I grew up on Our Bodies, Ourselves.

I understand the importance of looking after one’s health.

Recently I wrote what I call a diary-in-a-list when I found a pea-sized bump under my skin in an awkward place.

Here is what I did.

1.  I tried to find a mirror to do a self-exam.

2.  I finally used the one in my compact.

3. After looking at my lump, I Googled health care sites.

4.  I diagnosed my lump as a benign cyst.

THEN I WENT TO THE DOCTOR, WHO CONFIRMED MY DIAGNOSIS.  THEN THE PROBLEMS BEGAN. 

1.  My doctor barely knows who I am, because I am a very healthy person. (And that is a good thing.)  He/she knows me only from the records on his/her tablet.

2.  He/she confirms my diagnosis, but wants to know the date of my last pelvic exam. I do not have that data in my memory.

3.  The doctor asks if I have all my “lady parts.”  I do wonder why none of this is in my records!

4. But I have no qualms about putting my feet in stirrups, because I have had, of course, many pelvic exams.

NOTES ON A PAINFUL PELVIC EXAM.

1.  The speculum, an ice-tongs-like instrument that is used to hold open the vagina so the doctor can examine the cervix, is not a one-size-fits-all device.  The type of speculum used for a menopausal woman is different from that used for a menstruating woman.  (I learned this after the exam.)

2.   He/she tried to shove the speculum in.  I was in such pain that I instinctively shot up into a half-sitting position and told him I couldn’t take the pain.  I have never had this kind of pain before.

3.  He/she said he/she was almost done.  The nurse looked concerned.

4.  Instead of screaming, I endured the pain.  I was sure something was wrong with ME.  It wasn’t till later that it occurred to me the speculum was the wrong size.

5.  I went home and wept.  I had a burning sensation in my vagina and cramps.

6.  And then I went online and learned from Our Bodies, Ourselves that new guidelines from the American College of Physicians say pelvic exams are unnecessary for most healthy women.
The article says,

There are no data supporting the effectiveness of the screening pelvic examination (including speculum and bimanual examinations) in the asymptomatic average risk woman for any indication other than periodic cervical cancer screening. The procedure causes pain, discomfort, fear, anxiety, and/or embarrassment in about a third of women and can lead to unnecessary, invasive, and potentially harmful diagnostic procedures. …

There are also potential procedure–related harms. For example, researchers report that heavier women are more likely than women of average weight to report more disrespect and embarrassment during a pelvic exam. Women with a history of exposure to sexual violence are also more likely to report fear, embarrassment and anxiety.

So this was an unnecessary procedure for me.

I guess we have to research everything before we go to the doctor.  But we can’t.

I’m sure family doctors have only a two- or four-week gynecology rotation during their residency.  This is not their expertise.  And perhaps they don’t treat many post-menopausal women.

Next time, I’ll go to a gynecologist.