"painful woman health exams"

About: North Middlesex Hospital / Gynaecology

(as a service user),

unlike ada17  I did not go through a biopsy or hysterectomy but her comment on the way doctors responded to her pain rang a bell as I have been told repeatedly for various gynaecological exams (use of speculums, cervical screening smear, internal manual exam, transvaginal ultrasound...)  "that most women supported the procedure well".

This "is it not painful" speech given to patients is a lie when told before the procedure and a huge disrespect when told as a response to patients complaining of pain.

like ada17 i would like medical staff to 

-give better information on the level of pain associated with various medical procedures

-offer adequate painkillers when possible

-listen and respect patients complaints and request rather than dismissing it

-survey all patients (even the ones that looked fine or did not complain) on the level of pain/discomfort they felt during the procedure in order to gather accurate data

it is way to easy to shame individual patients when they complain about pain and claim that a certain procedure is "generally not painful" when there is no measure or actual statistic on it. I also have to point out that I have experienced this for all the gynaecological exams I have been submitted to but not when having blood test, stitches, broken bones...

Responses

Response from North Middlesex Hospital

Dear Morgane,

Thank you for posting your comments. I am so sorry you found your procedures painful. No doctor or nurse would set out to cause pain to any patient deliberately. We need to think about the words we use and the support we give patients.

It is increasingly common to do procedures whilst women are awake rather than anaesthetising them and this is a practice we support at North Middlesex Hospital as it is much safer.

I will pass your comments onto the gynaecology team so that they can reflect on them. If you would like to talk to someone in more detail about your experience, please contact Kerri or Karen in our PALS team on 020 8887 3172 or email northmid.pals@nhs.net.

Dr Justin Daniels

divisional director for women, children and support services

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Update posted by morgane (a service user)

Of course, I don't think that any of the professionals I met meant to harm me but the tools used are barbaric. in the last 2 centuries surgery went from using saws and alcohol as anesthesia to optical fiber and laser tools, while the only change to gynecological exams is from metal speculums to plastic ones: surely in the 21st century alternatives to big speculums should be available!

Here are a few proposals for better tools: smaller/narrower speculum, speculum of different shapes to fit different women's anatomy, inflatable speculum or other alternatives, use of optical fibre alone to look at the vagina or cervix (when there is no need for pap smear...)

Better use of those tools: use of lubricant, warming up the speculum to body temperature, opening it to the minimum, proposing alternative position to the patient (instead of the lying on the back usual one)...

And better support and respect for the patient: letting the patient see and choose the speculum size, letting the patient (or someone they trust) insert the tools themselves, letting patients bring someone they trust during the exam, explaining what is really required for a specific exam and the level of pain/discomfort to be expected.

I am well aware of the risk of full anaesthesia and clearly many procedures don't require anaesthetising but

1) there is a wide range of pain management options between no pain relief at all and full anaesthesia (ibuprofen and other general harmless painkillers, numbing gel, heat/cold patches, local anaesthesia...)

2) patient should be given proper information on the different methods and free to choose the method that best fit them (all the persons I know including myself who had wisdom tooth removal were given the choice of local or full anaesthesia so the same respect of patient choice should be given to women when needing gynecological exams/procedures)

Thank you for passing these comments along as widely as possible.

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