Friday, July 17, 2009

Is a Gynecology Exam a Violation of our Body?

I received an e-mail from Cassandra who has a blog,, who asked me to write an article on my blog and site about the harm from the routine gynecological visit. Cassandra also referred me to “women against stirrups” on Yahoo.
I totally agree with Cassandra that the annual gynecological visit is unnecessary. Many times women experience humiliation and distress, and in a fair number of cases, women receive unnecessary and sometimes harmful treatment. For example, many women in their forties and older dutifully go into the gynecologist’s office for a check-up, even though they have no symptoms of a problem, but leave the doctor’s office with a prescription for hormone-like drugs to treat their “dry vagina”.
How does this typically happen? If a woman is not having regular penis-vagina sex, the lining of her vagina becomes thinner. Because of the sexism in our society, men don’t seek out the company of women over 40 and those men that are married to women over 40 are getting older themselves and often they desire less sex. Also, many women are divorced or widowed or never-married and they are relieved that they don’t have to spend time and energy on maintaining a relationship with a man. As a result, even if a woman stays sexually active with other women or if she masturbates, the thick ridges of her vagina tend to flatten out some. Sometimes, the wall is so thin that when you put in a speculum, the vagina may develop small tears that bleed, leaving a trace of blood on the speculum when it is removed.
Immediately, the doctor informs the woman that she has “dry vagina” and has an inadequate supply of the hormone, estrogen, and she/he prescribes a hormone-like drug to build up the vaginal walls. The completely healthy woman is now taking a dangerous drug to cure a condition that she didn’t even care about.
Another common situation which leads a woman to become a candidate for hormone-like drug therapy is when a woman has some vaginal itching or discharge that prompts her to douche, and repeated douching can lead to vaginal dryness and itching. Unfortunately, since many women don’t know that vaginal secretions are normal, especially around the time of ovulation in the middle of their menstrual cycle, they douche and douche and douche, sometimes even using deodorant sprays for their nonexistent problem.
We found in our self-help clinics that we could treat this “dry vagina” problem by inserting a speculum or a dildo once a day for a few weeks (or sometimes women have used graduated smooth metal rods that their doctors have given them). This stimulation of the vaginal walls prompts them to thicken (much like the sole of the feet thickens by walking on them).
I have counseled several women to use this technique and it has been quite successful. One woman was referred to me by a women’s clinic, because she was having difficulty is having penis-vagina sex. She was in her early forties. She and her husband started a small business in their mid-thirties. Running the business took all of their time; they had no days off or vacations. Her husband, who was a few years older than she, lost interest in sex. Finally, when the business became more successful, they were able to recreate and have a social life. Then, when they tried to have sex, her husband had trouble maintaining an erection and she was experiencing pain and bleeding. I mailed her a speculum and she inserted it daily for a couple of weeks. We also talked about ways to make sure she was lubricated. She told me that her husband was attentive and considerate lover, but he was easily discouraged, and wouldn’t even try to have sex if he couldn’t feel confident that he could maintain his erection. She kept up her speculum routine anyway. Finally, he tried again and was successful and she was able to tolerate the insertion of the penis. In fact, she called the next morning to share how much she’d enjoyed herself!
The medical profession is totally ignorant of the realities of women’s lives, and it has nothing to offer us but drugs and surgery. I agree with Cassandra that women who are given hormone-like drugs for the treatment of “dry vagina” would have been much better off if they had never visited a gynecologist!


Cassandra said...

Thank you. It's a wonderful article.

Anonymous said...

Come check out or website:
We are a new non-profit organization dedicated to liberating women from the demeaning, unnecessary, and dangerous practice of gynecology.

Eliz52 said...

I'm Australian and 53 years old and have never had a routine pelvic exam, I was shocked when I first heard about well-girl and well-woman exams complete with stirrups.
UK women don't have them either, its been known for some time that they are of poor clinical value in asymptomatic women and expose you to risk. I think your doctors have come to rely on the income from these exams and from the unnecessary procedures that follow...IMO, these exams are more likely to harm you.
More of your doctors are coming clean and warning women away from these harmful exams - Dr Carolyn Westhoff in "Is the routine pelvic exam obsolete?"
Your doctors also routinely coerce women into these exams and elective pap testing to get birth control pills and other meds. This is outrageous - that sort of conduct would have our doctors before the Medical Board. The only think required for the Pill is your medical history and a blood pressure test.
American women are hugely over-screened for rare cervical cancer - it's a billion dollar industry on the back of a rare cancer! Almost every woman will have a biopsy or "treatment" after an "abnormal" pap test - almost all are false positives. Over-screening leads to over-treatment.
If you want pap tests you should consider:
Pap tests are pointless in women who are not yet sexually active;
Pap tests do not change the tiny death rate from cc in women under 30 (but produce the most false positives - 1 in 3 for those under 25)
Pap tests annually or 2 yearly is OVER-screening and of no additional benefit over 3 yearly testing and only marginal benefits over 5 yearly. The risk of a false positive goes up the more often you screen - with annual testing almost every woman will be referred at some stage, 2 yearly - 77%...
The lifetime risk of cc is only 0.65% - take out false negatives and fewer than 0.45% can possibly be helped by pap testing. (and there are other factors naturally affecting the incidence rate - more women have had hysterectomies, less STD, better condoms and hygiene and fewer women smoking)

It's now clear women can simply have a hrHPV test at age 30 and if negative and in a monogamous relationship or no longer sexually active, can forget testing or have another hrHPV test in 5 years time. This way you focus your attention on women "at risk" from cervical cancer and minimize the risk to healthy women - the more than 99% who'll never have an issue with this cancer.
The Dutch are proposing to move to hrHPV testing - 5 tests at 30, 35, 40, 50 and 60 and those positive will be offered a pap test.
Pap testing is unreliable and causes too much worry and damage to help a very small number of women. By age 40 only 5% of women are affected by HPV. I should add that a self-test kit and blood test are also available. The Dutch will be offered the self-test kit if they object to the invasive test.
As a low risk woman I passed on pap tests many years ago - I'm content to carry a near zero risk of cervical cancer.
Routine breast exams don't help either, they just cause biopsies.
If women want pap tests and can't access hrHPV testing, the Finnish program offers 5 yearly testing from age 30 to 60 - they have the lowest rates of cc in the world and send the fewest women for biopsies. (still high at 35%-55%, but the best you'll do with the unreliable pap test)
Women should embrace their bodies and health, not spend their lives poking around looking for "pre-cancer"...great for doctors and their profits, a lousy deal for women and a miserable life.

Izetta Holland said...

As a person who visit's an ob-gyn every year, I'm offended by this. Telling people not to get check ups is absurd! Cancer runs in my family and if it wasn't for yearly check ups to the ob-gyn than many of the women in my family would be dead. I do agree that the process could be handle more gently, but I also think that people shouldn't get stressed out about it. This is only my personal opinion, I don't think you have the right to tell people they shouldn't visit their doctor yearly, simply because it's uncomfortable or the doctor might prescribe something you don't agree with.

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