gyno exams in the UK

[bonniebon.livejournal.com]

after reading all the previous stuff about visits to the gyno, it got me thinking, there seems to be a big difference in the way it's done in the USA and the way its done here in the UK.
In the UK (at least in my experience) you get a letter after turning 20 (I think it was 20) saying to go and get a pap smear.
So at the age of 20, I went along to my GP (general practitioner) and she did the pap smear there. There were no stirrups, I did the frog legs thing (thats what she called it hehe) where you put your heels up to your bottom and let your knees fall to the sides, then she put the speculum in and did the smear and that was it, no pelvic exam, no bi-manual exam, no breast exam. Then a month or so later I got a letter saying everything was all clear.
The only time I had a bi-manual exam was when I had a problem, and that was done by my GP not a gynocologist, you don't get reffered to a gynocologist here unless your GP thinks theres something wrong.
It got me thinking, is gynacological care in England much less thourough than the USA due to the under-resourced nature of the national health service? sometimes I wonder what the gov spends all our tax money on! grrrr

Just my ramblings for the day, any other thoughts?

Comments

[zitronenhai.livejournal.com]

Well, I go to my regular doctor (a GP sort, MD in family practice) and he's the one that does it. The one time I went to a gynocologist, his physician's assistant did my exam, and I didn't like her. I was very relieved when I found out my regular doctor could. He's got stirrups for it, and it isn't fun, but I do feel safer when he's done and says he didn't find anything. They're feeling around for tumors and such. He wears a light on his head like a coal miner. :)

If your doctor isn't examining your breasts, I would recommend you do it yourself. At least once a month, feel them for anything that seems out of place. Squash them around a bit, if for no other reason than to get to know exactly how they feel normally. If something ever turns up, you'll know it doesn't belong there.

[kibbles.livejournal.com]

I personally think that everyone should have their doctor/midwife/NP/PA do a breast exam and SHOW you what certain things feel like. There is also a way to do it, a circular manner, and it should only be done certain times a month for best results.

For example, I was told about the 'stringy' stuff inside my breasts, and how to feel for them, and I had a cyst and I found out exactly where it was and what it felt like and how to follow it.

For nearly 20 years I had been examining myself (since I was a teen) without the slightest clue what to look for. It was my midwife that made me do it, in front of her, after she was done, and with her helping me with placement and technique, that took me to REALLY understand what was going on.

And mind you, I actually went to nursing school and worked in a hospital. You would have thought I would have been a bit more thorough in finding out how to do it.

[zitronenhai.livejournal.com]

Thank you, and yes. She should ask for a lesson on how to conduct a proper self exam.

[kibbles.livejournal.com]

PAP smears should be done as soon as you are sexually active. (I was already MARRIED by 20!) I get mine done every year or so, depending on when I am at the gynegologist/midwife (I have gone back to seeing a midwife for all my wellcare.) There are different ideas how frequently they should be done, anywhere from yearly to every 2 years. I havent always had to use stirrups, either. As long as they can get in there, thats what counts.

I think you should get at least one professional breast exam to teach you how to do it, but mine gets done every time I go for my regular check up.

If you are on the birth control pill, you should get more regular check ups because of the possible side effects of the pill (clots, blood pressure, etc.), at least at first. Here a GP or a gyno (or midwife) can do the well woman exams, it is up to the woman where she goes.

I lived in England for 2 years (south London) and never saw a doctor. Had private insurance though (couldnt GET NHS anyways). I wanted to go to nursing school there, finish it up (I had started in the USA). I will be honest, I was NOT impressed with the school itself (City College at St. Barts). More so, I was NOT impressed when my friend had a stroke and was put in Lewisham hospital. That place was a pit. That place SCARED me. It was horrible. I do know there are some good hospitals there, though, and that you have more choices if you have your own insurance.

There are pluses and minuses to both systems. I am THRILLED with the medical care here, particularly here in NYC (one in seven doctors in the USA are trained in NYC hospitals, and then we have international students -- and teaching hospitals are usually wonderful), but if I didnt have insurance, all these great hospitals would be out of my reach unless there was an emergency.

Can you talk more to your GP about going for exams? Maybe you might not get a letter, but you can ask if you should go once a year or whatever for pelvic exams/breast exams/etc.

[gigglinggorgon.livejournal.com]

I used to have all my paps done by my GP, but when I found my gyno, he is the first dr to give me a pap that neither hurt nor spotted afterwards, so I go to him for them now. My insurance carrier gives me the option to go to him whenever I wish.

[ailbhe]

I've had pelvic exams from UK NHS and Irish private doctors; one of them was followed almost immediately by a rush appointment to get an ultrasound. I've never been put in stirrups, either in the UK or in Ireland. I've never had a breast exam either, though.

I imagine if I went to a private gynocologist for my exams, they'd take longer and be more thorough. Given how much I or my insurance would have to pay for them, I certainly hope so...

[the-marionette.livejournal.com]

My ob/gyn office recently started doing urine tests with every visit. I find it strange that a pelvic exam is not recommended. Ovarian cancer is usually the main reason. Most people who die from ovarian cancer have never had a exam or haven't had one recently. I sometimes think that the breast exam is pointless as I see her every 6 months and cannot see how she can tell if something is different. I doubt the woman can remember my name if she didn't read it off the chart.

[sekhmetsat.livejournal.com]

i live in america, and i see a midwife for all that female stuff. no more doctors!!!!

[the-marionette.livejournal.com]

Yeah, I'm getting pretty fed up with doctors myself.

[vampodrama.livejournal.com]

Uh... I live in a tiny ex-soviet country and haven't got a gyn. exam in my whole life. I am 21 and on the BC pill and have never, ever even got undressed in the doc's office, not to mention anything else... well but actually since the system is quite fucked up here, I'm not even sure I have a medical insurance and if I don't, I can't even get any immidiate help I guess. :/