Women’s experiences of gynecological/obstetric procedures can be sufficiently distressing to cause post-traumatic stress disorder (PTSD). 500 women took part in a study about the psychological effects of vaginal exams, pap tests, and other gynecological/obstetric procedures. Of the 500 women who took part in the study, over 100 women reported their experiences as ‘very distressing’ or ‘terrifying’. Of the 100 women who reported distressing experiences, 30 were diagnosed with PTSD.
PTSD is described as a “reaction to catastrophic trauma”, and includes symptoms of flashbacks and repetitious re-experiencing of the trauma, avoidance of similar situations, and extreme distress when faced with events similar to those that caused the trauma (Menage, 1993, p. 221).
The study highlights the similarities between the after effects of rape and women’s experiences with gynecological procedures. Following rape, PTSD can result from the associated feelings of powerlessness and of being with an unsympathetic assailant, and also painful, humiliating, and/or mutilating experiences.
Similarly, the women diagnosed with PTSD as a result of gynecological procedures reported:
-a lack of information and consent related to the exam/procedure
-feelings of powerlessness
-feelings of being in an unsympathetic environment, and
-experiences of physical pain.
Some of the phrases used by the women who took part in the study to describe their experiences include:
-‘dehumanizing and painful’;
-‘degrading and distressing’;
-‘my opinions were dismissed as irrelevant’;
-‘hurting and feeling violated’;
-‘very brutal internal was excruciating’;
-‘it felt undeniably like rape’.
The study also highlighted the similarity between post-war veteran’s PTSD diagnostic scores and women’s post-gynecological procedure PTSD diagnostic scores. Post war veterans who completed the same questionnaire as the women in the study achieved similar scores. Menages states the “severity of the obstetric/gynecological trauma can perhaps be inferred from comparing these scores” (1993, p. 223).
There is a lack of research related to PTSD following gynecological procedures. The study quoted above was published in 1993, and there does not appear to be any follow-up research specific to gynecological procedure- related PTSD published since that time. There has been some recognition in the literature given to the trauma of pap tests experienced by women with a history of having been sexually assaulted, but the trauma caused by pap tests themselves is generally ignored.
The traumatic after effects of pap tests and other related gynecological procedures continue to go largely unrecognized by the medical community. Perhaps the consensus among clinicians is that by ignoring the issue it can continue to go unaddressed, and will not interrupt business-as-usual.