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Readers Respond: Reasons women avoid Pap smears: Is it fair to require them for birth control?

Responses: 194

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Updated October 14, 2010

YOU set the agenda

A lot of the issues here are caused by women feeling manipulated...no one should EVER feel forced or be forced in the case of holding birth control prisoner, to have anything not medically relevant to the Pills. Our doctors tell me that's a BP test. All screening has risks, that's a fact and that's why they can never be laws. The only exception is in the case of a health emergency like SARS in HK and China justified holding people involuntarily in hospital. Cervical cancer is nothing like that...it's a cancer that affects very small numbers of women and it's fairly easy to assess your own risk. Our doctors offer self-test kits to high risk women who can't test for whatever reason. Low risk women can do what they feel is appropriate. Sadly, many low risk women are pap-smeared constantly and that causes problems to women who'd never have an issue with this cancer. In countries where democratic principles don't apply to women in medical fields, you must act as your own advocate. Good luck
—Guest Chloe (live in Amsterdam)

HUGE pressure for a very small risk

Betty, You must have a great doctor. When I refused screening, I got a home visit from a nurse wanting to help me make an appointment. Can you believe it? Do they send nurses around to speak to smokers or speak to men about prostate screening...lung and prostate cancer are much more common than cervical cancer. No, they do not... The bullying nature of people involved in this screening is breathtaking. They have now received a letter from my solicitor. I don't expect another visit. Why don't they spend their time working on the common cancers, they'd save a lot more lives. I wouldn't say informed consent is respected in NZ, it's something they say because it sounds good, but at the surgery, it's the same arrogant treatment.
—Guest Leah

Controlling women is wrong!

I want to make my own decision with screening, not be pushed around like an infant. Critically impt information is hidden from us. I have an English fiancee and now know, we're all being conned...it's that simple. I can't operate with American doctors so I'll make do until we move to London next year. My fiancee can't believe doctors can get away with saying...these exams and test have nothing to do with birth control, but we hold them to force you to have totally unrelated checks. Checks that should be your choice! Then I find these checks are not done in the UK. No smears before you're 25 and then 3 yearly or you can sign a form and skip them altogether. I've found a Dr in London who is skeptical about the value of screening and is happy to give me all the information I need and I have a choice. She disagrees with the official/unofficial disrespect and breach of a woman's right to make her own decisions about cancer screening.
—Guest Rina

Living in the Dark Ages

I was so traumatized by a forced gyn exam to get birth control that my husband and I use condoms instead of BCP's. I don't see doctors and have a great naturopath. None of this is related to the safe use of the Pill. It's like saying all men must have checks for testicular and prostate cancer before they can get something totally unrelated like Viagra or some other medication. This is paternalism at its worst. I can't understand why so many women go along with it and how educated females could possibly agree with this practice. BC should be readily available so people can take proper precautions. Men can make their own decisions about medical checks and so should we... As a result of that first exam (I would say assault) I won't go near a Dr again. I have nothing but contempt for the medical profession. Feminism achieved nothing, we're all still in the Dark Ages. Why did they bother to give us the vote when we have no rights at all in the medical world and many think that's fine?
—Guest Amy

Be careful

I had paps as directed and the testing started at about 16 when I was still a virgin. I got an abnormal pap at 17 and had a cone biopsy and ended up with an infection. It was a devastating experience and the lowest point in my life. I have a lot of scar tissue on my cervix and haven't been able to get pregnant. I'm told I'd need medical assistance, which all sounds revolting. We've decided to try adoption. My doc was honest with me. I shouldn't have been tested so young, it causes incorrect results. I didn't need that cone biopsy, I went through it for nothing. Now doctors have come clean and have actually said no testing before 21. They have known for many years this testing destroys the lives of young women. The evidence was there from the UK and Europe. Never accept a doctor's advice and be extemely careful with this test. Most of the "information" we recieve is deliberately put together to get us to test, not to inform us. It's not truthful and omits really important facts.
—Guest Adele

This is bad

We've used condoms for 14 years because my wife won't agree to have an annual physical. I understand why she doesn't want it, but it means we can't get hormonal birth control. I resent doctors using their authority to block women from pills until they meet their demands. I think it should be up to the woman whether she wants preventative screening. I know these exams and test have nothing to do with the pills, it's just a way of taking away a woman's right to choose. I do find it shameful that we as a society allow this to go on and on. I'll keep using condoms, the alternative is far worse. I'm not asking the woman I love to "submit" just to get Pills. I've never faced anything like this...as a male I do as I like. Doctor's do seem to feel they are somehow entitled to mistreat women and that is something we all need to change. I have written a few letters complaining about the situation. Anyway, condoms are not so bad, we can both enjoy our sex life, free of exams and tests.
—Guest Mike

Respect for women's rights please.....

Historically, the medical profession has always treated women very badly and that usually means taking liberties with our bodies and dignity. The disrespect is well entrenched and cancer screening has resulted in another paternalistic exercise in the abuse of women's bodies. Men are respected and their informed consent matters, women are treated like bodies that can be manipulated and harmed. People talk about the loss of bodily autonomy, I don't think doctors have ever regarded women as having bodily autonomy. The harm caused to the majority of women by screening is a hidden shame. Most women harmed never consented, wanted or needed the test in the first place. I'm hopeful a class action will result in a breaking down of the accepted attitude that deceit and unethical tactics can be used against women, but never men. If women don't want this testing for whatever reason, like men, they should be free to refuse. Holding the pill is an example of a unethical tactic...like many others.
—Guest Law Student

gyn exams are not part of womanhood

I am 25 years old and I have not had a pap smear - only a pelvic exam when I was 17. It was painful after that I refused to have any more gyn exams. Recently I went to the doctor for the flu. I was so dehydrated I could barely walk. As soon as the nurse came in she asked me the date of my last period and then the date of my last pap smear. When I told her that I had never had one, she looked at me like I was crazy, rolled her eyes, and shook her head. She could not believe at my age I had not had one. She keep saying that's not good - that women's bodies are so complex many things can go wrong. The fact that I had not had been having regular gyn exams seemed to personally offend her - like I had broken the law of being a woman, as if it was unspeakable that I had not had a pap smear. The doc didn't mention a pap smear and I would have not agreed to one anyway. I'm sick of hearing all womenn need to be responsible and go to the gyno. You never hear about a woman's choice in the media.
—Guest kleigh

Risk assessments are important

I don't avoid them, I've decided not to have them. My husband and I were high school sweethearts and lost our virginity to each other at 18. You can't get HPV from a virgin. Testing runs the risk of false positives and then ending up having laser treatment or some other awful treatment. My risk of this cancer is too low to worry about. Dr's still try to screen me, but I'm a Uni graduate and can hold my own. All screening should enable women to assess their own risk and make the right choice for them. It's absurd to say we all have the same risk. Some women might prefer to accept the small risk, because they know they wouldn't cope with hospital treatment for a false positive. The risk of that happening is high although doctors will whitewash over that. The pressure we face is because doctors fear law suits and all this treatment brings in lots of dollars. I agree with the others...it shows disrespect for women and a lack of concern for our rights, heath and autonomy.
—Guest Alexandra

Check the risk factors

I had cryo at 21 and then had trouble getting pregnant because of scar tissue. An English Dr said I should never have been tested at 21 because it results in bad outcomes. We get treatment for something that looks abnormal...but its actually the normal changes that happen in young women. I now follow that doctors advice as I have no wish for more damaging cryo. I was told any young woman having cryo or anything else for an abnormal smear doesn't need that treatment and shouldn't be having smears at all. They recommend paps when you turn 25 (she thinks 30 is safer) and then 3 or 5 yearly. After looking at the risk factors though...my risk is so low, I'll send her an email and get more advice. I might not have them at all. I was told my risk of having more cryo etc was quite high while the risk of cancer very low. It might not be worth it, the test has done enough damage already. Your Q: No, it should be an option. It's not fair to force tests on us that can have bad outcomes.
—Guest Amber

Weird system

After reading this thread, I asked my Dr some questions. My Dr told me the insanity that prevails in the States is about money and fear of being sued... Your doctors treat women very poorly..they prefer to over-screen and over-treat, harming you because they think that's the better option for THEM. Fear of being sued is the motivator and making heaps of money. My Dr said many women end up with serious injuries as a result of your system. Our doctors recommend pap smears 5 yearly from 30 but not one has ever been rude or put pressure on me. I'd leave and find another Dr if any tried that.. I get the Pill with a blood pressure test. The stirrup thing you have is not something our doctors recommend. My Dr said it's absurd to say a healthy woman needs that and says it would also hurt lots of women. I think you should fear your doctors, not cancer!
—Guest BJ

Healthcare - don't make me laugh!

My sister had a cone biopsy in 2007 at age 23, it was negative. The experience was so traumatic that she developed post traumatic stress disorder and an anxiety disorder. The whole experience was brutal. Her psychiatrist said she often sees woman adversely affected by screening. She totally disagrees with forcing and pressuring women into testing. She told us my sister's risk of cancer was too small to calculate and all women face a fairly high risk of having negative biopsies. My sister will never have screening again. We're hopeful she'll recover shortly. My sister was placed under extreme pressure to screen and given no risk information whatsoever. Her psychiatrist has written to her GP and to the screening authority complaining about their conduct. She says my sister could take action as she didn't consent to the test in the first place. My sister now has cervical stenosis and will have issues in the future - all for nothing and to cover a minute risk of cancer.
—Guest Monica

Leave me alone

GL, your post hit a nerve with me. I faced the same horror...abnormal pap after abnormal pap and all the biopsies were normal/negative. My doctor tried to keep me on this roller coaster nightmare. I think this adds up to big bucks for doctors and they don't seem to care about what they are actually doing to us. This bad experience has affected me negatively. I avoid doctors altogether now, haven't seen one in 15 years. I see them as people who dishonestly harm women and strip away our dignity. None of this is good for women, it's good for doctors. The damage they cause should not be brushed under the carpet - we all matter, not just the small number who get cancer. I think women are treated shockingly by the profession...we're lied to, ordered and scared into tests and exams, our dignity is erased and our health is taken away. I now hate being a woman. Doctors have convinced me women are dirty and disease prone. Instead of embracing our femaleness, it's turned into a bad thing.
—Guest Sue

It's offensive...

The accepted thinking that women are not entitled to make their own health decisions and do not have the right to bodily autonomy is totally abhorrent to me. The women who also endorse that thinking should be ashamed of themselves - what did we fight for all those years ago? To accept that women have no say in penetrative vaginal exams for a rare cancer with a test that often leads to harmful and painful biopsies or cryotherapy for nothing is shameful. To make healthy women think their bodies are hazardous and need regular probing, scrapping and palpation is absurd and offensive. It is a sick way to think... The constant indignity, pain and suffering that flows from the regime called women's health is far more harmful than cervical or any other sort of cancer. The damage done "supposedly" to fight cancer, is nothing more than using women's bodies for financial gain. I protect my body from "women's health" - my chances are much better with cancer!
—Guest HE

Find the right Dr for you...

I've never agreed that women must do as they're told and are not to make their own decisions with healthcare. Informed consent is a principle of screening for a reason - risk to a healthy person. The actual facts seem to be suppressed when it comes to women and screening and the attitude is, do as you're told, even if it hurts and upsets you. I strongly disapprove of this attitude and think big changes are needed. Every woman should find a Dr who respects her as an adult - freeze out Dr's who treat women like children - let other women know to stay away from them. My Dr does not agree with screening at all and so his patients are free to choose - a nurse does testing for those who want it. I see a female dr who works in his practice even though I've rarely needed an embarrassing exam - I've had one urinary tract infection in my 37 years. I wouldn't put up with the pressure many women face, I'd find a more respectful Dr.
—Guest Berry

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Reasons women avoid Pap smears: Is it fair to require them for birth control?

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