Thread: @RCObsGyn @RCoANews

Three things all trainee and practicing gynaecologists, GPs and hysteroscopists must understand to be effective.

Read this - and learn about the women you will be treating.
1/ Gynaecology can be embarrassing.

It 'shouldn't be.' But:

Female socialisation has eternally told us about PRIVATE parts.

'Pudenda' comes from the Latin for 'to shame'.
Many languages even contain the word 'shame' in vocabulary for female genitalia.

Religion and culture intrude - periods and their pain can be known as 'the curse of Eve'.

Punishment on all the female sex for one woman's sin.
We're having to deal with a lifetime of female socialisation every single time we encounter you.

Suddenly having to bear all to you, especially if you are of the male sex, is embarrassing.
2/ Gynaecology is frightening, and triggering.

We know the vast majority of women have had their #metoo moments, many from childhood.

We've also grown up with the shadow of female cancers, and the good-girl advice to get your tests done.
Just being in your office brings that dull background dread into sharp focus.

Any past physical trauma - endometriosis, difficult childbirth, previous ordeal by hysteroscopy without anaesthetic - the memories can be overwhelming.
Having you in our space, your hands, instruments and blades in our bodies, your voices in our ears telling us to 'relax - of course it doesn't hurt' is a stark reminder that psychological trauma is a powerful thing.
3/ Gynaecology hurts

We're so often told

'It doesn't hurt' It does

'It shouldn't hurt' It can

'Well, most women are fine with it' We're not (see 'good-girl female socialisation')

'It feels like a period pain' It doesn't (and how would you know?)
Of course it hurts

Hands, speculums, forceps, needles, scopes, hoses, water, cameras, blades - these things hurt.

Especially when you deny us any form of sedation, local or general anaesthetic.

And chatting nicely to us about nothing while you do all that is NOT pain relief.
And remember ... just because hardly any women complain doesn't mean that you're doing it right and not hurting us. We don't complain because we've been taught since childhood that everything is ALL OUR FAULT. We're too fat, too stupid, too emotional, too childless, too ...
...virginal, too tense, too dramatic, too attention seeking, too anxious, too menopausal ...
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More from @HysteroscopyA

30 Sep
Thread: Reactions to fear/pain can be complex and mixed.

You've heard of fight or flight, but there's more to it.

And for those of us who've experienced #hysteroscopy without anaesthestic, it's all very familiar:
Fight - getting angry, getting loud, challenging, doing something to defend, protect, prevent

Flight - get away, run away, stay away

Freeze - can't move, cant breathe, can't speak
Fawn - yes it's fine, thank you, everyone was so lovely, happy with everything, no complaints

Faint - ... faint ...

Flock - gather, mobilize, speak up, research, complain, write, publish, broadcast, question, change.
Read 4 tweets

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