Is a pelvic exam pointless if you're a non-sexually active lesbian, with mostly intact hymen?

[she101.livejournal.com]

I'm nearly 24 years old and have been wondering if I should ever have a pelvic exam/gyno exam/pap smear (not sure what the big difference is or which one I'd need).  I've never had any kind of checkup like that before, and I just feel like I'd be really wasting the doctor's time by going for several reasons.

Firstly, I'm worried the exam won't even be PHYSICALLY POSSIBLE because my hymen opening is just so small.  I doubt any instruments would even fit in there.  I can't even insert tampons!

Secondly, I'm practically a virgin (not sure if the occasional lesbian sexual encounter counts as being sexually active or not in this context).

Thirdly, I don't ever plan on being that sexually active, so a small hymen opening might not seem a big deal, but I would love to be able to use tampons instead of big bulky pads all the time!

This hymenotomy I've heard about has raised my interest, but once again, I'm just heaps paranoid that the doctor will think I'm ridiculous for showing up for an exam, let alone asking about a hymenotomy.

Am I just being OVERLY paranoid?

Is it worth making some sort of appointment, can they even DO anything in the appointment?  I rarely see doctors for anything, so I wouldn't even know who to contact to make an appointment like this.

Thank you
from
*confused, worried and paranoid*

Comments

[archangelbeth]

One thing that a pelvic might be able to check for would be ovarian cysts. However, that requires that the doctor get a couple of fingers inside, and press down on your stomach to feel the ovaries. Thaaaat... might be rather difficult if tampons can't fit.

I would suggest calling up the office, and saying you're calling specifically regarding a hymenotomy. I'd suggest telling them you would like to be able to have doctors able check for cysts and whatnot even though you are not penetratively active -- and because you would like the option of using tampons. If they meeble around, then you can say, "If you're not willing to consider this, then I'll call another office."

You have two perfectly reasonable and even non-sexual reasons to want a hymenotomy -- don't let anyone meeble around at you or trivialize them! But do tell the doctor ahead of time that your first priority is the hymen, and any internal exams are going to have to wait till that's dealt with.

Luck!

[elettaria.livejournal.com]

Yes, smear tests are recommended for lesbians too, I checked this out for a friend of mine once, though it's probably not a screamingly urgent need just yet. Lesbian sex is still sex. Some people might count penis-in-vagina sex as the only form of sex, but doctors tend to have more sense (especially since other forms of sex can still spread STIs: a doctor friend of mine said that there were a lot of lesbians coming into the GUM clinic when she was working there, they were getting STIs from sharing sex toys). I had a cervical polyp, which isn't caused by sex of any sort, picked up during a smear test. Ask in advance about your concerns with having trouble getting anything in there, see what the doctor suggests.

[neaira.livejournal.com]

Yes, because paps test for abnormal cells that could cause cervical cancer, and exposure to HPV is not the only way for those cells to form. Plus, lesbian sex can still potentially put you in line for exposure to STI's.

And lastly, a gyno recommended to me that I have a hymenotomy when I was 15 because my opening was so small (and at that point, there was no mention of sex. I was there for a yeast infection.)

[misslynn.livejournal.com]

actually, HPV is the cause of cervical cancer in the vast (like, 95%+) majority of cases. that said, it may well still be possible for her to get hpv; i'm no expert. and yes, there's certainly still an STI risk.

[neaira.livejournal.com]

HPV is not the only cause of cervical cancer, as I stated above, which is why it's important to see a gyno regardless of your sexual activity.

[misslynn.livejournal.com]

i'm not disagreeing that it's important to see a gyno, not at all. but i also thought there were several causes of cervical cancer, and it turns out that it's very rare to get it from a non-HPV cause. so i was just passing along what i'd already learned here. :)

[neaira.livejournal.com]

I might just be overly cautious because I know someone who had non-HPV formed cancer.

[facemcgee.livejournal.com]

my friend has cervical cancer and doesn't have hpv.

[marionravenwood.livejournal.com]

You will get varying answers the more you google around, but hpv causes anywhere from 95% to "virtually all" cervical cancers. See previous thread here (http://community.livejournal.com/vaginapagina/10536660.html?thread=127554772)
I personally think the risk is so small for virgins it's not worth screening if you have no other risk factors (i.e., smoking), but that's something every woman has to decide for herself.

Lesbians are probably at a lower risk that heterosexuals, but at a higher risk than virgins. I would love to see some figures comparing cancer rates, but I never have. In any case many women who identify as lesbians have had sex with men at some point in their lives.

[neaira.livejournal.com]

I know the numbers, howwever, I also know a woman who developed cervical cancer without having HPV.

[geminigirl]

My well woman exams have included the bimanual exam (inserting gloved finger into vagina, and pressing on abdoment to feel for abnormalities in the reproductive tract), the pap smear, and a clinical breast exam. It's already been pointed out that the pap smear simply looks for cervical abnormalities, and while they're commonly caused by HPV, which is sexually transmitted, they can happen for many other reasons, not all involving sex.

A clinical breast exam is important too. And if you're not doing regular self exams, it becomes more important, plus a well woman visit is a good time to learn how to do self exams. There's a high incidence of breast cancer among lesbians as well, for a variety of reasons. At 24, the risk is still pretty low, but learning how to do self exams and setting up a good relationship with a health care provider for clincial exams and who can help with future care is important.

Perhaps a course of action would be setting up an appointment to talk about hymenotomy, rather than setting up a well woman exam that would cause you pain and not likely yield much useful information.

[starzysky.livejournal.com]

The exam is for a lot of things - you might consider refusing the pap smear, which is a screener for cervical cancer [they basically take a small scrape of cells from your cervix, and use them to look for any abnormal cells that could be the precursors to cervical cancer... wich is caused by a virus & you probably have had no chance of exposure]. I would tell the doctor exactly what sexual experiences you have had, so he/she can determine that you are truly not at risk for HPV in any way.

However, the rest of a traditional gynecological exam IS something that you will want to have done [of course, it's your choice!]. The pelvic exam consists of the doctor palpating [feeling] your uterus & ovaries to ensure that they are of normal size/texture/etc. The health of your reproductive tract is something that I'm guessing is important to you, regardless of your orientation! Even if you don't want to have kids, you'd want to catch something like, say, an ovarian cyst before it burst, or a thickened uterine lining that could be a problem, etc.

The gynecologist or nurse will probably also do a breast exam to check for suspicious lumps-- yet another thing that you could have regardless of your sexual orientation or experience.

Also, they may screen for a few STI's (usually chlamydia and maybe gonorrhea). I'm not sure if they can be transmitted via FtF oral sex, but they probably can.. and they definitely can be transmitted if there was any exchange of vaginal secretions between two women. It's always good to get tested if there's any chance of having somethign like that, for your sexual health & that of your future partners.

Finally, your interest in a hymenotomy is NOT a weird or even questionable reason to have an exam. It's actually a GREAT reason to make an appointment! You can't use tampons, and someday if you ever wanted to have a girlfriend use a sex toy or more than a few fingers inside you, you wouldn't be able to do that. Those things are perfectly valid reasons to request a hymenotomy. The doctor isn't going to say "Um, I'm not giving that to you b/c you don't like penises." I promise. The doctor is going to say, "yes I can see that you have a very strong/obstructive hymen that's impacting your life negatively, and here's what I can do..."

Ok? So YES you should feel completely validated in getting an exam. Just like any part of your body, your reproductive organs can have diseases and infections. Being a lesbian, even a virgin, doesn't play into it. At the clinic I work at, we recommend having regular exams starting at age 21 [or earlier if you're sexually active] - and orientation & sexual experience have nothing to do with that recommendation.

Good luck!

[starzysky.livejournal.com]

::reading above comments::

Ok well if you can have cervical cancer w/o getting HPV sexually then you would definitely not want to refuse the pap smear! Just ask your doctor.

[whitneythegreat.livejournal.com]

She could also have picked up HPV from one of her encounters with a woman, since she doesn't say how far any of these encounters went. If there was genital contact, it's possible to have picked up HPV, even though she's only been with girls.

I agree with the other commenters that it would probably be a good idea to have a full exam, if you've been sexually active with anyone.

[starzysky.livejournal.com]

That's why I said sexually, which does not imply PIV...

And I told her to tell her doctor about her sexual experiences so he/she could determine whether she was at risk; I'm pretty sure you can't get HPV from oral sex & I suppose that's what I was assuming was the bulk of her sexual experience considering her issues w/ penetration. But yes, you're right.

[kaelstra.livejournal.com]

Actually, she is still at risk for being exposed to HPV. There's potentially less risk, depending on what type of lesbian sex she's having, but there's still a chance she could get it. Basically, anyone sexually active is at risk, hence why it's so darn common.

[elettaria.livejournal.com]

I've been told my medics in the UK that they used to advise lesbians not to bother with smear tests, but have now changed the policy on that.

[procraftinator.livejournal.com]

I'm a lesbian too. I have had penetrative sex a quite few times, but now it's been a long time, so long, in fact, that I can't even fit a tampon. So when my pap smear came up I called and explained this, and I got a midwife that was really nice and accomodating and talked me through the whole thing, and actually managed to get a pap smear. I just wanted to have it done once for my peace of mind, even though I know I probably don't have anything that could cause an abnormal result. You should try cloth pads, by the way, they are way less bulky and more comfortable.

[crowjane.livejournal.com]

It's important for all women to get yearly Pap-smears to check for abnormal cervical cells, and a clinical breast exam to check for lumps.

[she101.livejournal.com]

Wow thanks for all the posts so far, especially starzysky. :) I already feel less awkward and embarrassed about wanting to arrange a pelvic exam. Now I admit I'm pretty naive about these things... so next time I see a doctor for something would I just quickly add before I go if I could get a referral to a gyno? Or do you just look up gynecologists in the yellowpages? (Sorry if that's a stupid question.)

Tho I have got to wondering about the costs of the exam, and of a possible hymenotomy... Hmm times like this I wish had insurance... ;)

[archangelbeth]

If you like your doctor, I'd call up zir's office... heck, call 'em up on Monday. Ask if they can recommend any gynecologists in the area. The receptionists alone probably know which gynos they have the most dealings with.

If you think your doctor is eh, so-so, look up gynecologists in the yellow pages. In this case, lack of insurance is going to give you a certain freedom since you won't need a referral for insurance purposes. You'll probably want to ask the gynecologist's office what their fees are, and what sorts of payment plans they arrange, too.

(In my area, there's only one Ob/Gyn office, so that simplifies things a lot. Fortunately, they're cool people.)

[kaelstra.livejournal.com]

You actually don't need a gyno to do the exam, most General Practitioners can and will do it. It's not an exam that requires a specialized degree or anything. You could just ask and see if your regular doctor can do it. If anything is abnormal for any reason, they could then refer you to a specialist, but otherwise, you generally don't need one for just a pap smear.

[she101.livejournal.com]

A GP doing it, yikes! I don't even have a regular doctor I see. I just go to my local doctors office around the corner and see the next available doctor (usually a 2 hour wait). They're kind of dodgy doctors, but the government pays for every visit so I put up with it. *shrug*

[ellinht.livejournal.com]

sorry if I am prying but your info says you are from Australia :) (yay me too!).
Here in Aust you just see a GP for a pap smear, check up etc. I think the only way you would be able to see a gyno is if there was something wrong and you need to be refered to them because they are a specialist..

It sucks I know! I don't have a doctor either and would feel so much more comfortable seeing a gyn.

[jennifer0246.livejournal.com]

I second the notion that in AUS you typically would see a GYN only for a problem or issue, but given this desire for exploring hymenectomy or hymenotomy, I think that's more than enough reason to ask a GP for a recommendation.

OP, I would recommend having your GP perform as much of the exam as they/you are comfortable with (probably at least a breast exam and physical examination, without penetration) and provide you with a referral.

[caletara.livejournal.com]

defiantly ask your own gyno on this one but my gyno told me that since im not sexually active and have only had non penetrative no toy lesbian sex with another virgin, I could have a pap smear ever 2-3 years. My risk of anything was negligible. But different doctors probably have different policies.

[purpleumbrellas.livejournal.com]

You should definitely get a check up! Lesbian sex is still sex and even if you had no sex other things can still go on down there that would be caught in a check up which is important!