Is an internal examination necessary for the contraceptive pill?

Question

This question is asked to allow me to try and put my mind at rest after 15 years. Should a doctor have had need to 'internally examine' me when I went to him for the Pill? I had/have no medical conditions that I believe would warrant this. The doc concerned never used medical equipment (except gloves) during the examinations, just his fingers. I first saw him when I was about 18, (perhaps naively returning to him on several occasions over the years) and, over time, I have realised that he has been the only doc to do this. I have been thinking back to my experiences and have a horrible, horrible, horrible feeling he should not have done this. Would I be right?

Thanks for your thoughts.

Answer 1

I live in the U.K, and categorically, i can tell you that what happened to you should not have occurred.

The contraceptive pill does not interfere with the inner workings of the v****a. There is no reason someone would have to insert a finger up there, as the pill only affects the ovaries, and a finger will not go past the cervix.

It is clear that he has taken advantage of your naivity (i was also very naive when i first went to the FPC, and this could have easily been me!).

If you can remember his name, i would strongly advise reporting him, as he could easily still be practising as a doctor today - and this could mean he is still doing this to unwitting girls.

All they should do when you ask for the pill is ask questions such as "Do you smoke?" and ask about your family history.

I'm so sorry to hear you went through this, and i hope you can get some justice done there, because i can't imagine how it must feel to wonder.

Answer 2

I had a similar experience when I was 14 and I had to go on the pill for painful periods, and to this day (although I have never mentioned this to anyone including my parents who are Dr's) there seems there to me would be no medical need to do this. It bothers me to this day! And it felt wrong at the time, it's hard to explain but I can empathise. But then again, we aren't privy to your medical history and neither were we there, so maybe there was a need? If this is really bothering you, then please talk to someone about this.

Generally speaking, it isn't normal practise (these days) to give an internal examination for just prescribing someone the pill.

This Dr was a senior partner at one of the practises my mother was a locum at. So for years I kept telling myself there was a need. I feel stupid now that I didn't say something to someone at the time. This particular Dr didn't wear gloves , this sounds so incredibly stupid but I just at the time trusted him as a Dr and thought it was OK. I think it's best to talk to someone about this, just to set your mind at rest. I recently read a few years ago this Dr threw himself out of a window of a psychiatric hospital he was admitted to. He must have been a very troubled man.

EDIT

The lady below me, is 100% correct and I forgot about that, if you are living in the US it is normal to have an internal examination before being given the contraceptive pill. I'm unlclear as to why, why but in the US this is common practise. In the UK, I still think not.

edit

Hi, not at all, these thoughts  have always been at the back of my mind with regards to my experience, although it has just suddenly occured to my thats why I might have a fear of smear tests.. I think the best thing to do, is confide in your GP, and perhaps he can refer you to counselling, and maybe your GP can also shed some light on to the situation. Also maybe Dr Frank will pick this question up. I also hope I haven't advised you incorrectly with regards to this situation thus causing more anxiety. I really, to the best of my knowledge don't think it is common practise to give an internal before prescribing the pill. What confuses me is the fact he used no other medical instrument, speculum for example, there is little be to seen with fingers alone. But I could be wrong. Hopefully Dr F will pick up this question x

edit

It sounds highly strange, the fact no one else was present during the examination. As Dr Frank says, there is usually always someone else present during these kinds of examinations. Do talk to someone about this, don't suffer in silence.

Answer 3

I am so sorry to hear of this uncomfortable experiance...My doctor never examined me before he put me on the pill at 19, he told me right out that there "was no need" to do that at this point.  If you feel violated you should tell someone, that will be the first step in feeling better...never let even a doctor do something to you that is uncomfortable, also get a second opinion if you dont feel right about something.  I hope you can work through it and don't feel horrible about it, it wasn't your fault!

Answer 4

I'm not sure where you are from, but in the US you have to have an internal and/or pap smear before you can be issued birth control pills. And you must also do this every year in order to renew your prescription once a year.

The rule is in place so that women will get their yearly exams, because a lot of the time we find reasons not to go...or at least I do...LOL.

So yes, the few times I have gotten on birth control, I have had an internal exam. However, it's always been by a female doctor because I simply don't feel comfortable with men doctors.

Answer 5

Times have changed in the 40 years since I started at medical school. and a lot more routine internals were performed on women then than would be considered necessary and normal now. For example internals were carried out at first antenatal clinic visits to the GP to help assess the duration of the pregnancy and then repeated, often with a smear at the first booking appointment at the hospital. If there happened to be a student midwife or a medical student present, although the patient was always asked first, they often repeated the examination. Certainly at the first GP contraceptive visit an examination and often a smear was performed, even if one had been done only a year ago. All of this was then considered good, thorough practice. At that time a doctor would have been considered as doing less than his duty, if he failed to perform these examinations.

As the years have gone by, more and more of these examinations have gradually ceased as there was little evidence that they contributed to medical care, and much evidence that they were in many instances an unnecessary and undignified procedure. I suppose that at a guess internals have fallen by about 80% in that 40 years.

I don't think most doctors themselves gave it a moments thought and for 99.9% of them, a vaginal examination was always just another chore that was necessary in the assessment of the patient.

What concerns me most about your story is that only a manual examination was carried out, there was no routine speculum examination. This always tends to give much more information than the manual. If I had not been concerned about this, I might have brushed it off as some old doctor, failing to keep up with modern practice and continuing to do internals with the missionary zeal he learnt in his training.

Maybe it is something like that, I hope so, as I am as appalled as you are about the alternative. You don't mention it, but i would be a little more reassured if you can tell me there was a chaparone present. I certainly never performed an internal without a chaperone in my 30+ years as a doctor.

( I like Rhianna am talking about UK practice, I suspect from your use of the words GP and Family Planning Clinic that so are you. Here smears are now seldom carried out more often than 3 yearly unless there are clear indications to do so.)

Answer 6

Not sure if this will put your mind at rest but when I went on the pill at the age of 15 (25 years ago) I also went to a FPC and had an internal examination before being prescribed the pill.  I seem to remember that I also had yearly smear tests.  My mother was present when I had my examination so I had no reason to think it was 'unusual'.  Though I have always thought that some internal examinations just seem pointless.  As Dr Frank has mentioned, over the years these examinations have decreased, so maybe when you experienced this 15 years ago it may have been common practice.

Answer 7

Yes you are absolutely right. He should not have done this.

I would seek legal advise (and perhaps some counselling for you).

Im so sorry you went through this and the fact that you are still going through it 15 years after it happened is all the more reason to seek legal advice.

Best of luck hun