing a pelvic exam differently than other parts of the physical exam. Whereas we practice other parts on fellow students, for the pelvic (and the uro-rectal-genital exam on males) we have special teaching assistants come in. They teach us not just the procedures necessary, but also how to treat our patients and show respect and care in our behavior and language.

I can assure you that as a person who has both "chaperoned" for others giving the pelvic exam, and as someone who now must perform them, there is nothing sexual in our minds at all (this from someone who dabbles with females on occasion, so could possibly see them sexually). I can tell you that my male classmates feel just the same as I do - we want to make our patients comfortable, and do a good job so that we can catch any health issues before they become more complicated. That's it. Once you are trained as a medical professional, you view the body, well, differently.

I think I see MORE beauty in the human form now than I did before, but that's because of my greater understanding of how the body works, and how it's put together. We're pretty neat, you know? But it is not a sexual thing. It couldn't be. In order to think clinically, there just isn't room for sexuality.

Now, I am not saying there aren't bad practitioners out there who do cross those lines, and I hope we find every last one of them and completely destroy their reputations (since that is what typically matters to them)... but it is NOT the norm. If you are uncomfortable with your doctor or PA, then find a new one. You owe it to yourself and your health.

Kapsalis Bio
This is her faculty bio and it says nothing about her credentials regarding "gynecology instructor". She's an artist.
Source
Not even worth paying attention to, really.

I appreciate this post.

The problem some women have, and I think some offices are not aware of this, is that the exam IS so clinical. It's cookie-cutter. The woman has been reduced to a body part, not a person who can feel pain or humiliation. I posted previously about the book Public Privates written by gynecology instructor Terri Kapsalis. She dares to address these issues of doctors being insensitive and clinical. This is happening today, not in all cases, but it is not seldom either. Different women have to be approached different ways. Different women have different perceptions of sexuality. The whole gyno approach needs an overhaul.

For example, dental spas. There is such a population of people who have such anxiety about going to the dentist, that dental spas have become the rage: herb tea, ambient lighting, soothing music, massages. And this approach is effective. It is socially acceptable to have anxiety about the dentist, and the industry has addressed this effectively. Gyno exams should follow suit.

Also, and this is not directed at you personally, but there are some women who are bothered by the chaperone being in the room. Though it's tradition, it shouldn't be assumed that this is a help to the patient. She should be asked first.

There should be a diagnostic survey for each woman that will determine what kind of doctor would be most suited to her. Some women like a paternal approach, others like a clinical approach, some like a dental spa approach, etc. Then the woman can be directed to a specific doctor who practices with that approach.

But anyway, my whole point of posting is directed back to the OP: women shouldn't be ridiculed for asking the questions the OP did and for desiring a different approach. It's the "you should suck it up and take it" social stigma that drives women even further away from the gyno. (I know you didn't come across like that, but some earlier in the thread did.) Everyone perceives sexuality in diverse ways, and tradiional Western medicine has not caught onto this yet -- even in this modern age. Some of the women's wellness centers, which tend to be more liberal in thought, have caught on. Kudos to them.
-----Added 2/8/2008 at 06 : 57 : 50-----
Here in my hardback copy, it says:

"Terri Kapsalis is a health educator and performer. Her writings have appeared in Lusitania, New Formations, Public, and TDR. She has taught in art schools and medical schools..."

Look on page 8 of the book. Do you even own a copy or have read the book? I will quote it for you:

"I approach this topic as not only a medical consumer, but as an educator and performance practitioner....I was working as a gynecology teaching associate for a Chicago medical school, teaching a small group of second-year medical students breast and pelvic exams on my own body....Soon thereafter, I became a member of a women's health collective, working as a health educator, teaching women breast and cervical exam."

Sorry, but I will take what her university stats say over what she claims in a book.
Fact is, she is not of the medical community, her main career is as a performance artist and her claims are, at best suspect. If I want to sell a book, I'm certainly not going to promote myself as someone who's just a writer with an opinion-I'm going to embellish, exagerate and promote.
For anyone to take the musings of ONE person as fact is, quite honestly, ignorant. It is not educating oneself, it's finding one thing that agrees with what you think and calling it fact.
But, that is, after all, your choice. Let's hope it's not a wrong one.

Drawing conclusions about a book's authenticity and the author's experiences before actually reading the book is ignorant as well.

Perhaps, but I took the time to read about the author. By finding out about who writes what, you can be in a better position to make a decision about what to read and research. It's no different with finding a practitioner who can fill your needs. Research and trying to find out as much as you can allows you to make an informed decision regarding which direction to go.By researching the author, I am in a position to accept or reject what she writes. If all you have as your information is one book written by one layperson, your information is sorely limited. And when your information is limited, your choices suffer.

ngdawg,

Certainly you are free to accept or reject what literature you deem worth your valuable time, but I think you still make a hasty, biased judgement.

Kapsalis' book has 28 pages-worth of footnotes and bibliography; in other words, the information she cites come from (for example): The American Journal of Medicine, The First Pelvic Examination by Julius Buchwald, M.D., Evolution of the Gynecologic Teaching Associate. by Robert M. Kretzchmar, M.D.. But if they are not credible sources in describing the evolution and practices of gynecology, then give examples of what you personally find to be credible. I'd be very curious to know.

Whether or not Kapsalis has a medical degree or not is irrelevant to the reason I mentioned her book. I brought up her name to make the point that she is one of many women who recognize the deficiency that still exists in traditional gynecological exams. Yes, it has evolved since the Victorian Era of vibrators, but it still demands improvement. In fact, putting the book aside, there are webpages, blogs, and message boards full of women's gyno horror stories describing how they were mistreated or humiliated physically and emotionally, some never to return to any gynecologist, ever.

This was my whole point in bringing up the Public Privates title: while gynecology has evolved, it hasn't evolved everywhere, and the women are paying a very high price as a result.

A woman can research all she wants to find a doctor, but there is only so much that can assure her of a humane, dignified experience until she actually experiences it in the moment. There are no guarantees, especially in emergency situations where she doesn't have a choice.

And yet you reject the very notion of annual exams based on the minority of incidental data.
Had she chosen to write a book about the strides and advancements in women's health would you then accept or reject the data used?
The point is we accept what we want to accept, and when it's a negative toward an issue, we embrace it more. But negative connotations, especially as they pertain to our own personal well being, hurts no one but our own selves.
While you choose to be anti-progression and vigilant in pointing out the "horror stories", which are far outnumbered byt the advances, I choose to be pro and vigilant in my assurances that I am getting the best I can find.
In my over half a century on this planet, I have yet to be "sexually violated", the victim of poor medical decisions or taken advantage of because of my status as a female.

I already acknowledged that gynecology has evolved in the past hundred years. I stated in a previous post that the experience should evolve to be like that of dental spas, so you cannot accuse me of being "anti-progressive."

Of course there are wonderful doctors who don't take advantage of their patients. I'm not denying that. But there is also a population of doctors who do not treat theur patients appropriately, and this cannot be ignored. Neither can the patient's personal perception of sexuality as religion and culture plays an enormous and diverse role in shaping this.

All I am doing is validating the women who have had bad experiences and offering them emotional support instead of condemnation.

Is it possible for you to become an activist in the scope of women's health?
No one is condemning anything except the A*** that dare to call themselves doctors.
Cultural and religious roles in women's health are being addressed quite actively and in many arenas. What needs to also be addressed is the issue of separating those cultural and religious beliefs of sexuality from the mindset that somehow a pelvic exam is a sexual act. It's sad that that is what is happening. Regardless of whether it stems from mental health problems or how one was raised, simply validating another's feelings isn't enough. Women are dying and/or being exploited all over the world because no one "helped" or taught them this doesn't have to happen.

Did you know that women in parts of Africa that suffer aftereffects from childbirth that cause uterine wall rupture are being ostracized and disowned? The genital mutilation of young girls is widely reported on and activists are hard at work to stop this horrendous ritual, but very little is said about the women who, when giving birth, suffer a condition that tears the wall between the vagina, urethra and sometimes the rectum, causing bladder and/or rectal incontinence. The condition, called Obstetric Fistula, is almost unheard of in industrialized countries. These women are not treated for the condition, but rather tossed from their homes, disowned, their babies taken away. They can not have more children and no man, even their husbands, would want them.
It occurs because the women don't get basic ob/gyn care. Poverty as well as cultural leanings have everything to do with this.
Women like Dr. Catherine Hamlin aren't just writing books and offering support, they are doing an impossible task: treating these women. The surgery to correct Obstetric Fistula is simple most of the time.
But more has to done and that comes through education. Women need to be educated that a pelvic exam, obstetrics and gynecological medicine is NOT sexual, is NOT anti-religious or anti-cultural but life saving. And they have to know that they have the power over their well being, including getting quality medical care.

I just wanted to mention that women in Australia and the UK DON'T have routine pelvic exams - they are considered unnecessary in asymptomatic women and in fact, my GP said they can be harmful...(false positive, unnecessary further testing, discomfort, anxiety - low clinical value)
I was surprised to read that US women are expected to have all these invasive annual exams...

In Australia - women are offered cervical screening every 2 years - starting 2 or 3 years after they start having sex...but the two yearly internal has been criticized as too often and many doctors ahve moved to 3 or 5 yearly intervals.
Too frequent screening exposes women to lots of false positives and unnecessary follow-up - colposcopy and biopsies, which can cause other problems. (psycho sexual problems, cervical stenosis, problems with fertility and during pregnancy etc)

Many are also critical of testing women under 25 or 30 as these women are more likely to return false positives or have treatment for changes that would resolve without any further treatment. UK now only screens from age 25, Finland and the Netherlands from 30...and these countries opt for 3 and 5 yearly intervals - so fewer women face the anxiety of a false positive. .
It sounds like US women are over-screened - I was shocked to read some US doctors even test virgins!
Cervical cancer is uncommon (about 1% of women) and the Test is unreliable...
Of the 1% that get cancer, one third of those women will have received one or more false NEGATIVES - they may be disadvantaged by screening because they're falsely reassured by the Test and delay seeing a Dr for symptoms - so that leaves about 0.66% of women who'll benefit from the test.
All women and especially, low risk women need to consider the risk v the benefits of testing.
Annual screening means 95% of women will have a colposcopy and biopsies, yet only a tiny number will have any sign of cancer - two yearly - it's almost 78%...(Koutsky)
Sadly, women are rarely given access to complete information - without risk information, you can't give informed consent.
The General Medical Council in the UK has warned doctors about the need for informed consent and now require doctors to reveal they have a conflict of interest (paid to recruit women and to take smears), disclose to women they have a low chance of benefiting from the test and explain they have a fairly high risk of an incorrect test result that may lead to further testing. (the risk varies with your sexual history, age and screening interval)
Cervical cancer is (in almost every case) caused by HPV...
My husband and I were virgins when we married - my GP, after discussing the very low risk of benefiting and the high risk of harm - left the decision to me - no smears at all or once every 5, 7 to 10 years.

Breast exams - doctors have been reminded in the UK and Australia NOT to routinely examine breasts in women under 40 or 45...(false positives, false reassurance, low clinical value, unnecessary biopsies)
I started to have a CBE when I was 45 (every 18 mths or so)
Women are offered mammograms every two years from age 50 - I've decided not to have mammograms - there is lots of worrying research about this test - they can INCREASE the risk of breast cancer, (bruising of the tissue) have a high rate of false positives and unnecessary biopsies and they detect a slow moving cancer (Ductal Carcinoma In Situ) that roughly 40% of older women have to some degree - in most cases, DCIS will never harm you - however, once biopsied, it can become aggressive and once diagnosed, the breast usually comes off (the doctor fears liability)

I think it's really important for women to do their reading - it's the only way to safely negotiate the medical world - and US women are IMO being put through lots of unnecessary invasive tests and being overscreened...exposing yourselves to harm!

BTW the only exam required for the Pill is a blood pressure check - there are lots of articles on-line critical of the US practice of holding the Pill until women agree to unnecessary exams.
Good luck everyone....anyone interested should look at articles by Prof Michael Baum, Dr Angela Raffles (her research showed that 1000 women need to have regular testing for 35 years to save ONE woman from cervical cancer!) - also, L. Koutsky Cancer prevention, Fall 2004, Issue 4 & RM DeMay "Should we abandon pap smear testing" Jnl of Clinical Pathology 2000...

My friend has been going to annual cervical exams since she was 13. Mostly because she was sexually active at that age. (Yeah young.. but at least she was smart about it.) She ended up having cervical cancer at the age of 16. She's never had any type of STD before and it doesn't run in her family. They caught it in the nick of time and she's been good ever since.


I'm very sensitive down there.. but I actually don't mind going to see a gyno.. guy or girl. I know there are some sickos out there... so I judge the doctor by how long they take looking down there compared to what they see.

First two visits were veryyy quick. I lied down and spread my legs and scooted down a little and they lubed me up and stuck the metal thingamajig in and widened the thingers (I dunno what it looked like or what it was called.. I'm going by feel).. they took a light and checked it out then lubed it more and stuck in two or one fingers for like ten seconds. They looked up at the ceiling or towards the ground while feeling around. Then.. they took everything out.. let me sit up.. told me everything was A-OK. Oh.. they also explained everything they were doing as they were doing it.

Most recent visit took a bit longer because she saw and felt something.. and results came back as low grade cervical cancer.


Not saying that there aren't doctors out there that are sickos.. my sister has met one that was drunk at a party she went to. He said some really vile things about patients he's had before.


But, if you really feel uncomfortable doing it.. then ask your doctor to tell you what he's doing or talk about something else to take your mind off your vagina.


Also.. the guys that don't go to the doctor unless an ambulance has to take them are dumbasses and those kind of men end up dying all because they didn't want a scope going up their ass.

Nothing would ever turn me on during a pap test because I hate them.

I do agree totally about being uncomfortable with a nurse being there. When women go for these things they often have a lot of questions to ask their doctors and it's embarrassing to have an audience, so I don't ask them.

In fact, even though I do have cancer, I HAVEN'T HAD A PAP TEST IN YEARS simply because I don't like the invasion of privacy. I think it's terrible that women are treated like children who can't be trusted (or who don't trust their doctors). I think it's demeaning and I feel women should have a choice about whether or not they want an audience.

I doubt men would tolerate a female doctor bringin in a male while he is having a prostate test and I don't understand why the medical profession is so much against WOMEN BEING GIVEN THE RIGHT TO CHOICE! This is an ultra ultra sore point with me and it makes me literally HATE the medical profession.

They bring in the nurse as much to protect you as to protect themselves from accusations. They should also have time to spend with you *clothed* to discuss any issues in private.

They should but they almost never work that way.

The way it works in most office is that the woman books the appointment six months in advance. When she arrives, the nurse rips the paper off of the table and tells the patient to get undressed and get on it. Then the doctor comes in and does the test. Then he leaves while the patient gets dressed. I have never in my life seen a doctor return to talk to the patient after that. They are all very rushed and have many patients to see, so they don't come back for Part II of an appointment. Even if one ever did come back I would have wanted to discuss things with him BEFORE, not after!

I realize that there are probably more doctors who are fearful of neurotic women accusing them of wrongdoing than the other way around, but still, WHY CAN'T WOMEN BE GIVEN CHOICE? Would this cause major serious difficulties? Would it be an extremely serious crime to give women a choice? What's so terribly wrong with CHOICE?

Being liberated I believe ALL women should be entitled to choice and not just a few, especially with regard to their own bodies. After all, their bodies belong to them and not to anyone else.

I can understand also that many doctors would be disgusted and/or feel threatened by bold, overly-sexed patients. I would feel the same. I just wish there was a way to give everyone rights without limiting them to only the doctor and one particular type of patient. If only some imaginative person could think of an ideal solution!

Possibly the best, if male doctors are fearful of women, is to put thousands more WOMEN through medical school. While I prefer male doctors because I'm self-conscious in front of women (knowing they like to compare to themselves just as men do), given the choice I would still rather go to ONE female doctor who didn't require an audience than to one male doctor who did.

What's stopping me from doing that?, you might ask. "The shortage of female doctors!"

..

Thanks for your article Julie51! Wish I had read it before they discovered my extremely slow moving DCIS. I had a segmentectomy about two years ago. I refused radiation and chemo after that because I didn't like the thought of either. That entire process was tough.

First I got a biopsy two weeks before the operation. The needle in that first biopsy was like a knitting needle with a hole in the centre. If you want to see what it looked like, look up the VERICHIP on You Tube. It was exactly like the needles they use to implant microchips.

Because I read about it beforehand I realized they put such things in women’s breasts to mark the spot of the operation. (Guess they figure the breast is the size of a football field). Not wanting that, I asked them to please not put them in. They’re not called microchips anymore by the way. They’re called titanium breast markers. They promised they wouldn't put any chips inside. Hopefully they told the truth!

Although the biopsy itself wasn't too painful the inflammation that followed for the next couple of weeks was bad. I described it as a swollen red hot VERY ANGRY breast that had been suddenly awakened from a comfortable peaceful sleep! The wait for the operation seemed much too long at that point, yet that was probably good because it allowed the swelling time to go down.

After a couple of weeks I had to go to get wires put into my breast so the doctor would know where to operate. Then i headed to the hospital and waited for awhile. it was even more sore then.

I guess they were telling the truth about the chips not being put in as I requested; otherwise i probably wouldn't have also had the wires put in. But come to think of it, if I didn’t have chip put in, why did they need to use that huge knitting type needle with the hole in it? I still don't understand everything.

The next day they wanted to inject some radiation chemical (Techtenium I think it was called) into my breast before the operation. By then I was afraid of all that breast mauling, feeling that if I didn’t have cancer before, I was sure headed for it now, so I declined at the last minute.

They then asked if they could at least inject blue dye so they could find the lymph nodes. Since I escaped the conscious pain of the third one, and they would do this while I was “unconscious,” so there would be no pain, I reluctantly agreed.

Eight hours later I woke in comfort in a beautiful vibrating bed but with tubes in my nose and a huge patch over my breast for external stitches. After that I dosed off immediately and fell asleep for another 8 with the same breathing tubes as well as well as morphine draining into my arm. The operation was at 2 PM and I woke permanently at 8 AM the following day -- in other words, 16 hours after the operation. Then they said to go to the bathroom to get rid of the blue liquid. That wasn't easy because the anaesthetic made me forget how and without drinking water all night, there wasn't much to get rid of. I felt good after that and wanted to go home even though they said I could stay another day if I wanted. At 10 AM I was felling so well I left.

They had great news that day. The two Stage-1 cancer lumps they removed (each about an inch) had been very slow growing so they hadn't spread to the lymph nodes. Wow! Great! Later though, I started to think, "what if it hadn’t been cancer at all, and they just didn't have the heart to say so after all of that pain and trouble?"

Seriously though, it had to be. Fortunately I had received a digital mammogram before all of this took place. That meant it was possible to purchase the pictures (CD) for $30 and take a good long look at (which i did for nearly a year before the operation because i couldn't make hide nor hair of it and could find no good explanations on the internet) . Finally I took it to the cancer society and said, ‘if you think this is cancer, please show me in this picture why." The nurse was fantastic and explained the difference between cancer and a cyst. After that there was no doubt. Cancer is so ugly in a picture compared. Had I not had plenty of time to absorb that CD in detail, I likely would never have believed it was cancer and would most certainly have refused the operation.

Once I got home and the morphine wore off the pain was unbearable! They had given me about 10 extra strong pills and I started popping two at a time. My breast was swollen and flaming red so I drove to the clinic in fear to have it checked out, forgetting I was drugged to the eyeballs.

It was tough functioning on my own. By the third day I had accidentally torn out two stitches merely by attempting to put shoes on. Of course I couldn't see the stitches because they were internal but the tearing could be felt, and liquid ran down the inside.

By then my orange-sized breast was about five times bigger than normal! It was only then that I realized I had no drain tube! When I called, they said it wasn’t an oversight. It was just the way they did things sometimes. So women should always ask about that beforehand.

Now the breast was so filled with water that I couldn’t carry the weight. I should have gone to the store in advance to not only purchase the most solid bra they had, but also one with a cup size about four times bigger than normal! There was no way a normal bra would hold all of that squishy weight up! As I moved, it would go sqwish, sqwish. it was so painful I spent most of the next few days in bed.

When i was up i walked with my arm against my breast. This continued for nearly 2 weeks for about 8 hours a day during waking time. Today when I see a woman walking with her arm against her breast I know she has just had a breast cancer operation.

The 4-1/2 inch wound from that operation is still red and sore, although the three inch one under the armpit has long been healed. Before the mammogram i had no pain whatsoever. But I think it's starting to heal now and the pain will be gone in a few months.

It's been about 1-1/2 years since that operation and i still haven't gone for another mammogram, although I do worry constantly that all of those treatments should surely foster a much more aggressive cancer in the future.

I have also since developed centre chest pain which continues for several days a week. Hopefully it's not heart damage from the blue dye or anaesthetic (After all, I did sleep for 16 hours afterward and was so tired it was an effort to breathe at all, which is probably why the breathing tube was there. With a healhty night time rate of about 40 beats per minute, who knows what the pulse reading was at the time.

I don't know if I've done the right thing. If another woman asked for advice I wouldn't know what to say. But if i had to do it over again for my self, i might have chosen a double mastectomy instead. Segmentectomies or lumpectomies generally require more painful preparatory work and have a higher risk of coming back. They also generally require more radiation (for the innocent stage of cancer I had). Again though, i did refuse the radiation and chemo.

By the way there was no detectable lump before all of this started. The entire discovery happened when my doctor insisted I go for a mammogram after not having had one for a few years. He did know I had calcifications several years earlier though.

I haven't had a mammogram since that operation about 1-1/2 years ago so I don't know if it has spread. Sticking an inflamed breast under a mammogram sounds quite silly to me at the moment -- insane to be honest. Nature never designed women's breasts to be treated so brutally, especially wounded ones.

Cancer itself doesn't hurt. It's the procedures and operations that hurt for months or years! Whether those things in themselves cause more aggressive cancers, I might not know for awhile, but the suspicion is definitely there. When you get cancer, your choices in treating it are much like playing Russian Roulette.

I realize that this is an old thread and this post will probably go unnoticed but whatever... I feel sooooo much better finding out that I am not the only woman that feels raped or violated or whatever after getting a pelvic. I've been on birth control for 4 years and this is the first time they insisted on a Pap test and a pelvic. I've only ever been with my husband and he has only ever been with me meaning neither of us have ever been exposed to HPV which would cause cervical cancer in someone in my age group (22 years old). My husband and I are not ready to start a family so we have been using birth control (we don't want to use condoms). The doctor refused give me a Rx without an exam claiming his malpractice insurance will not allow him. I am 100% willing to sign a legal waiver stating I am aware of the risks if I were to have cancers and the effect that taking supplemental hormones can have. I did research in college on breast cancer cells so I am NOT ignorant. Even with my husband there I cried and shook the whole time but at no point did the doctor ask if I wanted him to stop. I felt soooo powerless and humilitated. Afterwards he asked me if we were still friends... I am pretty sure that certain rapists use the same line once they too have "finished". At this point I don't even want my husband to touch me, so much for needing that birth control.

Twenty2,
If you and your husband were virgins when you got together, you need to be very careful with cervical screening. You accept high risks for no benefit - cervical cancer is linked to HPV, a sexually transmitted disease. (as you know)
Your age worries me as well...no country in the world has shown a benefit testing women under 30, but testing young women produces lots of false positives which means fear and worry while you wait to re-test or referral for colposcopy and usually some sort of biopsy - cervical damage can leave you with problems (especially after unnecessary LEEP and cone biopsies) cervical stenosis - infertility, infections, endometriosis and may require surgery if the cervix is scarred shut, cervical incompetence - miscarriages, high risk pregnancies, premature babies and more c-sections. 1 in 3 pap tests are "abnormal" (false positives) in young women caused by the pap test picking up normal changes in the maturing cervix. (or transient and harmless infections) CC is very rare in women under 30 and testing usually misses the very rare case anyway...these women get false negatives. (usually because the very rare case in a young woman is an adenocarcinoma and the pap is bad at picking up this even rarer form of cc)
Due to over-screening (annual testing) and including young women - the States has a very high lifetime risk of referral - 95% - almost all are false positives. (DeMay article)
The lifetime risk of cc is 0.65% but with no randomized controlled trials we'll never know "for sure" if anyone is actually helped by pap tests, if they are, the numbers are very small, less than 0.45% - after you take off the false negative women and factor in the other things that are naturally reducing the cases of cc - better condoms, more hysterectomies, less STD, better hygiene, fewer women smoking...
Anyway, many countries do not test sexually active women before 25 or 30 and then only 3 or 5 yearly to 50, 55 or 60, but in your case...you need to be VERY careful. (American doctors even test virgins from age 21 which makes no sense at all)
I'm a low risk woman and have always declined pap tests - the risks are too high for a near zero risk of cc. A high risk woman only has a remote chance of benefiting from pap tests.
I believe your doctor was dishonest with you...pap tests are an elective cancer screening test and have nothing to do with birth control. I'd report him and even seek legal advice.
Dr Robert Hatcher from the "Managing contraception" site has some harsh words for doctors who "hold" scripts. Also, see: "Women after birth control get unneeded pelvic exams" WSJ
Sadly, I can't link articles at the moment (this is my first post and you need 15 posts under your name before you have linking privileges)
The article by Dr Hatcher - search his name plus add the words, pelvic exams and birth control and it should appear....

Routine bimanual pelvic, rectal, recto-vaginal and breast exams are not recommended by our doctors - they are of poor clinical value and risk your health - they partly explain your high rates for hysterectomies, cervical and breast biopsies, other procedures and even surgery. (removal of healthy ovaries etc) See: "Questioning the value of the routine pelvic exam" and comments by Dr Carolyn Westhoff.

I think doctors who mislead and coerce women into pelvic exams or pap tests need to be challenged and reported - I know the practice is widespread in the States, but there are many American doctors working toward change.
You'll find some great references and discussion at Dr Joel Sherman's medical privacy forum under women's privacy issues - see research by Dr Angela Raffle, Prof Baum and Dr DeMay. You might also like to share your story at Blogcritics and "Unnecessary pap smears" - which has more than 4500 posts from concerned women.
Hope this information helps...

---------- Post added at 07:10 AM ---------- Previous post was at 07:04 AM ----------

The other important reference for: Sexually active women under 30 don't benefit from pap tests (only American doctors test women not sexually active - it makes no sense at all and risks their health) - See: "Cervical cancer screening" in "Australian Doctor" 2006 by Assoc Prof Margaret Davy and Dr Shorne - it's a download.
Angela Raffle's research rocked the UK in 2003/4, "1000 women need regular smears for 35 years to save one woman from cervical cancer"...she also talks about the high numbers of false positives produced by young women - 1 in 3 smears.
You'll find the reference in the British Medical Journal at Dr Sherman's site.
See commentary at, "Why I'll never have another smear test" by Anna Saybourn.

Julie25, What an ordeal...
You might be interested in listening to a 35 minute lecture at the Medphyzz site - given by Prof Michael Baum recently at UCL and called, "Breast cancer screening: the inconvenient truths"...any woman considering mammograms should listen to this lecture. Prof Baum is a senior UK breast cancer surgeon who helped set up the first breast screening clinic in the UK...he knows about screening and now has some SERIOUS concerns. Also, the Nordic Cochrane Institute were so concerned at the misinformation being given to women that they produced, "The risks and benefits of mammograms" - it's at their website.
Make up your own mind - I've passed on breast screening and CBE's are not recommended here, they don't help....I practice "breast awareness" devised by the late Dr Joan Austoker - simply taking note of the look and shape of your breasts in the mirror every morning after showering. Breast self-exam has been out for years - it leads to excess biopsies.

I dont understand why they put you through this. I am in England, where we get smear tests at a certain age - but not the horrible stuff described by some of you ladies. I did keep going back to my doctor because I had pain after having a coil. It was not taken seriously. Some years later I bought myself a gynaecologist for xmas. A very nice man, he said a pelvic exam wouldnt show what he had decided was most likely wrong with me. That from an excellent surgeon. Yep I was right, I did know my own body. Because of stuff from the coil being fitted, I ended up having a laproscopy first, and then five hours of corrective surgery. One thinks, a good specialist should know by description if these things, these invasions are necessary. I feel sorry for those of you who feel raped by the medical profession - and I dont think you are being unreasonable at all for feeling that way. I think you need to try and find a good GP - ask your friends for recommendations - its what us old bitches do.
Oh, and if you come across doctors who are particularly horrible - kindly suggest to your sisters, that they might prefer to go elsewhere. Sometimes you have to circle the waggons and protect each other.

Hmm, I never thought about it that way. I had a pap smear once at 21 because I was told it was necessary at 21 by the gynocologist even though I wasn't sexually active. I haven't had one since then(three years ago) because it was an uncomfortable experience. However, what you mentioned about other kinds of cancers would be a something to take into consideration. I wasn't going to get my second pap smear until I became sexually active.