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

Responses: 181

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Updated October 14, 2010

Although Pap smears are an essential part of cervical cancer prevention, some women are simply unwilling or unable to have one. This can, potentially, cause other problems for them since many doctors refuse to give out oral contraceptives without a Pap smear - even though a Pap smear is not medically necessary to receive pills. Share your stories about whether you think that such requirements are unjust, or whether this "rule" has encouraged you to be proactive about taking care of your health when you might have otherwise avoided the exam.

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Fight back...

Lins, So sorry... It's awful to see the damage this testing causes and the way it devalues the lives and ruins the health of so many women...all for a rare cancer. It's crazy! Ethical screening does not have that effect, but this is something far more sinister - coercion is a very serious matter. If you can travel to Singapore or Amsterdam, the Delphi Screener is available - you could test yourself for HPV. if you're negative, you can test yourself a total of 5 times - at ages 30,35,40,50 & 60 - if you're negative and no longer sexually active or monogamous, you can forget all further testing. Look at the Delphi Bioscience website and send them an email - ask them the easiest way to get hold of the device. You DO have a right to the Pill with no exams - the only clinical requirements are your blood pressure and medical history. I'd go doctor shopping, get the Pill online or see your lawyer. Could your psychologist send them a letter, testing is clearly bad for your mental health?
—Guest Elizabeth (Aust)

CHOICE!!!

I am a survivor of childhood incest and I am emotionally incapacitated for at least 2 months due to this ridiculous test. I take the pill because of hormones that I need in order to function and an indescribably humiliated and ticked off at our system for pushing this upon us. I feel that I should be able to make this type of decision about my body and, more than that, my life in general! I would much rather get cancer (which is highly unlikely), die younger, and live a life where I do not lose 2-3 months of my life in misery by being forced to relive my childhood victimization. I believe I should have that choice.
—Guest Lins

Treating women like adults...

I'm in Europe and loving getting my pills off the shelf. Women here have better health, relationships and lives. To suggest locking the pill behind doctors improves our health is crazy. Here there are also far fewer unplanned pregnancies and abortions. Our doctors are not really doctors, they mistreat and harm women...like dirt under their feet. Think I'll stay here...
—Guest Jenny

It's your decision

It's great to see more honesty appearing in women's cancer screening, here is a doctor who has decided not to have pap tests. Women need to talk about these things and hopefully more will see this is an elective test like colonoscopies...and it is reasonable to refuse any or all screening. http://www.independent.co.uk/life-style/health-and-families/features/why-im-saying-no-to-a-smear-7577967.html
—Guest Elizabeth

Dont get it

I dont understand why doctors try to shove this stuff down our throats. I went in just to get birth control and she took out a shot WITHOUT EVEN TELLING ME WHAT SHE WAS DOING and came up to me and me having such a fear of needles freaked out and she was trying to give the the shot that is supposed to help again cervical cancer. I didnt ask or talk about that with her? she didnt evenbring it up? I said no im not getting it and she tried to convince me but no im not doing it and nor will i get a pap smear. I think they should think of a different way to do them because they are way to uncomfortable for people
—Guest Bethany

No way Jose!

No, it's not, I come from a small town and there is only one older male doctor my family mix with socially. There is NO WAY I'd permit him to do a pap test on me. I couldn't get birth control and moved away from my family to a city which gave me a better chance of protecting my life from an unplanned pregnancy. Men can decide whether they want screening, women are forced and an unplanned pregnancy risks our life, yet this is allowed to continue. I have lost all respect for doctors, they take advantage of women and treat us like pieces of meat to be manipulated for their pleasure and profit. I can now buy my pills over the border and across the counter. My health is great and my life in control. I only have one partner and he has only slept with me, the hysteria about pap tests and cervical cancer doesn't make much sense to me. I guess it's profitable and fun for some doctors to force young women into these exams.
—Guest JH

I was never a feminist until this

My doctor will no longer renew my oral contraceptives that are used only to treat slight menstrual problems without my having a pap smear. I told the doctor I would not be having the test done, now or ever, and therefore my prescription is being withheld. I have found proof from the WHO, ACOG, and FDA that this test is not required for the prescription, and that nothing found in the test would prevent the pills from being able to be prescribed. I am willing to accept responsibility and sign a waiver that the doctor was not at fault if somehow I were to develop this cancer, but the doctor will not allow it. It seems to me like this is an example of consent by coercion. If this is not illegal, it is unethical at the very least.
—Guest Amanda Smith

Unneccessary for monogamous women

Why do married women get coerced into getting a pap smear for birth control? Birth control has nothing to do with a higher risk of cervical cancer. I shouldn't have to go off the pill and use condoms (which can break and are very risky compared to the pill I am taking) in order to avoid this horrible test. Some women do not have a problem with it, but for many it causes severe pain. I am one of those people. My doctor said it was "anxiety" because she thought I had been sexually abused as a child and I was "blocking the memory". So horrible, I knew it wasn't true but how many other people hear this and get scared? The fact is, God did not intend for us to have plastic and metal crap shoved up there by some idiot doctor. I'm trying to find a place where I can refuse the pap smear and still get my birth control prescription refilled. I am not ready for a baby yet, I've only been married a year and I'm only 22. It's so upsetting that I might have to go through this horrible pain again.
—Guest SB

Scariest offer given

I was going to my yearly physical and the nurse asked my if I have ever gotten a pap smear. I explain im 21 and still a virgin and she was trying to tell me I "HAD" to get it done. my doctor came and I explained to her and she said she would try.but if I couldnt handle it .. It was ok. She didnt even started and was panic and cried.. Thank God she understand and I didnt have to get it done
—Guest Laurita

Pap smear should not be a requirement

Thank you ladies for your comments. I thought I was the only one who find the requirement absurd. It is my body and I have all the rights to what should be done. Other nation's doctors acknowledge this and USA doctors need to stop being greedy--it is all about money. I don't think they would do the pap if it was free.
—Guest Mary

Media coverage

American women might be interested to google "women who want birth control get unnecessary pelvic exams". I think this is a positive sign, more coverage of your doctors unethical conduct and this article will empower more women to pointblank refuse unnecessary exams and tests to get the Pill. There is also a push for OTC access for the Pill in the States. It should happen everywhere, it's a lot better than the alternative - coerced into invasive exams, unplanned pregnancies & abortions. I hope this article is the beginning of the end of a coercive, harmful and oppressive womens' health care system in the States. We have our problems, but nothing like American women - we get the Pill with a BP test. I've always refused pap tests, an informed decision - our doctors don't recommend the rest of your well-woman exam, but I would have refused that as well. Thanks to the moderator, this is an important thread, most sites would have deleted it ages ago - you have informed women!
—Guest Eliz52

I'm ashamed of our doctors

Katherine, Isn't it sad that Dr Sherman's point of view is rare? You would imagine he was speaking the obvious, if we didn't know better. My close friend got pregnant last year after being refused BC. She refused the well-woman exam because most of it is totally unnecessary and as a UK citizen, she knows testing before you're mid 20's or if you're low risk carries the very high risk of biopsies. Her host family have 2 daughters in their early 20's and both have had work done on the cervix, unnecessary, as usual. It's insane to be doing this to our female population. The rare case of cancer does not give doctors the right to dictate, control and harm us and destroy lives. Now an abortion will be necessary and all because doctors thinks a rare risk of cancer is more important than a real risk! Why is informed consent a laugh in our healthcare? I feel ashamed to be American.
—Guest Gayle

Thanks, Dr Sherman!

http://www.kevinmd.com/blog/2009/11/informed-consent-missing-pap-smears-cervical-cancer-screening.html Here is a rare point of view, women should be given the facts about cancer screening and have a choice. After reading lots of articles about informed consent with prostate screening, funny it's rarely raised with cervical or breast cancer screening. I guess men are considered adults who are respected to make their own decisions, whereas women are still "dependents" of others. We haven't moved forward, have we? Anyway, I thank Dr Sherman for his words, shame he's one in a million. This topic would never occur to most doctors, coercion is the norm in womens' healthcare. Ms Boskey, maybe these comments have helped you to see another side of this subject, that women are adults and informed consent applies to us as well. Hope so... The article on this site, "Why must I have a pap test to get birth control" made me cringe, the tone of the author made it sound like prison officer and in-mate
—Guest Katherine P

Treat us like men please!

I think one sentence I read recently says it all, "we recommend testing of all women from 21 because some women are not honest about their sexual histories". In other words screening in their opinion is compulsory for all sexually active women and they're happy to test virgins because some women may lie about having sex. I had to read the sentence three times to make sure I was reading it correctly. Who made doctors judge, jury and executioner? Doctors need to be put in their place, it is not their right to assume anything, PAPS ARE NOT A LAW, we can have them or not and we don't need to convince them of anything. How dare they? What an attitude, no wonder women have an issue finding doctors who treat women with respect, as adults. Also, these doctors are risking the health of virgins by arrogantly "assuming" they're liars. Any virgin who has been pushed into testing should seek advice, your health was risked for no reason. WE are in charge of our bodies, doctors need to butt out.
—Guest Amanda W

Am I better off for the paps?

I had two conizations in my early twenties, one at 21 and the second at 24. Neither showed cancer or dysplasia, they were normal and my doctor said the paps were probably abnormal because of inflammation, a passing and harmless thing maybe irritation from condoms. She said the pap will come back abnormal for all sorts of things and cancer was rarely the problem or pre-cancer. It made me doubt the value of the pap if it can be abnormal because of lots of harmless things. I've lost some of my cervix after the conizations and my doctor says pregnancy might be high risk for me. I have some scar tissue as well and that might cause problems getting pregnant. What exactly did I achieve by doing the right thing and having paps? I sometimes feel that I'm worse off. The cervix is not dispensable, its there for a reason. Doctors should not be casual about this test and pushing treatments, it's more than the risk of the cancer warrants. We could limit the damage by giving women more information.
—Guest Kathy
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