Yup, it’s another one
Posted: September 1, 2007 Filed under: Navel-Gazing | Tags: girly bits, things we need to know 3 CommentsI’m doing these “things we need to know” things because they’re important things that either I haven’t known myself, or others have asked me about.
This is one of the things I didn’t really know about myself.
Apparently, it’s now common practice to hoik UK girls into their doctors’ surgeries at the tender age of twenty and tell them that they could really do with having their girly bits prodded.
Hmmmm. Wish my school had told me that.
Last I knew, it started at 24, but admittedly this was when Mum once (very reluctantly, and a long time ago) told me where she was going and why. Anyway, because I’m on the Pill my doctors’ surgery is quite interested in prodding me, generally.
A couple of weeks ago, they took my weight and blood pressure. Woop. So I know that yes, my heart is still beating, and no, funnily enough, I’m not weightless! I don’t know how much I weigh, though, because…. I don’t really care! Hah! So there!
Anyway, so after the nurse then had made her assumptions, and irritatingly been proved right (“Aha! So, you take the Pill; Thus, you are in a relationship; Thus, you are sexually active”), she told me that given this information, I would benefit from a cervical smear.
Basically, the point of it is to determine if the cells of your cervix are normal. Which, 90% of the time, they are. You see, it wouldn’t be “normal” otherwise, would it?
Anyway, the other 10% of the time, you’re “abnormal”, and they basically sit back and wait, prodding you more often than if you were in the lucky 90%. (They normally call you back every 3 years. If you’re unlucky, it’s every 6 months or a year, depending.) Mostly it’s nothing. Sometimes they catch cervical cancer at the very beginning, which gives you better odds for surviving it.
Now, as the nurse rightly said, I am indeed sexually active. So I am no stranger to having things in my girly bits. It normally feels pretty damn good, if not better. And I am no stranger to talking to the doctors about personal things, even the ones that scare me by looking and sounding like an irish great-uncle of mine.
But even so, it was an effort not to turn and run very fast in the opposite direction from the appointment.
Anybody who’s still reading this because they’re looking for an impersonal account to take their fears magically away, I’m sorry.
Cervical smears are not nice.
They’re not even vaguely nice.
They don’t hurt.
And they’re not cold.
But having impersonal, latex-clad fingers on you does not feel nice. Looking up to see an instrument that looks like it would be the response to the request “nurse, the claw” does not feel nice.
Having things like long cotton buds are prodding about inside you does not feel nice.
It wasn’t really a claw, by the way. It was mostly just like a hollow metal dildo. Albeit one which stayed still, gave me no pleasure whatsoever and split open, a bit like scissors, to keep me open and allow access to my cervix.
Obviously, I consented to it.
But I still felt violated.
Once outside the surgery, I felt wobbly-kneed and tearful.
Even though the nurse had been calm, reassuring and generally lovely, even though it was something that I wanted done….. that didn’t, couldn’t prevent my instinctive disgust, my feeling of Fuck Off, It’s My Body.
On the plus side, at least I got to take my socks off first!
A Second Thought 
i think they call it the duck as it has the duck bill, urgh…
If I may be permitted to justify some of the invasive practices that healthcare professionals inflict on women of reproductive age, since I feel this understanding is important for the “things we need to know” theme…
Two major complications of the combined oral contraceptive pill are deep vein thrombosis and myocardial infarction, and obesity and hypertension amplify these risks further, hence the need to monitor one’s weight and blood pressure before prescribing the pill. Furthermore, smoking also greatly amplifies these risks, so the combined oral contraceptive pill is actually contraindicated in smokers. Ideally, they’d also ask about a history of focal migraine, and family histories of stokes, breast cancer, and endometrial cancer, as these are also serious complications.
With respect to cervical smears, keep in mind that one does have the absolute right to refuse screening. They aren’t pleasant, but neither are most medical investigations. It’s true, around 90% of smears are normal, but consider the fact that the remaining 10% of the whole screening population is actually a very large number of people.
The reasons for screening are that cervical intraepithelial neoplasia, the precursor to cervical cancer, is completely asymptomatic, and can only be detected through cellular analysis. Hence, it is not something that one can detect on one’s own in the comfort of one’s own home, such as would be the case with a breast lump or a testicular lump.
Another factor is that infection with human papilloma virus, the causative agent of cervical intraepithelial neoplasia, is predominatly asymptomatic in men, and, without trying to sound cynical, many people have been considerably more careless with past sexual partners than they acknowledge. Hence, even if you have been in a steady monogamous relationship for some time, there is still a risk.
Furthermore, since the virus commonly infects the skin, ejaculation is not required for male-to-female transmission. In fact, it is the same family of viruses that cause warts and verrucas. Hence, condoms only reduce the transmission rate by 70%, so there is still a considerable risk with the use of barrier contraception.
Due to the introduction of screening programmes, UK deaths from cervical cancer have decreased by 45% between 1979 and 1997, and it is estimated that if the screening programme reaches a coverage of 80% of women, a 95% reduction in cervical cancer deaths will be achieved. Thus, this is a major cause of severe morbidity and mortality that can effectively be prevented through screening.
Interestingly, we are seeing an increase in the number of cases of oropharyngeal cancer due to oral human papilloma virus infection.
Just a further piece of information: current NHS guidelines for cervical cancer screening recommend screening between ages 25 and 64, with 3-yearly smears between ages 25 and 49, and 5-yearly smears between ages 50 and 64. This is because under age 25, the cervix is still undergoing cellular changes, and so false positive results are more likely in this age group.