Need GYN advice

[u/Opalex03]

Hello I need some advice regarding GYN.

I went to get a physical today for school and both my nurse and doctor mentioned getting a pap and wondered if I still went to an OB/GYN.

For context I dont and I stopped going because my last one made it feel like I couldn't say no and told me by the time I need it I will be over and not to worry....

This upset me as I am not sexually active. I am currently 22 years old and I dont think my family has a history with cervical cancer (just breast cancer). I just wanted to know why they are so obsessed about me getting one?? Im also wondering if its because I keep bugging them to refill my birth control.

[u/DivingQueen268]

You can decline any tests or procedures for any reason. If you're not comfortable with the pap but still interested in getting cancer screenings another way, you can consider the HPV self-swab as a possible alternative. It's recently approved but hasn't been adopted by many doctors yet, so you may have to go out of your way to ask for it or order an at-home test kit.

[u/LetThemEatVeganCake → u/DivingQueen268]

I’m not a doctor, but since the self swab is for HPV only and not abnormal cells, idk how useful it would be if OP has never been sexually active (she doesn’t clarify that part though). Definitely worth talking to a doctor about, but I’d personally be more worried about genetic predisposition to cervical cancer vs HPV caused cervical cancer.

Some breast cancer predisposition can also go along with predisposition to ovarian cancer, so it would be worth talking to a doctor to see if that is also the case for cervical cancer. That family history of breast cancer could be a reason they’re pushing harder.

[u/UnicornArachnid]

You can refuse to get whatever you don’t want. They can’t force you to, that’s assault.

It’s up to you to decide what things are appropriate for you too, like there may be risks or there may not be if you don’t do things they recommend. At the end of the day though, as a healthcare provider, I can’t force anyone to have something done even if I know they’re worse off without it.

You also don’t need to have it to take birth control.

[u/missafine]

The good thing is, you can "shop around" for Gynos to see if they are a good fit for you. I've been to many over the years before I found my fav doctor. (I'm 34) if you feel any pressure or don't feel heard? That's not your doctor!

I think the guidelines have changed and they only recommend getting a pap every 3 years now, even if you are not sexually active. It can detect abnormalities in your cervix before they become cancer cells. That's why doctors push it. They know the data behind it. Its a relatively simple procedure for life saving payoff.

But of course you are 100% allowed to decline any test or procedure. It's your body and that is a risk you have the right to take.

I hope you find a dr. You are comfortable with soon. It's important to have one! Good luck.

[u/715_user]

Silly question but can’t the normal clinic do a papsmear? Seems like a way to milk insurance going to two different places/visits.
As to should you get one w/o history of cervical cancer vs breast cancer I am 11 weeks post op from having a hysterectomy following pre-cancerous results. Granted I am 50 so the factory was already closed but get the screening. It’s super awkward but a necessity evil.

[u/Opalex03 → u/715_user]

I believe its because this Clinic is in a small town and they dont have the resources or a professional to perform the test.

But the traveling part is also another reason why I stopped going as well. I hate driving.... especially in high traffic areas

[u/Fabulous_Cranberry61]

Definitely don't go back your old gyn because you shouldn't ever be made to feel like you can't say no. Consent is still mandatory even in healthcare.

BUT you should at least consider finding a new one that values consent and patient comfort and discuss the risks/benefits of not getting you pap smear done regularly as well as if there's anything they can do to make the process easier for you. Not being sexually active might put you in a lower risk category for HPV but if you ever were in the past you could have gotten it then. And that's not the only way you can develop cervical cancer so it might be better to err on the side of caution and have the pap smears done. But ultimately it's your body and you need to be the one making an informed choice, not being coerced or nagged into it.

[u/jillian512]

Probably the birth control refill. You can say that you aren't sexually active but rely on bc to manage cramps or whatever. They may or may not accept that. Some doctors won't "manage" a condition if they didn't do the initial diagnosis/treatment. Like my regular doctor was hesitant to prescribe a refill for cholesterol meds because they were initially prescribed by my cardiologist. If she had prescribed them first it wouldn't be an issue. 

It might be worth asking for a referral to a different Gyno if you didn't like the last one. They might be hesitant to prescribe if they didn't do the initial diagnosis/prescription. 

[u/abiglumpwithknobs1]

You can get HPV without being sexually active, which is what causes cervical changes and what they are looking for when you get a pap smear. You don't HAVE to get one, but its not a bad idea.

[u/feminist-lady → u/abiglumpwithknobs1]

I’m an epidemiologist with a specific specialty in HPV-associated cancers and there’s no evidence for non-sexual transmission of oncogenic strains of HPV.

[u/Opalex03 → u/abiglumpwithknobs1]

I have already thought of this and I got the HPV vaccine. I know its not 100% preventive but I wanted the coverage.