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Friday “Fun” Topic – Talk About Your Gynecological Care

April 11, 2008

Over at Feministing, there’s a good discussion going in response to the question, “What have your experiences been with gynecological care?” There are a lot of bad experiences (comments on vagina size, inappropriate lectures about personal beliefs) being shared, and some good ones as well (like those nice folks who warm the speculum).

I don’t want to limit this to ob/gyns, because I have seen a mix of providers for my annual pelvic-pap-whathaveyou, but what has been your experience? I’ll start:

My 1st: Mom dragged me to her ob/gyn as a teenager. This guy was about 500 years old. The exam was fine, but a little lacking in explanation of the purpose of each step. We had a little talk about sex and contraception and whatnot. So far, so good. After it was over, though, I found out that when he left the room for me to redress, he went and talked to my mom about our sex conversation. He hadn’t told me that would happen, or that it did happen – I only found out because my mom brought up with me some of the things I had said to him. Obviously, my trust was completely violated and I knew I could never be straightforward with him. I never went back.

2nd: CNM in college student health. We had a running joke that any time you went to student health, even if it was an earache or something completely unrelated, she would talk about whether you could have an STD. It sounds silly, but I bet she got more sexually active college kids to get tested than most other providers.

3rd: Female ob/gyn in a small town. Options were limited, and I had heard good things. Very good at the exam and explaining what was going on. My only slightly weird experience was the time my appointment happened to fall on Halloween. The clinic staff were wearing costumes. Seriously. That is a pelvic you either never forget or completely block out.

4th, and current: Women’s health NP in a nurse/midwifery clinic. Awesome. No bad experiences.

Okay, your turn. 🙂

12 Comments leave one →
  1. Anne permalink
    April 11, 2008 1:59 pm

    1st) Went at 16 because of almost constant periods for several months. My mom, a nurse, was in the room because she thought I was sexually active but I wasn’t. I was sent for blood work to determine my wacky cycle.

    1st follow-up) Was diagnosed with polycystic ovary syndrome based on my bloodwork and irregular cycle, but none of the classic physical symptoms were present. Was told I would be reproductively-challenged for life.

    5th) Went for an annual exam following a semester abroad and my first sex partner. When mentioning an irregular period and worries of pregnancy (regardless of impeccable condom use – I’m paranoid) with regard to PCOS, she bluntly asked if I got a period every month. When I responded in the affirmative and then was flippantly told I didn’t have PCOS. Previously held assumptions on my lack of fertility changed unceremoniously.

    Currently) See an adorable old man who sees me in his office before the pelvic exam, tells me exactly what he’s doing, and gives me as many free samples of birth control he can. Awesome!

  2. April 11, 2008 3:20 pm

    My first visit was to Planned Parenthood as a college student. I’d been sexually active for about a year, and finally decided to get birth control. The examiner was female and kind, but was completely bewildered when I asked her what it meant if I’d never had an orgasm. She said she’d never heard of that happening, and that I ought to see a specialist if I wanted to do something about it.
    The birth control experiment was a disaster – lots of discomfort and bleeding – so I quit after a few months.

    I didn’t see a specialist about my missing orgasms – I was a college student for heaven’s sake – but I didn’t see a gynecologist for several years either.

    My second visit was about five years after that first one: finally I had health insurance, and I was also worried about STDs. (The orgasm issue went away with increased experience and confidence, as they usually do.) Because of my worry, I really just took the first nearby doctor who could pencil in a new patient. I really lucked out. This doctor was not judgmental about the HPV he discovered and was extremely informative about the Gardasil vaccine. Between the several visits for wart treatment and several visits for vaccine installments, I saw him a lot more often than one sees one’s gynecologist; I nearly always brought a list of questions and he did his best to answer all of them. If he didn’t know, he’d look it up and call later that week. I’m seeing this doctor for as long as I live here.

  3. Eucritta permalink
    April 11, 2008 3:51 pm

    My first and worst experiences were with a doctor named Coffin, and it suited. The exams were also incomplete, as I had an unusually wide, tough hymen that proved a barrier to the speculum, and in retrospect I’ve been very, very angry that no-one who was aware of this ever mentioned that it could’ve been easily remedied — and *should* have been — with a smidgen of topical anaesthetic and a scalpel.

    My best experiences were at a free clinic in the late 70s, the Evergreen Clinic in Seattle. Now defunct, more’s the pity. The docs there had gentle hands and always talked through the exams, not just what they were doing but why, and I got so interested I forgot to be self-concious.

    Currently, I’m with a doctor whom I’ve come to realize is just plain uncomfortable with me — with my debility (I’m severely arthritic), my fat, even, weirdly, my sexuality, given that I’m a straight married woman. I suspect the last is due to the first, though I suppose she could just be a prude too. No mind: I’ve decided it’s time for a change.

  4. gorlitsaknits permalink
    April 11, 2008 5:04 pm

    My first was at the age of 11 when my step-mom thought I had a yeast infection. I blocked out most of that trip.

    Second was to planned parenthood as a college student, preparing for my wedding. I wasn’t sexually active, and the staff didn’t really know what to make of me. No risk of, well, anything. What are you doing here again?

  5. April 11, 2008 9:52 pm

    These stories are interesting. I guess I’ll share mine:

    1.) My mother brought me to a gyn because of severe dysmenorrhea at the age of 17. The gyn was an older woman and was very gentle. When her nurse handed her a speculum, she said to give her a small one as this was my first exam and I was a small girl. Talked to me with my clothes on. After, she had me go into her office with my mother to discuss treatment, which included birth control pills. I was all for it, as I was also sexually active but my mother didn’t know. I think it was an extremely uncomfortable experience for my mother.

    2.) Went back to the same gyn a year later. Had graduated to the yet to be fashionable shaved style (this was in ’93, before this was the “in” style) so I don’t think many gyn providers had seen this. I went into the stirrups, and the nurse promptly laughed out loud while staring at my vagina. Like out loud, very funny joke. The doctor, who was so good the year before, tried really hard to stifle her laughter and used a large speculum despite still being a “small girl”. Actually, I was smaller than the year before.

    3.) Went to a well respected male gyn that I worked with. He was very experienced and all his patients seemed to love him. During the breast exam he tried really hard to make casual conversation but it was clear as day he was very uncomfortable. He did the pelvic exam without a chaperone and used a large Graves speculum. I lost respect for him and didn’t go back.

    4.) Went to another well liked/respected gyn via work. Everything was fine until I realized that she did a half ass bimanual exam. There was no way she felt my uterus and adnexa the way she barely pushed on my lower abdomen; my uterus is retroflexed and I was/am overweight.

    5.) Best was via my primary care doc. She is my age, and was totally cool, efficient, and comfortable. I was pissed she moved to Virigina.

    So there you have it.

  6. onesillyme permalink
    April 11, 2008 11:35 pm

    My first visit to a gynecologist was in high school at Planned Parenthood to confirm pregnancy and schedule an abortion. They were great– contrary to what some people believe ALL of my options were explained. As there was time, they encouraged me to take time to think about my decision and to talk to my Mom. The gyn who did the abortion, on the other hand, criticized my choice of college major while making small talk during the procedure. I fell apart. To this day I don’t know if it was the stress of the circumstances in general or the fact that I was loopy on Valium, but I have never taken the opinion of a stranger so seriously before or since.

    Next visit, again via Planned Parenthood, I had an abnormal Pap. Referred out to a jerk who let me know I wouldn’t have this problem if I weren’t sleeping around. Geez, I was on my second partner at that point, intended to marry the guy, and no woman should have to listen to a lecture with feet in stirrups! At that point I determined not to let anyone refer me around again, I’ll pick my own doc, thank you.

    Next visit to a Gyn, in college I had discharge from one nipple that turned out to be milk. The doc was awesome, explained all the possible causes, what to do about it, and talked to me until I calmed down from fear that I’d die of breast cancer (all I remember of my great grandmother is her extremely painful death from it). Even after I graduated college & moved away, I traveled 1 1/2 hour to see this guy until he moved away himself.

    When I was in my late 20’s, I saw a highly recommended Gyn because my primary care doc wasn’t comfortable fitting a diaphragm. I mentioned that my periods were slightly irregular and he mentioned in an off-handed way that I’d probably need Clomid to get pregnant. 6 months later I was pregnant with twins… good thing I wasn’t trying!

    Several years and 3 kids later, I was having 8+ day periods, cripling cramps and severe anemia. First Gyn I saw wanted to remove everything remotely female. I doctor-shopped until I found a woman trained in Quebec who agreed that if the problem was my uterus that was all that should be removed. (And, no, it wasn’t an elective hysterectomy. Ablation would have bought me some time but not a permanent fix.) At 33 my ovaries had plenty of work to do and she understood my concern that removing my cervix might result in scarring and sexual problems. She even straightened out and shortened my C-section scar. I was so bummed when she moved back to Canada!

    At this point, my internist does my annual exam and I’m hoping I won’t need to see a Gyn again.

  7. beate permalink
    April 13, 2008 1:00 am

    Awesome thread. I’m not so good at chronology, so here are a few relatively recent experiences, from when I was in my 30s.

    1) Small college town, first visit to obgyn for an annual checkup and just to make sure everything was in order before I started trying to get pregnant. Having grown up in Europe, I was unfamiliar with the etiquette of disrobing and donning the paper gown. When I asked the assistant for guidance on just how much of my clothing to remove and what to do with the gown, her eyes nearly popped out of their sockets: “You mean over there you just take off your clothes???” To me, the paper gown still feels vulgar. I prefer the more matter-of-fact approach of baring those parts that are being examined and otherwise keeping my own clothes on.

    2) Same doc, during prenatal exams during the second trimester, after hearing that I was taking birthing classes from the local women’s health activist group rather than the hospital. He justified episiotomies thusly: “When the clitoris is hanging by a thread, you’ll wish that I’d made the cut.” What an asshole. I switched providers and gave birth in a birthing center, assisted by a midwife.

    3) Oh yeah, in my early 20s, I had an obgyn admonish me to conduct self-exams of my breasts because my breasts were my “friends”.

    4) Now the memories are coming back. In my teens, in a small town in Germany, a female obgyn nearly refused to fit me with a diaphragm because she didn’t want to become a “murderer” in case I’d have to ask for an abortion if the birth control failed.

  8. April 13, 2008 2:56 pm

    I’m really really sorry for budding in on what is really a women’s discussion, plesae forgive me in advance. I like to scan the women’s blogs to know what women are discussing, and it helps me with my own blog. I found this conversation to be very humbling, and I think back to some times that I have probably made women feel uncomfortable in my office.
    As a male gynecologist, I have to contend with the fact that many women find that my gender is a barrier before we even have our first conversation. Fortunately, most women that find male gynecologists uncomfortable will not be coming into my office in the first place. Before they see me, they already know that I am a man.
    I really don’t see how gender matters when it comes to medical care, although I fully respect the fact that everyone needs to find the doctor that they are most comfortable with. I’ve heard before the claim that a man can’t understand women’s issues, but I never heard that to be a cardiologist you need to have a heart attack first, nor to be an orthopedic surgeon do you have to break your arm first. In the same way, I’m not sure why someone would need to be a woman to be a gynecologist.
    Thankfully, I am busy in my practice, so it seems that at least my patients realize that the most important thing is to find someone knowledgable, experienced and above all, caring respectful, and willing to listen.
    As far as bad experiences are concerned, let me fess up as to some of the dumb things that I have done in the past.
    Early in my career, I discussed the risks of sexually transmitted infections with a 14 year old in the presence of her mother before I even knew anything about her sexual history. I think I freaked her out enough to scare her away forever. I learned then to take it real slow and take on subjects subtly and over time, and only bring up issues when someone is truly ready for them.
    The most delicate and difficult encounters are with younger women when they come for the first time. It is rarely necessary to even do an exam the first time. Almost always you can simply speak with the person and develop a comfortable relationship. You have to find out from the patient whether she would rather speak with you alone, or with her Mom or someone else present. You have to reassure her of true confidetiality (assuming you are aware of the laws of parental consent in your particular jurisdiction). The exam can usually wait until next time, or the time after that.
    I apologize again for entering this conversation even though I don’t have an experience of my own to share, but I thought you might find my perspective interesting.

    • priya permalink
      June 16, 2009 3:38 am

      hi, im sorry its a topic ul spoke about more than a yr back… im 19 n havnt been to a gyn evr becaz its somethng i probly wnt b able 2 deal wid, but if i hav 2 n there is no other option il probly b more comftbl wid a male gyn…

    • Etherealchick permalink
      August 14, 2009 12:23 pm

      In response to Saul: You don’t understand why some women choose a female gynecologist? Well, for me, my vagina is the most personal place I can be touched/examined. I don’t really care who touches my arm or my foot. The thing is, I feel much more comfortable getting a pelvic exam done from someone who has likely experienced it. My female gynecologist knows what it’s like to be exposed, legs in the air, and have a speculum inside of her vagina. I know I am probably wrong, but it seems that she might take more care to be gentle. Also, they likely understand what it’s like to have cramps and bleed heavily. Some people gravitate toward doctors to which they can relate. I don’t want to discredit male gynecologists in any way. I respect them just an much and I understand that they are just as qualified to do their jobs. But, it’s all about preference. To some women, it really doesn’t matter. To others, like me, a female gynecologist is necessary. Otherwise, I wouldn’t go.

  9. Lula permalink
    May 9, 2008 5:24 pm

    Great topic! I am a little late but I hope that you won’t mind me sharing my experiences.

    1. My first exam was in France, the lady doctor was very professional and made me feel at ease. Also I felt less embarrassed because French isn’t my first language. A great first experience.

    2. A nurse at different local surgery who cheerfully remarked whilst waving the speculum aloft, “see, men get much bigger than this!” Ugh!

    3. Finally an innocent trip to get a diaphragm fitted at the local family planning centre who are supposedly specialists. The nurse who I saw first of all seemed to have no experience and could not get the right size after many attempts and apologies. She then asked if I would like to see the doctor who had more experience. I said yes. She then told me that the doctor had a student with him, a qualified GP, who was doing a FP course, would I mind her sitting in? I said ok then. BIG MISTAKE! The “student” was the most patronising woman I have ever met and she was dead against any idea of a diaphragm as well as having no experience fitting one. She lectured me at length about different methods when I had already had the same conversation with the nurse and my GP, read all the leaflets and made an informed decision based on my circumstances. She could not believe that I was capable of making up my own mind and she made me feel like an idiot and worse. She also strongly recommended contraceptive injections which considering I was changing from hormonal methods because they do not agree with me did not seem like a smart move.

    When I first had to lay on the bed she made me cover my crotch with a piece of paper towel. This made me feel like she thought my genitals were something to be ashamed of. When the doctor went out of the room she asked if I was cold, would I like my coat over me. I said no thank you, it was not cold. She came over and draped my coat over me anyway to cover me up. Finally after many different tries from both her and the real doctor to it the diaphragm with her making comments about me as though I was a piece of meat I was so sore and humiliated that I could not take it any more and I told them that I wanted to stop. She then stayed in the curtained off area by the bed with me when I wanted to get dressed, still lecturing me about how a diaphragm was not a good method. I had to quite forcefully ask her to leave several times so that I could get dressed before she got the hint.

    When I left the clinic I burst into tears on the street as I felt so frustrated at the way I had been patronised and humiliated by that woman and I have not been back.

    Sorry for the long rant, my boyfriend does not understand how I feel about this and I have noone to talk to about it.

  10. September 7, 2009 3:00 pm

    New Here – Wanted to Introduce Myself
    Chris Wodja
    Christopher Wodja

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