[dobee]

Hello everyone. Any sincere help is very welcome.

My doctor has suddenly decided to take away my birth control pills until I consent to a physical. I am looking for suggestions of other ways I could meet her half way on this without actually submitting to the traditional physical.

I recently read a New York Times article that said that a genetic test for cancer (a simple blood test?) is much more accurate at determining cancer than a paps smear. I also heard that there are now home kit smears that a person can do themselves for colon cancer. If these tests will do the job, why do I have to consent to a physical? Does anyone know?

I'm a woman in my 40's and a child sexual and physical abuse survivor with a diagnosis of Generalized Anxiety Disorder. When I was younger I used to have regular yearly physicals (for about a 20 year stretch I went every year). I never once had a positive paps smear, I don't smoke, and I have no history of cancer in my family. However, in the last decade I have had only one physical (about 4 years ago) and I'm terrified of them now. I just can't bear it anymore.

I take birth control pills because I have a chronic problem with anemia (B12 is always low and I must take daily 1000mcg doses, but if I don't take birth control I need to take iron pills as well, which make me sick to my stomach). I also have very painful lengthy menstration that feels like labor - for several days (if I don't take the pill). Birth control pills, to me, are a needed medicine, NOT a contraceptive.

Why do women have to have yearly physicals? I mean, who makes up these stupid rules? Will something bad happen to my doctor if I don't have a regular physical (will she be punished somehow)? Why is she suddenly acting like a Nazi about this?

Also, is there not some other way I could give her what she needs without having to be naked and submit to these humiliating and frightening proceedures?

Please help me, if you can, to think of ways that I can meet my doctor half way on this...but avoid the traditional physical experience.

This may sound trivial to some, I know some people are extremely sick and have to submit to treatments much much worse than a physical, but this is a very big problem for me. And worrying about it is only giving me nightmares, sleeplessness, and enhanced OCD and chronic anxiety.

Thank you very much for taking the time to read this and sharing your thoughts and ideas with me.

[Texinator]

What about the physical bothers you most? The procedures themselves or the worry that the doctor might find something wrong with you?

[ItsASecret]

I am sort of the same way. For me the physical is not the part I hate since a blood pressure cuff, some looking in the ear, or opening the mouth and saying awwwwwww is not going to damage me emotionally. The problem I have is the gyn exam (I am not sure if that is the physical exam that you are talking about). I am personally going to avoid the gyn for as long as I can and if it takes switching doctors to remain on my birth control I will do that. The poking and proding is not okay with me, not in the area that I am already most uncomfortable with. Ironic part is that I want to be a doctor lol. From the doctors standpoint she is right in wanting you to get a physical, however if it is just a regular physical that she wants you to get (BP, ear check, mouth, maybe a simple blood test) then maybe you should. I think many doctors recommend that you get a physical...but they cannot make you do anything. You are her patient and she needs to monitor you on all aspects because keeping up to date records is of utmost importance in medicine and your health is her main concern.

If things just do not work out you could always try to find a new doctor.

[Texinator]

dobee, medications have the potential for side effects, and the state of your health determines for which of those you are most at risk. I don't know how it is with birth control other than that a physical is at least highly recommended, but there are certain medicines a doctor will refuse to prescribe you unless you have a physical.

It's not enough for you to say you are in good health or for you to do certain tests on your own.. the doctor needs to make sure herself. Even birth control has the potential for side effects because of how it influences your endocrine system, among other things. Otherwise she leaves herself open to lawsuits if she gives out medication without making sure it is safe for you to use.

A physical is recommended anyway just to make sure everything is in good working order. As you get older, you also become more at risk for certain diseases and problems, and a physical is a good preventive measure. Anything caught early can save you discomfort and money down the road and maybe even save your life.

I don't know if it is just the gynecological exam or the physical in general that you dread. Like ItsASecret said, you should at least have the rest of the physical performed. I'm sure you'd feel much better afterwards with the peace of mind it gives you. It might even be a good opportunity for the doctor to prescribe something for your anxiety.

As for the gyn exam.. well, I can't quite relate.. the most invasive thing I've ever had was a prostrate exam and then the doc having his face inches from my nether regions while he told me to turn my head and cough, and that's obviously not the same thing. But my thoughts on this are that doctors are professionals who are there to help you with your health and not to judge you. Naked people and genitals are something they see countless times a day.