What Doctors Don’t Want You to Know About Pap Tests and Pelvic Exams

You might have wondered why doctors are so persistent when it comes to your pap test and pelvic exam.  You might also have wondered why doctors don’t give you information and offer you a choice in the matter.  Here is some information about pap tests and pelvic exams that doctors rarely tell you:

Pap Tests – Undisclosed Information:  Pap tests detect abnormal cells on your cervix.  What doctors don’t tell you is that the results from a pap smear are often inaccurate (between 10 and 60% of pap smears are inaccurate) and will show a false positive for abnormal cells if you have recently had intercourse, taken a bath, used a tampon, or any number of such things.  An abnormal pap smear does not necessarily mean you have cervical cancer, or that you are even at risk of cervical cancer.   ehealthmd.com/content/how-accurate-are-pap-smear-results

Cervical Cancer – Undisclosed Information:  Doctors also don’t want you to know how rare cervical cancer is.  Your odds of getting cervical cancer are 1 in 13,699 (in developed countries).  Your odds of dying in a motor vehicle accident each year are 1 in 6,535.  In other words, you are more than twice as likely to die in a car accident than you are of getting cervical cancer.  Also, the odds of getting cervical cancer are even lower if you are a young to middle aged woman. http://www.statcan.gc.ca/pub/82-003-x/2012001/article/11616/tbl/tbla-eng.htm

Extra Fees – Undisclosed Information:  Doctors are able to charge extra fees for pap smears.  Doctors don’t want you to know that they are making more money from your visit every time you agree to a pap test.  http://www.pbs.org/wgbh/pages/frontline/shows/doctor/care/capitation.html

Bimanual Exams – Undisclosed Information:  Doctors perform a bimanual exam (insertion of fingers into the vagina) along with the speculum exam.  What doctors don’t want you to know is that there is no data to support the relevance of the bimanual exam.  Studies have shown that no abnormalities have ever been accurately detected by inserting fingers into a woman’s vagina. jwh.2010.2349 (application/pdf Object

Pleasure – Undisclosed Information:  Some doctors enjoy performing pelvic exams.  But do not take my word for this – read for yourself a male doctor’s point of view on pelvic exams: http://forwomenseyesonly.wordpress.com/2012/09/09/the-other-side-of-the-speculum-a-male-doctors-point-of-view/

Further Tests – Undisclosed Information:  Many women who receive a false positive pap smear result are sent for further and more invasive testing.  This leads to further income for medical professionals, but this is also where further damage to the cervix can occur from colposcopies and unnecessary biopsies; resulting in risk of heavy bleeding, infection, irreparable cervical mutilation, unnecessary hysterectomies, and difficulties with pregnancy and giving birth as the following evidence shows:

Based on solid evidence, regular screening with the Pap test leads to additional diagnostic procedures (e.g., colposcopy) and treatment for low-grade squamous intraepithelial lesions (LSIL), with long-term consequences for fertility and pregnancy. These harms are greatest for younger women, who have a higher prevalence of LSIL, lesions that often regress without treatment. Harms are also increased in younger women because they have a higher rate of false-positive results. Magnitude of Effect: Additional diagnostic procedures were performed in 50% of women undergoing regular Pap testing . . . The number with impaired fertility and pregnancy complications is unknown.  http://www.cancer.gov/cancertopics/pdq/screening/cervical/HealthProfessional/page1/AllPages#Section_133

So, as you can see, there are many good reasons why your doctor doesn’t want to offer you information and a choice regarding pelvic exams and pap tests.  Do your research, protect your healthy mind and body.

About forwomenseyesonly

Hi. My name is Sue and I am interested in promoting holistic and respectful health care.
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276 Responses to What Doctors Don’t Want You to Know About Pap Tests and Pelvic Exams

  1. Kleigh says:

    The way doctors mislead woman about hpv is sad. I read a husbands post on another blog telling how if his wife had not been screened she would have never been cured from her “hpv cancer” that is so wrong for gyns to mislead woman and there familys. They act like they have saved so many womans lifes from hpv.

    • Alex says:

      I guess they like the deception. Screwed-up, huh?

      mgpr2013- How’s it going with those pamphlets or whatever you were doing? I don’t remember if it was a leaflet you were going to be handing out or show you were going to be on, but I remember you wanting advice on what information to put in something.

      • mgpr2013 says:

        Hi Alex, I’m great. I am taking the approach of screening in general but will mention stats on cervical cancer and breast cancer and the huge amount of screening and treatment that is done to save only a few. I will definately mention the rate of cervical cancer as well. Both prior to paps being done and post pap screening.
        I also wrote a letter to the women’s clinic I went to to say how angry I was that the dr I saw could answer none of my questions and I will write a similar letter to the colposcopy clinic saying how angry I was that the receptionist basically threatened me with having cancer if I didn’t show up for this appointment.
        I’m trying to find the article again but it said that 80% of CIN3 regressed on it’s own. EIGHTY PERCENT. I don’t know the age group but I’ll see if I can find it.
        The other part that I’m trying to find out is how do I know if I”ve got a persistant HPV infection or not? I’ve had a new partner in the last 2 years…so I don’t know. The more I read the more I realize they don’t know a lot about HPV either. It may lay dormant, it may not. Most of the time it goes away, sometimes it doesn’t. It seems to me that instead of spending the money on a vaccine (that is useless anyway IMO) they should have spent the money on figuring out more about HPV altogether.
        And one more thing….I HATE the term precancerous cells. That seems to me an implication that they WILL turn into cancer. That simply isn’t the case. By that logic pretty much every cell in my body is ‘precancerous’. I understand that some may be more predisposed to be cancerous but ….they aren’t cancerous.
        It’s just tragic the number of stories I’ve been reading about, young women especially, who had their ‘lives saved’ because they had precancerous cells removed.
        I have a girlfriend who I’ve recently shared my new cause with and she was very upset with me. Paps ‘saved her life’ too. She told me she had cancer removed …. I was shocked and I said I had no idea she had cancer and she said yes, they were classified as atypical squamous cell of undetermined signifigance. She believed she had cancer. She did not want to listen to what I had to say about it. Tragic. So many ‘survivors’ and so little disease.

  2. Moo says:

    Sorry a woman having CIN3 might want to get a colposcopy since she could have cancer because the pap is inaccurate both ways. It could miss cancer. The problem is getting a colposcopy without the pressure for treatment. Such as some women might want to wait to see if their HPV clears and their dysplasia clears up before doing a treatment or use alternative therapies. Only most doctors do not want to wait. It is legal issues too.

    You can find plenty of journal articles that discuss the percentages of regression etc. however if it is your cervix and your health, try to get as much info as possible. Do not expect to get information from a receptionist. That is not their job. Even the doctors do have time. They system is just wrong.

    Depending where you live you can ask for a HPV test. Ask about whether the results show if which types. Types 16 and 18 are most likely to cause cancer. But if a woman has these types and CIN3, she might consider getting treatment rather than just nothing.

    • mgpr2013 says:

      Moo you’re absolutely right. I didn’t mean to imply you should ignore it or not get it checked. I simply want to let women know that HPV is common, and in most cases goes away. As does CIN3. I am no doctor, I just think women have been scared for so long and I want women to be educated on the realities of cervical cancer and then make a decision. Informed consent … to me is the most important message.

  3. Elizabeth (Aust) says:

    Many women with CIN 3 think they would have developed actual cervical cancer, they assume it’s a natural progression, it’s not.
    From memory about 12% progress to invasive cc…some studies go as high as 20% and I think one said 30%…regardless, the majority have nothing to worry about, of course, I can understand why someone in that position might be concerned.
    The scare-mongering and misinformation definitely hasn’t helped, but IMO, that was their intention, “HPV is everywhere, we’re all at risk!”….it helps cast a wide net and scare the daylights out of everyone….and they hope create a scared, compliant and grateful herd.

    • mgpr2013 says:

      Hi Elizabeth…I”m Canadian :)
      The scare mongering is very effective. I change my mind daily, sometimes hourly, about whether or not I’ll get a colposcopy/ biopsy. It really depends on what I read and who’s written it LOL,

      • Moo says:

        The CIN level is about how many layers the HPV infection has spread done to. If it is CIN3 the it is down to the bottom layer and the theory is that the HPV infected cells are producing proteins that induce cancer. So CIN1 is only the top most layer affected and more likely that the body will clear it so the higher regression rates. CIN2 is between the two and into the middle layer. There is also a good chance that it can regress as well. Some strains of HPV involved in CIN3 are very likely to cause cancer. But just getting a CIN3 pap result probably means your body is having trouble clearing the virus.

        What affects regression is the size of the HPV infection. It could be a small pin size so that could still be deep in the layers such as CIN3 but the body might be able to handle healing it. However if the HPV infection is over a larger area the body might need some help. If you have CIN3 you should probably consider at least finding out how big a problem it is before deciding any treatments from a colposcopist.

        Healing HPV on your own depends on certain factors such as age, smoking, vitamin deficiencies, other infections, immune status.

        Maybe you could consult with a naturopathic doctor for treatment. Some of them will send their pap lab work outside of your province for processing so the results will not be recorded in the provincial registry. However they charge and will also recommend diet, lifestyle and supplements to go with the treatments. It could cost you several hundred dollars.

        Do you not understand what the colposcopy process and biopsy is about?

      • mgpr2013 says:

        Hi Moo, yes I fully understand what the colposcopy and biopsy is about, which is why I don’t know if I want to get it done. I had an ASCUS pap. Which I suppose could be anything. But considering my overall risk of getting cervical cancer in my lifetime is so very low I don’t know if I want to keep digging around in there. The truth is, if I could go back in time I never would have had paps done at all. Or even tested for HPV. The rate of regression for these conditions is so very high and the risk of cc so low…I’d rather not know. But now that I do know…I’m torn about what to do.
        I now know that the truth is they don’t know which will regress and which won’t. So they treat everything just in case. I get it. But … I don’t know how I feel about it.

      • Alex says:

        mgpr2013- Aside from the fact that just because you ARE a woman doesn’t mean that you are likely to get something that only a woman can get- they don’t mention that these are high risk & low utility methods of detecting something that’s massively rare. I figure it’s a good idea to take this into account if you’re thinking about follow-ups to things.

        Something I told Ro (I think) that might be helpful:

        People tend to presume honesty & accuracy when interacting with someone. That’s not always misplaced- if you were to ask someone what time it is & they told you “3:30,” their watch probably does say “3:30.” Same goes with tone, body language, etc… .

        This can be used against someone & through subtle methods. Like when someone says something where something else would have to be true- it implies the background that would support the situation. A common trick is someone presenting something as a fixed situation (as if there exists no capacity for things to unfurl any other way). Like when they say that they “WILL” be doing something or that someone is “GOING” to be having something- that implies that things are this way. They don’t mention that an action has to be engaged in order to occur.

      • mgpr2013 says:

        Hi Alex, you’re right. And as I say I can’t decide. Luckily I don’t have to. I have several months for my ‘urgent’ ASCUS case gets examined. The fact is that cervical cancer happens. It is rare. Every woman needs to decide how important it is to her to get checked, but…that is only the beginning. Once you’re checked…then what? According to some it’s very serious. According to others not so much. I compare it to a smoker who is deciding whether or not to be tested for lung cancer. I’m at a higher risk because I am HPV positive but it doesn’t mean I have cancer or that I will develop cancer. I wish I had information sooner but I’m glad I have it now.

      • Alex says:

        That’s a good comparison! I didn’t think of that one (but I’m sure, as there’s no excuse for personal agency as far as they’re concerned, they’d try some kind of imposed situation with that).

        If I might offer a bit of advice: Look at the chance of NOT having cancer more than the possibility of having it. It’s not just that there’s a massive amount more one way, but also if you focus so much on that one potential it’ll usually start to seem like a definite thing.

  4. Moo says:

    I thought you said you have CIN3. Just ASCUS? I would personally not bother with colposcopy for ASCUS but that is my body.

    What puzzles me is what does “persistent HPV infection” mean? Is it with the same strain or if someone is tested for HPV every three years and all positive, regardless of strain, is that persistent. Is the carcinogenic effect of HPV infection accumulative or more related to strain? Who has those answers?

    If someone has one HPV strain and clears it, then apparently they can not be reinfected with that same strain again otherwise the vaccines would not work for long. The immune system cells remember only for so long though.

    I do not buy this “HPV reactivation” in older women. I think that they are probably new infections with different strains. Yes an odd cancer cell could hang put and decide to grow crazy later (we all have cancer cells) but there must be some stimulus.

    Most of the HPV tests are crocks because it is possible to identify each strain individually but they just group them all to make more money. Now the newer ones are having separate results for strains 16 and 18 because of the vaccines. This is because if a women has the vaccine she could test positive on a regular HPV test. There are also many other strains that are cancer causing so they need to cash in on that.

    • mgpr2013 says:

      Hi Moo, exactly what I”m saying. I have had ASCUS paps before, a few years ago, but no HPV. My pap last year was normal but this one now comes up with HPV and ASCUS. That’s why i’m soooo dubious about this whole rush to cut part of my cervix off and test it. I”ve also had a new partner in the last 24 months. For a little more info, I was pregnant last year and miscarried and I have read that that can make HPV pop up because your immunity is compromised. Also, I told the dr that I just finished my period the day before this pap. I was wearing tampons the day before…so I know that can affect the test. So, I am left wondering exactly what you’re asking. What is persistant? Who has these answers? Why aren’t they finding these things out instead of pumping money into vaccines? I think we all know the answer to that one.

  5. Anonymous says:

    mgpr2013 – I was in a similar boat – CIN1 colposcopy requested but I refused and was currently in menopause which by the way could have thrown up the abnormal cells. I could not put myself through this with possible treatment for something that may or more likely may not become cancer. Its a very long rollercoaster ride, for years! They claim it is simple and pain free, I don’t buy this at all. When it is me/yourself or any woman in those stirrups legs akin, a stranger behind the sheet hiding all those tools and acids , it is in no way SIMPLE! Overtreatment is huge, massive in almost every medical area. I feel I have protected myself from harm to this date, from 2009 this began and I am still here. The more I read, from here and elsewhere the more shocked I become, from all the lies. I have seen quoted on training sites “don’t tell the woman this or that because she will refuse the test” etc. All the projects they spend money on soley for the purpose of increasing uptake. If they have to lie and try so dam hard to get us to comply then something is seriously wrong, ALARM BELLS are ringing. It has to be with FULLY informed consent and as they hold back honest information, then it is not informed consent! This is not ethical. I understand your frustration as have been there, like many on this site, and still get questioned at every doctors visit. I was a little abrubt this time but was at the end of my tether, I’ve already said NO several times so again I said “its an informed decision and thats final”. I have another appt 10th April, lets see what happens this time. Oh and the Doc was sneeky and asked if I would have a cholesterol test, I foolishly said yes and the nurse told me its high at 5.6 and now I believe that is normal in the uk for the average woman-huh whatever average is LOL. Now I know that it was simply another screening test, Dam! Being told it was high made me angry then upset then angry again, followed by no dinner, a headache and a rough nights sleep! I am 47 kilos for goodness sake, why on earth would he want to test my cholesterol – easy answer – more targets and incentives!! Anyway I know my weight is fine but it did bother me, guess I’m just one of those sensitive types LOL! Good luck with your decision but make it yours and not anyone elses decision.

    • mgpr2013 says:

      Thank you so much for sharing your story. And I know exactly what you mean. I think the thing I never thought about before was “If I get screened, and they find something….what am I prepared to do about it?”
      And I believe that I have about a 90%+ chance that I am perfectly fine. I think I can live with that statistic.

    • Moo says:

      To anonymous. I got the cholesterol test because the rant was “prevention is important” however he never gave me any numbers just “it was ok” . If he ever asks again he is going to have to give me previous test results, paper copies and not try to charge me an outrageous fee. I know now much printing a piece of paper from his computer cost.

      How can I possibly know if my exercise and eating habits are good enough when I have no numbers. I am overweight but I refuse to weigh at the clinic because the scale is in the reception area. Not private.

      The e-medical files is a sham. It allows other health care workers to easily access your records but you, the patient, cannot see your own information unless you pay the outrageous fee. Presently the fee is $30 for the first pay and extra after that.

      • Finnuala says:

        Hi I am in New Zealand and they are bringing in Electronic Medical records here. It is an opt off system just like the NCSP register. I have already been to my GP surgery and opted my entire family off. To his credit my GP is not doing it……for now.

  6. ChasUK says:

    Sorry that last post was from me ChasUK

  7. Kleigh says:

    Anon. I Am happy to hear you stoud up for your self at the doctors. If you dont mind me asking, What was the docotrs and nurses reaction when you you refused and mentiond informed concent and over treatment? I had a bad experiance with a nurse who didnt even know what a pap cheeked but scolded me for not haveing a pap date for her.

    • Alex says:

      Ever notice how they either act like they’re experts in a field, but then don’t know anything about it or DO know what they’re doing & lie about it? Either one is a scam. Fraud is fine in a medical situation, then? No, of course not.

      They also tend to act innocent & like any other medical personnel is innocent no matter what they do. They are not innocent of their own actions!

      I guess you can’t expect them to dress like Dracula & bare their teeth at you before they try to cause a problem.

      • bethkz says:

        A few years ago, there was a bill on the Oklahoma State ballot which explicitly gave doctors permission to lie to their patients! http://www.cnn.com/2010/OPINION/04/28/carr.abortion.oklahoma/index.html  The bill said that a doctor did not have to tell a pregnant patient of a foetus’ birth defects even if she directly asked him and he knew. It’s a slippery slope which would require only a single court case to decide that the “intent” of the law was to allow doctors to lie under other circumstances. The most amazing thing was that it was passed into law!

  8. Kleigh says:

    Alex, I also think they hide behide these exams being “standard of care” and also the follow ups. Even if the screening makes no since and the follow ups are damaging they do think if they dont follow up they are gona be sued. Its about money i think the Acog makes these “recomendations” to protect profit. “woman should have this” its like not doing it is not right and doctors thin kick woman out of there office if they do not comply with standard of care. IE FORCED PAP SMEARS.

  9. Kleigh says:

    also the nurse that scolded me for not haveing pap smears. Thought pap smears had somthing to do with mensturation and didnt know crap about the screening and i think she felt thretened when it questioned it and new more than she. An educated nurse.

    • Alex says:

      I’ve heard that as a running theme with nurses (at least in America). They’re usually lazy, arrogant, control-freaks that think they’re educated & have an “I’m not going to be ignored” attitude. They also seem to not be able to handle things well at home, so they try to play “commander-in-chief” with patients.

      I remember one of my mother’s friends was a nurse & she was sub-human. Not to get too graphic with details, but her son was “less than loyal” as a brother to his two little sisters & not only did this bitch pay for his $400 worth of parking tickets but she forced these girls to see him again & let him be alone with the next two children she had! Oh, but I was considered a “bad influence” or something along those lines.

      • mgpr2013 says:

        I don’t think it’s fair to label all nurses as lazy, arrogant, control freaks. There are lots and lots of nurses who are wonderful, caring, hardworking people. I personally believe that most doctors and and nurses BELIEVE they’re doing the right thing. Paps have been around a loong loong time. I think they’re taught what they are and how to do them and what to look for but not the full risks and benefits.

      • Alex says:

        I wasn’t trying to label them ALL that way, but I was talking in trends. Sorry if I offended you.

        I was going to say “the road to Hell is paved with good intentions,” but I truly don’t think they have that many good intentions. That’s a personal take on things, but it’s not baseless. If they really wanted to help people, they wouldn’t be doing things that are incongruent with that (forcing women into these kinds of tests, for instance- regardless of potential utility). Attack is antithetical to assistance, after all.

        I don’t mean to come off condescending, but is someone attacking somoene (iatrogenically or otherwise) helping them? I could go & burn someone’s house down & maybe they’d have a good weekend living with their relatives, but that is not an act of assistance.

    • D says:

      I’ve had a number of nurses and physicians scold me for not getting exams frequently enough, and for an educated decision I had made for my health. Like, seriously, scold. I’ve had someone sit in on an exam once and they were surprised by the attitude I received. It made me want to go back less than I had been. These medical workers are only human and I understand their concern for me, it is their job. But, if I were in their position, I would use positive reinforcement. That I was going in at all was a huge deal. I do feel that these screenings are important. But the more I read and the more I understand my own risks (I may have fewer as I have an unusual situation), and the more nurses I know who have weird attitudes and biases, the more I educate myself. I go in when I think it is time, and I do. I space my appointments as I wish. If I feel like I really don’t need a test at the time, I won’t do it. I won’t be pressured into it or be made to feel bad.

      • Kleigh says:

        D. I to have been scolded by a nurse bc I have never had a pap and explaned to her i was never sexually active and it was like she didnt know what a pap smear was for. She even said that it had somthing to do with woman mensturating and she acted personaly offended. But it is a thret to there bussnes when woman chooce to cut back or not have these exams screenings at all. I whould not let them talk to you as its your body not theres and they have no right.

  10. Moo says:

    Part of the argument for pap screening was that the precancerous condition is “easy to treatment” before it becomes cancers. Once a squameous cancer starts, it spreads quickly to other parts of the body and then “it is too late”. So cervical cancer is supposed to be a “preventable cancer” What is the truth in this, if any? Keeping in mind only CIN3 is considered a precancer.

    What other types of cancer can be “prevented”. What other precancerous changes in the body can be detected by a test or observing?

    For example melanoma can be fatal. Some moles can turn bad. So are all moles scraped and biopsied? Lung cancer is huge but does every cough need a chest X-ray and a biopsy? When is testing necessary and when is it overdiagnosis?

  11. FEDUP says:

    comment removed by moderator due to rude, crude and offensive language.

    • Alex says:

      Dude, you’re out of your fucking mind! You figure a husband should kill his wife because he can’t get jacked-off by a doctor as easily as a woman COULD use a doctor as a gigilo?!

      The general situation is that women get PUSHED into this situation whether with false advertising or coercive practices- they don’t mention risks, inaccuracies or alternatives AND as a general rule people get argued with when they express issue with the dynamics of the situation.

  12. Moo says:

    Attention moderator.
    Please erase this abuse and ban the previous poster.

  13. Pingback: Pap Tests and Pelvic Exams | THE TRUTH SEEKER

  14. sue suwandi says:

    If anyone knows the class action filed to sue this seemingly legal practice, pls contact me (ssuwandi@gmail.com).. when I asked if there us any cure from the biopsy results and the nurse said there is no cure, I definitely know what my option is. I told the nurse it is my body and I will let nature takes its own course.. this was first pap done in a prominent hospital.. prior paps in a small clinic did not suggest any biopsy. Be careful of rubbish practise, your body is traded off for profits!!!

  15. BethK says:

    I found a patent, approved in 1982, for a speculum cover that protects women from cross-contamination – being infected with diseases from the doctor’s prior patients via the unsterilized speculum (just washed off in the sink between patients, no matter what those patients may have been infected with). https://www.google.com/patents/US4492220 This issue has been known since at least then, and why hasn’t this device, or better ones, become the standard of practice?

    • Moo says:

      The use of single use plastic speculums is supposed to help reduce cross contamination. The bulk boxes or packages of speculum purchased are not sterile however and would only be sterile when the package was first opened. However unsterile plastic speculum can be contaminated by surfaces, handling, dirty gloves, splash back from a dirty sink where these are wettened before use.

      Metal speculum were previously used and had to disinfected between patients (not usually sterilized). Covers for metal speculum are rather redundant.

      Sterile plastic speculum are available but mostly used for pregnant patients. I think that all speculum and gloves, tools (ultrasound probes) used for any pelvic exams such be sterile. After all anything that your dentist puts in your mouth is carefully cleaned and sterilized.

      I would like to try this. Take a plastic spoon to your next doctor appointment. Put it in your mouth and then take it out. Or just put it around on surfaces in their office. Offer to rinse it off or wipe it with alcohol and ask him/her if you could put it in their mouth. Say you would even wear gloves, likely they will refuse. Really? Then tell them you feel the same about your vagina.

      • BethK says:

        I don’t want them putting a plastic or metal speculum into me, sterile or unsterile, with or without a plastic cover. I’ll pass on the plastic spoon illustration.

        Given that they ARE resusing these single-use medical products – including specula and now, it’s even come to light that they’re reusing hypodermic needles(!!!), and that packages of even sterile specula are no longer sterile after packages are open, the problem with these rinsed-off-in-a-dirty-sink specula is a recognized problem. It’s just that they don’t recognize it enough in their office to the patient. I think they recognize it, and it’s a lucrative way to get more patients with infections, more visits, more chances to grope and prod, and more payments.

  16. Moo says:

    No doctor in their right mind would reuse a plastic speculum ever. It is disposable on purpose. Unless you live in some third world country where this apparently happens often such as reusing plastic syringes because of low resources.

    You could possibly purchase your own sterile speculum and take it with you to your doctor appointment and insist that is used. Sterile gloves are also available.

  17. Kathy says:

    In 2013 there was 29.4 million cervical cancer tests (pap smears) performed in the US. But only 12,000 women were diagnosed with cervical cancer. For so many screening tests being performed certainly the US would have the one of the world’s lowest cervical cancer mortality rates. Unfortunately that is not the case in fact the US is not # two or three or four.

    • Elizabeth (Aust) says:

      Exactly, Kathy, in fact the country with the lowest rates of this always-rare cancer is Finland, they have had a 7 pap test program, 5 yearly from 30 to 60, since the 1960s. Even now there is “concern” in some countries about winding back pap testing, is it safe to go to 3 yearly?
      They’re not interested in the evidence, dragging all women into the mix is good for them, but a harmful and unnecessary burden for the 95% of women who are not at risk and cannot benefit from pap testing. Looking at over-treatment rates, and there is (conveniently) very little research into the area, Australia has huge and hidden referral rates (caused by early screening and serious over-screening), the States would have similar, if not higher, rates. In the days when most US women were having annual pap testing from teens almost all women end up being referred at some stage, in the article by DeMay he puts the lifetime risk in the 90s (95% or so)
      So early screening (before 30) and over-screening (1, 2 or 3 yearly pap tests) = high over-treatment rates. The more often you test, the more likely you’ll end up referred and be over-treated.
      The Finns referral rate is much lower and now with evidence based screening (the new Dutch program) and pap testing only being offered to the 5% of Dutch women aged 30 to 60 who are HPV+ …this will see referral rates plummet. (and their rates are already well below our referral rates, they have never over-screened women and do not test before age 30)
      This subject is made complicated by those who benefit from that confusion, it’s really quite simple, put women first, follow the evidence and respect informed consent.

    • Moo says:

      Do you think that low income women in United States have access to medical care when they need it? More likely these are the women who are dying of cervical cancer. The rich and insured are getting paps done every year if their doctors demand it and can get paid for it by insurance companies.

      You can compare countries who have public health care programmes. Even then some women do not have paps at all or rarely. The participation rates in screening programmes has to be considered to show that screenings is effective (which it is not).

      As Elizabeth points out, the HPV test is more important.

  18. Elizabeth (Aust) says:

    Just using your example: 29.4 million pap tests = a huge amount of money
    Now evidence based testing would ONLY test the 5% who are HPV+ (and who want to test)…can you imagine the huge loss of income to doctors, specialists, hospitals etc. We’re talking about enormous sums of money, no wonder there’s a lot of “concern” about evidence based screening!

  19. Hannah says:

    I had a biopsy following a smear with low grade dyskarosis. Ever since I can’t orgasm and just feel pain instead. More then anything it’s emotionally painful. Will I never enjoy sex again? Is there anything I can do?! I feel so annoyed that I trusted them and they’ve ruined my body and my sex life. It’s so frustrating and upsetting can anyone help?!:,(

    • Alex says:

      Well, I don’t know if this’ll line up with your situation, but I’ve heard it said that “the answer to pollution is dilution.” This was talking about the environment, but I think it might also apply to general life. Trying to get more good things in your life maybe would help. It’s got to be its own thing, though- because if it’s some kind of a mission of counteraction it’ll probably keep reminding you of what you’re counteracting & just keep pissing you off.

      Something I’ve been thinking about a lot lately is that when fucked-up things happen, it’s kind of like a portrait with a cigarette burn in it & adding new “paint” can have a bit of sharp edge to it. This “paint” might be something that gets you to thinking “Where was that earlier?” or it has a bite because of the contrast (you get to thinking about what it’s not). That or it feels tragic in some way, like good people falling off a cliff & landing on jagged rocks or something- that it has that “aw, it’s such a shame” bite to it.

      Again, I don’t know if any of this applies to you, but it sounds like this was an abusive situation (and the don’t make a big habit of telling people about risks, inaccuracies, or alternatives with anything). Overall, deception vitiates consent- it’s not someone making their own decisions if someone else is lying to them. Things like this can have a severe effect, even if it wasn’t an ostentatious situation.

      One more thing: I remember hearing that, similar to being drunk, what someone’s state is comes out. Maybe it’s not their personality, as such, but the state that they’re in at the moment. This could always be more of a background thing, than a surface-level thing.

    • Elizabeth (Aust) says:


      How long ago did you have the biopsy? I take it you mean a colposcopy and biopsy, not a cone biopsy. I assume you’re American, I doubt any competent Australian or UK doctor would refer a woman for a biopsy after a low grade change, but know some American doctors still refer women for minor changes. If you’re under 30 as well, an “abnormal” pap is very likely, a false positive caused by transient and harmless infections or the pap picking up normal changes in the maturing cervix. This is why an evidence based program does not test before age 30.
      Women often experience sexual issues after a biopsy or treatment, sometimes it’s psychological, a feeling of being “dirty” or just put off after finding the treatment traumatic, embarrassing, painful, invasive etc. Also, if your cervix is still healing or has some scarring this may be causing you pain/discomfort, that could certainly prevent an orgasm.
      You’re not alone, a lot of women end up worse off after these treatments and biopsies, my younger sister had an unnecessary cone biopsy. She was told that might cause issues if she wanted to have children. (she was told after the procedure)
      It should be a scandal that women are pressured and misled into this testing,and early and over-screening, that so often leads to excess biopsies etc….all with no informed consent and often, there is no consent at all. (for example: you must have a pap test if you want the Pill)

      • Hannah says:

        I’m in the UK. I’m 25. I waited a month after the biopsy till I had sexual intercourse again. When it was painful I thought it must be too soon. It was another month or so again and I’d pretty much forgotten about having it, till again painful sex and can’t come anymore. Have you heard stories like this before? I only found one saying she lost sensation and it’s been 5 years etc..
        The letter I received from the doctor after the biopsy said it hadn’t been very helpful as the important part of my cervix was not represented. But he was sure it all looked fine. And that was it.

  20. Elizabeth (Aust) says:

    Actually Hannah…having a quick look on the net, you’re certainly not alone, there are quite a few women looking for answers.
    For some of these women the pain/discomfort lasted weeks, others months, one said a few years. Some were put off sex by the procedure itself, others found sex painful. (so an orgasm is not going to happen, sex should be about pleasure, not pain)
    Aside from psychological issues, some women develop an infection or have inflammation after this procedure, the inflammation is called cervicitis. This could explain pain during intercourse. I couldn’t find any stats, the system doesn’t want to know really, they like to tell us all of these procedures are minor and life-saving.
    Hopefully, things will settle down shortly, otherwise you might need to get some advice.

    It’s a shocking way to treat women, the lifetime risk of colposcopy/biopsy is a huge 77% here in Australia thanks to over-screening and early screening…note the lifetime risk of cc is only 0.65%
    A remote risk should not mean most women having something “done” to their cervix.
    The cervix is there for a reason and should be respected and protected.
    So sorry you have been negatively impacted by this testing. I’d urge you though to do some reading about this testing, then you can make decisions from an informed position, IMO, we cannot trust the official discourse in women’s cancer screening.

    • Hannah says:

      Thanks for your reply. Possibly it’s an infection as after intercourse I’m really swollen up to my chest for a few hours after. So wish id found this site before. Obviously the first ten-20 sites are all pro biopsy etc. It makes me so angry. So with these other woman did any of them say the pain went away do you know? I’d really like to know if it did. Thank you.

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