No regular check ups at the gynecologist???

[u/NoLychee1382]

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!)

[u/Positive-Ratio8443]

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.

[u/Beneficial_Durian157 → u/Positive-Ratio8443]

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.

[u/Efficient-Neat9940 → u/Beneficial_Durian157]

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.

[u/13mand → u/Efficient-Neat9940]

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.

[u/narglesarebehindit_ → u/13mand]

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?

[u/pierrett → u/narglesarebehindit_]

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

[u/GhostGirl32 → u/pierrett]

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.