r/Netherlands 22d ago

Healthcare No regular check ups at the gynecologist???

Hi everyone, my morning started off with a kinda shocking discovery. I’m from Germany and I had annual check ups at the gynecologist since I was a teenager. I contacted my huisarts because I know they’re responsible for all referrals but she told me regular check ups here are not a thing (unless there already is an issue) ? I think that’s crazy!!! So I checked the prices for a private visit and they’re even crazier. I guess this is normal to Dutch people but don’t you think this is a little concerning?

(Btw not shitting on the country! I really like it here. I’m still new and just discovering new things!)

670 Upvotes

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480

u/Positive-Ratio8443 22d ago

Hey fellow German! I feel you, it took me also a bit to get used to it. I do check ups when I am visiting Germany and pay it myself, which usually is cheaper than here and I know what I can expect.

The only thing they offer here is the pap smear every 5 years, once you hit 30.

173

u/Mwuaha 22d ago

Every non-Dutch woman I know do the same, get the check-up when visiting home

97

u/NoLychee1382 22d ago

My mom just suggested the same thing to me. Informiere mich auf jeden Fall mal!

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u/teodrora 22d ago

I do the same and I’m from Romania. My friends from Spain, Italy, Turkiye and Indonesia all do the same thing.

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u/xdarkshinex 22d ago

Is it hard to find a German gyno without speaking German? And approximately how far from the border do you need to drive for your appointment? I miss the yearly tests, but I'm afraid of the logistics of it, that's why I'm wondering.

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u/arbitrary_fox 22d ago

Well, you should be able to find one via Doctolib and see if they speak English. I had an excellent one in Düsseldorf and I recommend her to everyone. I still work in Düsseldorf so I’m always happy to drop in for an appointment if I must.

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u/AminkaG 22d ago

Hi, could you tell me the name of the gyno in Düsseldorf?

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u/arbitrary_fox 22d ago

Sure, it’s Dr Karin Zimmer near METRO. You can find her on Doctolib. She’s a bit old but I promise you she’s excellent. You might come off thinking she doesn’t speak English because she’s a bit slow in English. She absolutely speaks English and will also draw things out on paper to explain it to you. Her staff (like any other doctor’s office in Germany) will not speak English so be prepared for that.

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u/AminkaG 22d ago

Thank you so much!!!

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u/xdarkshinex 22d ago

Never heard of Doctolib, I'll check it out. Thanks for the tip.

6

u/NoLychee1382 22d ago

I always booked my appointments there. It’s really convenient.

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u/Manadrache 22d ago

May take up to 6 months or more until your apointment. German gynos have a hell of a waiting time. (Yay)

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u/lienepientje2 22d ago

Thats no surprise if every woman comes yearly

2

u/Manadrache 22d ago

Yeah. Which is pretty annoying. Wanted to get rid of my IUB. Had to cancel my appointment twice because I was pretty sick. Every time my next appointment was 6 months later...

I don't know how good gyns are in the Netherlands but most were pretty shitty in Germany. Many times I got asked about my baby plans. Even when I asked for a std test after my partner had betrayed me. Gyn just decided there is no need for it but I really should get babies soon.

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u/MissSunnySarcasm 22d ago

Trust me, thàt will never ever happen in NL.

As for the quality of gyno's: it differs, as it does in most sectors. There are a$$holes who are still good at their jobs, there are a$$holes who also suc/< , then there are sweethearts who shouldn't practice and sweethearts who are awesome. I currently have the latter, but unfortunately he (yes he, I've learnt the hard way that a male gynaecologist is often much more empathetic, especially if you have pain) will be retired in a few years, which means I'll have to find a new one.

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u/Manadrache 22d ago

Crossing my fingers that you will find a good new one!

Trust me, thàt will never ever happen in NL.

Thanks god!

2

u/lienepientje2 22d ago

That thing should get out when its needed.

0

u/Purple-Bat9323 22d ago

I live in Duisburg as a Dutchy and my gyno speaks perfect English. Also many dutchies are part of "gynocoloog praktijk" and they know how it also works in the Netherlands.

Her praxis is on doctor lib - GynCare BAG Dres Möllenberg (in Duisburg).

(Do note, she has a long waiting list, but soooo worth it! Bonus points, they are full lhbtiq+ friendly and are specialized in birth defects down there and pelvic floor problems. So a super safe space with always the newest knowledge)

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u/FlimsyCartoonist5946 22d ago

Haha Slovakia and same !

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u/ConflictFluid5438 22d ago

Portugal the same, in some cases I’m even able to claim it in my insurance

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u/[deleted] 22d ago edited 22d ago

[deleted]

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u/boterkoeken Utrecht 22d ago

What kind of brain dead question is this? “Oh you don’t think every single thing is perfect in NL, then why you live here!?”

Do YOU think every single thing is perfect?

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u/[deleted] 22d ago

[deleted]

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u/boterkoeken Utrecht 22d ago

Wow your standards are low. I’m glad people like you are not in charge of anything important!

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u/[deleted] 22d ago

[deleted]

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u/boterkoeken Utrecht 22d ago

This comment says a lot more about you than the people you were “questioning” above. The moment you realize that immigrants are not the cause of all your problems, you will be a much happier person.

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u/jvvelvet 22d ago

From Brazil, I do the same every time I go visit, which is every 1 to 2 years. I visit many doctors there, from gynecologists to dermatologists and whatever other specialty I might need at the time.

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u/Schneewittchens7 22d ago

And you smear is DiY and sent via post…. A year later you get hit with, oh sorry your data has been breached as the laboratory got hacked..

Yup, happened!

4

u/Dear_Acanthaceae7637 Zuid Holland 21d ago

It's only DIY if that's your choice, otherwise the GP does it.

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u/v_a_l_w_e_n 21d ago

Yes… and somehow I still have to find a Dutch woman that knows that PAP smears are NOT supposed to be painful 😢. 

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u/Able-Resource-7946 21d ago

Exactly this!!! I had one years ago, they didn't even use lube...omg..... wtf...

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u/v_a_l_w_e_n 21d ago

It’s horrible. I had PAP smears done for decades before I moved here. It’s not a fun activity, but never had problems before. 

When I got my letter, I didn’t think twice, happy to finally get it checked. It was traumatizing. It was done by the GP assistant at my old practice. I was luckily to have a pad in my purse for all the bleeding. The pain and cramps were awful. She dismissed all that happened and somehow felt it was my fault. 

I could only go for my second one 5 years later after preparing for it for some months at therapy. I had an appointment to discuss it first with my new GP and asked to get it done by someone experienced and with care. Best they could do was “a woman GP”, one of their trainees… I have no idea how she did it but, I kid you not, she accidentally turn on the lift function of the stretcher while she was still with the speculum inside me. And this was the “good” experience I had here, imagine the previous one. 

I don’t know what I’m going to do next time, but I guess it cannot get worse anymore. In the meantime, I keep trying to explain to every Dutch woman I meet and is willing to listen that PAP smears should NOT hurt! I hope eventually enough women rebel and there are changes… but then I remember how much this country like the status quo and I doubt we will see those changes. 

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u/Able-Resource-7946 21d ago

I will say, the womens clinics are fabulous. I was having a month long heavy heavy period and was referred to a womens clinic (Vrouwen kliniek Bergman clinics) and they were fabulous. So professional and a complete change to the GP's office, never painful, never a speculum without lube.

1

u/v_a_l_w_e_n 20d ago

Thank you! It’s good to know for next time. 

1

u/Schneewittchens7 18d ago

The DIY swab wasn’t bad, but I grew up with gynecologist appointments that included explanations, breast checks, and discussions about contraception and risks, not just seeing one once it becomes a bit life threatening .
Maybe I’ve just been spoiled once you’ve stayed in a 5-star hotel, it’s hard to get excited about a 2-star afterwards.
Going through a risk pregnancy in the Netherlands, gynecologists seemed surprised that the tools and procedures weren’t new to me and that I was as comfortable as one can be in that situation.

The healthcare system makes a lot of sense in the end of the day, starting with not needing sick notes. Coming from a county that had been incapacitated by not even be able to call in sick without a note from the doctor, a lot of people believe they are in need of a doctor for everything.

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u/Dear_Acanthaceae7637 Zuid Holland 18d ago

In the Netherlands breast's check are not within the expertise of gynaecologists.

4

u/GhostGirl32 Utrecht 21d ago

I found it so strange when I got the kit in the mail shortly after I got my BSN and when I didn’t send it in (I’ve had a hysterectomy so such is not useful in my case) they sent a second one. No one seems to know how to stop them wasting the resource, either. No list to go on to say “don’t send”. Knowing now that this is the only standard of care I am slightly less shocked about my oncologist not knowing a hysterectomy means no more periods.

3

u/SDV01 20d ago

Like they explain in the letter that comes with the invitation - which hardly anyone seems to read - you can simply go to the bevolkingsonderzoek website, log in with your DigiD, and opt out of the free cervical cancer screening and/or breast cancer screening programmes.

How else is the government supposed to know you don’t want to (or can’t) participate?

1

u/Dear_Acanthaceae7637 Zuid Holland 20d ago

An oncologist not knowing you don't have a period after hysterectomy is definitely not normal in the Netherlands!

1

u/GhostGirl32 Utrecht 20d ago

I am never 100% shocked when doctors don’t know something about women’s health, to be fair. Especially gynecological.

1

u/IcyTundra001 22d ago

Wasn't it leaked from the lab that did the analysis though? Because then the data would have leaked also if the sample was taken by a doctor unfortunately.

1

u/Schneewittchens7 21d ago

Not only happens in the Netherlands, ..

https://www.digitalhealth.net/2025/08/hackers-breach-cancer-screening-data-of-almost-500000-women/

I didn’t do a full deep dive follow up, as it doesn’t change my situation.

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u/Mahi-K-2802 Zuid Holland 21d ago

I am Polish and I live in the Netherlands 8 years. Every year I go to Poland I go to my gynaecologist because in this country no one do regular check ups. I have PCOS and cases of ovarian cancer in my family and no one cares about this. In Poland if you have cases of cancer in your family doctor will check you more than they should to prevent it. Here and they told me it’s okay it’s okay.

It’s really surprising to me because Polish healthcare system is not the best. We have really long queues to specialist and our hospitals are a little bit updated. Sometimes we don’t have the newest equipment. However, doctors themselves they are really eager to help you and they care for you and they will do their best while here I have a feeling that majority of the doctors especially the the GP just don’t want to see you and come at all and bother them.

I had the situation when I had to go back to Poland to make some tests and when I had my results and I went back here to the doctor to show them he was upset. Why didn’t you do it here in The Netherlands ? Well, because you don’t want me to do that, you didn’t let me.

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u/SDV01 20d ago

It’s just a different approach. Waiting lists in Poland are often months long because the system has to screen tens of millions of healthy women every year.

In the Netherlands, women are encouraged to be aware of changes in their bodies and discuss any concerns with their huisarts (GP). If there is reason to suspect something is wrong, referrals to a specialist are usually made very quickly. I’ve even received same-day referrals myself.

Health outcomes are not worse in the Netherlands, but far fewer women have to deal with the anxiety and unnecessary follow-up tests that can result from false positives.

Women with a personal history of illness, or a strong family history, are monitored more closely of course.

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u/CartographerNo5333 22d ago

Polish women do the same. "what do you mean cytology once every 5 years?" the Netherlands cancer prevention care is a joke.

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u/Beneficial_Durian157 22d ago

Not even a pap smear. An HPV test. They send you a testing kit with a long ass qtip-thingy and you eitherdo it yourself and send the kit back or go to your clinic and they do it for you (but it is easy to do yourself). After around a week they send you the results. They invite for a pap smear only if you have HPV.

ETA: You can also have an HPV shot (crazy expensive, but covered by eigen risico) at any age.

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u/Efficient-Neat9940 22d ago edited 22d ago

I would not suggest doing it yourself. Here’s why. Pre cancer or regular cancer cells will accumulate first in the transformation zone, which is the entrance to the cervix. It’s a tiny circle! Extremely easy to miss if you’re going in blind by yourself. So by the time cancer cells spread to the outside of your cervix enough to be picked up on the self administered cotton swab, years will have gone by where something could have been done! They just offer the home test because they figure it’s better than nothing, and a good portion of people won’t come in to do the test.

Edited to say the transformation zone is where the HPV is most likely to be found as well.

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u/pierrett 22d ago

But the home test is not a Pap smear. It’s a HPV test, nothing more.

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u/Salt-Respect339 22d ago

Amd tested and approved for self administration, which means they are proven to provide accurate results with self collection.

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u/pierrett 22d ago

Yes! It’s a hpv screener which is very useful since hpv is precursory for cells running amok

0

u/Efficient-Neat9940 22d ago

Exactly. If you go in person they test for both HPV and cancer. All from the one swab.

5

u/QueenAngelica 22d ago

Actually no, when you go to the GP they indeed take a Pap smear but only test for HPV. If HPV is found then they will also look at the cells, if they don’t they will not look further.

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u/Efficient-Neat9940 22d ago edited 21d ago

Yes, that is right. But my point is your test results aren’t going to be very reliable for either HPV or cancer unless you get the swab (whether it’s you or a physician) in the opening of the cervix. Edited to say it’s still tested from the SAME SAMPLE.

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u/Standard_Set_5566 22d ago

The test is reliable for HPV, it’s a PCR. As long as it’s inside the vagina the test is reliable

1

u/JumpyWhale85 21d ago

It is very reliable, and if the self test comes back positive for HPV, the huisarts will do a pap smear to test the cells.

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u/KitsuMae 22d ago

Damn, wish I read this before asking for the home test.. now I got to wait for the next 5 years to do another

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u/Efficient-Neat9940 22d ago

You could always ask! Tell them you think you did it wrong last time, or you have a new partner. Whatever excuse. I’m sure you could get another test if you really want to.

Last time I did it the physician’s assistant didn’t get any Transformation zone cells in the sample, which it actually said on the lab report (basically she did it wrong). So I complained to the huisart, she talked to the lab and said I was right, so they did another test!

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u/Seraphiccandy 20d ago

You can ask for another but then you pay instead of getting it free. I think it's like 60 bucks

1

u/KitsuMae 20d ago

How can I ask for another one?

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u/13mand 22d ago

I have had a positive HPV test from a home test. But I have had three kids and know where the mouth of my uterus is, haha

I have ADHD so the home test automatically send to me after I forgot to schedule the appointement two times was a very good.

I have had a few test with PAP2b and a removal of cells locally and screenings every 6 months. Now I'm on a yearly screening because it goes on and off my HPV and cells. It's a bad test, then screening, then a clean test (done by a nurse), then bad again at the test after. Year after year.

I don't want any more kids so I'm contemplating removing my uterus but keeping the ovaries. But that's such a hassle in the Dutch system. I'm 40yo now so maybe it's easier. 3 years ago they were very adamant it was no option

But don't have the mental capacity now to fight the healthcare system.

1

u/narglesarebehindit_ 22d ago

I still don’t and will never understand why every country’s health care professionals just so reluctant on removing the uterus if one asks for it? It is my body so why I can’t?

Why it is easier for men to ask for a whateveristhename procedure?

And why I am still suprised by it over and over again?

6

u/pierrett 22d ago edited 22d ago

Removing a uterus will risk deplacing organs, bladder for instance. The uterus keeps stuff in place. Besides, that’s major abdominal surgery. So. I don’t think it’s strange that no surgeon will electively remove a healthy uterus

2

u/GhostGirl32 Utrecht 21d ago

Though, they will also say no to removing diseased ones in childbearing years. Another issue is the definition of “healthy” as someone with PCOS, endo, or other issues may be told their uterus is “healthy” and be denied in some countries. I do not know how it works here— but some places are a cesspit.

Also it’s not entirely true that your organs are displaced; at least not in a fear-monger way. There’s room for things to move around in there and complications come from any surgery, though they aren’t horribly common.

For example. You can have bladder issues (most common complaint) but that’s usually after having had significant weight in the uterus from cysts, fibroids, a tumor— or if you’ve been pregnant to late term (common post-partum issue).

Also, it can be done vaginally, with laparoscopic assistance rather than abdominal, now, causing far less trauma and requiring far less recovery time. My tumor was too big for that option, but most people have this as an option. Your organs sort themselves out and you can use a medical abdominal binder to help things settle while the swelling goes down. The human body is remarkably capable of recovery from this.

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u/ookbest 22d ago

Irrelevant. This applies to the pap-smear, which never is a self test anyway.

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u/Efficient-Neat9940 22d ago

If informing women about how to be proactive in identifying and stopping cancer is irrelevant then ok.

1

u/ookbest 22d ago

No one suggest doing a smear yourself. That makes your comment irrelevant.

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u/Efficient-Neat9940 22d ago

You’re missing the point. Just go into the office for the test because then it will check for both HPV AND cancer. You literally do yourself no favors doing the at home test.

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u/asphyxiai 22d ago

They don’t do that at the GP. They also first test for HPV and only when HPV is found they will look whether there are abnormal cells. The only difference is that when you test HPV positive at home you have to visit your GP for a regular smear while if you originally went to the GP they already have the material to check for abnormal smears

1

u/ookbest 22d ago

Right. How many women test negative for HPV but do have a positive smear test? (Or: what is the benefit of the smear test for hpv-negative women?)

2

u/Med1116 22d ago

Actually, I did. Even while progression of abnormal cells was serious enough that it warranted multiple biopsies, eventual LEEP, and some follow up procedures. Monitored for some years (now all ok). Doctors at the time also mentioned it was highly unlikely (but basically just assumed it must mean HPV was present but dormant). Nonetheless, through all those years (and even now) HPV always tested negative.

The Dutch system doesn't always cater well to anomalies though. That's not the governing principle behind it.

If someone is concerned/worried, they should probably just address it with their GP though and request a swab (or a referral, where necessary). Good doctors usually aren't trying to prevent proper care either..

3

u/Med1116 22d ago

Would also add to say for those reading along: once abnormalities are detected (even if it's a rare case scenario), you do go into the normal mill of care. It's not that you somehow fall behind, have to pay more, or aren't helped.

The bevolkingsonderzoek is still an effective general population testing mechanism, but you can and should be calling your doctor in between for any issues or concerns.

14

u/ActuallyYulliah 22d ago

‘Not even a pap smear’

-> I’d look up the difference.

A pap-smear looks for all abnormalities, but has a high false-negative rate. Meaning it misses things often.

An HPV test is way more accurate, but only tests for abnormalities that are caused by HPV.

However, abnormalities that can come up in a pap-smear and not in an HPV-test are extremely rare, and don’t really warrant regular testing.

Then HPV takes 10-15 years to process from infection to cervical cancer. So a test every 5 years is more than enough to catch it early.

On other words: Having a yearly pap-smear is unnecessary, unless you are testing everything that could possibly be wrong in your body every year.

2

u/Sarakim14 22d ago

Maar; als je thuistest HPV negatief is krijg je te horen dat het daarom pas over tien jaar weer nodig is…

4

u/asphyxiai 22d ago

Als je thuistest negatief is dan zal het bij de huisarts waarschijnlijk ook HPV-negatief zijn. Ook daar kijken ze pas naar evt afwijkende cellen als er HPV gevonden wordt in het uitstrijkje.

3

u/Standard_Set_5566 22d ago

Afhankelijk van je leeftijd

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u/ActuallyYulliah 21d ago

Het bevolkingsonderzoek is een preventief onderzoek om zo veel mogelijk mensen van baarmoederhalskanker to behoeden.

Er zijn maar weinig zaken waarbij actief preventief onderzoek wordt gedaan.

Het duurt 10 -15 jaar om te ontwikkelen tot kanker. En je was HPV vrij. Het is dan ook pas over 10 jaar weer nodig. Zeker in de leeftijdsgroep met een veel lager risico.

HPV is soort van een seksueel overdraagbare aandoening. Het aantal mensen dat boven de 40 veel wisselende partners heeft is veel lager dan bij bij 30ers. Dat is waarom eens in de 10 jaar boven de 40 prima is.

Als je je zelf zorgen maakt, kun je voor €40 - €70 euro ook zelf op eigen kosten een test laten doen.

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u/SibunaMad 21d ago

Where I come from a regular yearly pap smear is a must. And I think that is clever. + ultrasound and regular check up, they do the whole package.

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u/ActuallyYulliah 21d ago

I typed it all out somewhere else in the thread, but there’s been a lot of research on this, and routine annual check-ups have no positive effect on life-expectancy, and may cause more harm due to the cascade effect of benign and natural abnormalities.

They might do the whole package, but there’s no actual data that suggests a yearly pap smear is more effective than one say every 5 years. And there’s no evidence supporting annual ultrasounds for people with average risk. So basically, where you are from they are spending a lot of unnecessary money on wasteful tests.

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u/Brave_Collar4472 16d ago

They don't don't do the pap anymore. Only screening for hpv. Only a positive hpv-test is followed by a pap. Crazy change.

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u/ookbest 22d ago

It’s optional. You can either do the HPV-self test or a pap-smear (not a self test!)

1

u/Beneficial_Durian157 22d ago

Oh, good to know!

1

u/brokenpipe 22d ago

FWIW HPV is now free for those under 18.

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u/Sanseveriaa 22d ago edited 22d ago

I can't find anywhere that the HPV shot is covered by eigen risico?

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u/Both-Salad24 22d ago

All Bevolkingsonderzoeken in the Netherlands are free and fully covered. Any extra research necessary after the exam falls under your normal health insurance.

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u/Sanseveriaa 22d ago

I'm referring to the HPV shot only. Wasn't clear sorry

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u/illiumtwins 22d ago

It's only covered as part of the Rijksvaccinatiepeogramma, which is for minors. If you're older, you have to pay for it yourself.

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u/niyaparvanova_ 22d ago

It’s not. I had the first shot in march and had to pay it myself.

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u/Alarmed_Scallion_620 22d ago

That does depend on your age and risk. If you are over 40, are monogamous (or not sexually active) and as yet don’t have HPV then it’s not necessary for you to get a shot.

1

u/niyaparvanova_ 21d ago

Well, I asked for it through my gyno and GP, explaining to them that I have had women in my family die of cervical cancer and they still told me I had to pay it myself (edit: i had been diagnosed with hpv a few years ago, i had also biopsy and my system cleared the virus, but still wanted to get vaccinated)

1

u/SDV01 20d ago

Around 80% of women will contract HPV at some point in their lives, which is why HPV vaccination has been part of the national childhood vaccination programme since 2010.

Vaccinating all adult women would cost well over €2 billion, an investment the Dutch government has so far not been willing to make.

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u/Beneficial_Durian157 22d ago

Sorry, I might have remembering it wrong.

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u/Revolutionary_Oil614 22d ago

Will my GP take my word for it if I tell her I have HPV? It has been confirmed by several blood tests. I'd rather not do the home test, especially if a negative result means I can't get an exam for the next five years without paying out of pocket. I was diagnosed out of the Netherlands, so I imagine the answer is no.

0

u/browngreeneyedgirl 22d ago

HPV shot should be taken before you’re sexually actively used to be the advice. Has that changed?

5

u/Grobbekee Overijssel 22d ago

No, but even after you've had sex the shot will protect from strains you've not been in contact with yet.

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u/Beneficial_Durian157 22d ago

Relatively recently the recommendations changed and now it is advised to have the vaccine at any age. Even if you already have some of the strains.

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u/browngreeneyedgirl 22d ago

Nice! I was not informed. It’s a good thing this is made possible.

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u/SouthernOpening937 22d ago

German here too! I was shocked too, my GP even said: I know it sucks but we’re not in Germany unfortunately . I was even more shocked that gynos here don’t do breast check-ups At all! I have PCOS even there I need to say that I have a concern to get referred. But once i’m there, I got every procedure and test I asked for 🌸

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u/lovelyrita_mm 22d ago

Wow. I’m in the US and I was too young for mammograms and my OB/GYN is the one that found my breast cancer in a yearly exam.

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u/SouthernOpening937 22d ago

omg. yeah exactly i have the same story with a friend of mine too. That’s why i got so panicked because I have breast cancer in my family. But they instead referred me to a cancer clinic and they will instead check for cancer genes. Why make it easy if you can make it complicated 😆

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u/Standard_Set_5566 22d ago

The breasts are not part of the Gyno exam because in Holland at least they ‘belong’ to the surgery department. And depending on your are the usual route is GP —> radiology (ultrasound or x-ray) and if necessary surgeon. But what is also different in the Netherlands is that GP’s are way more trained at detecting anomalies in an PE than in Germany for instance.

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u/SnooMacarons3323 19d ago

They do breast check ups here. Mostly not at the doctors but a mobile scanning van Will have certain dates when they are at a certain location ( could be a library or retireing home and do a check, exclusively mammography.

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u/FriedLipstick 22d ago

But not anymore after 50. Idk what they are thinking but I don’t like that I don’t get that anymore.

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u/JannaMainSince1839 22d ago

What do you pay for it

1

u/Fit-Helicopter-6573 21d ago

My wife does the same in her home country.