""It'll probably go away on its own" is not a diagnosis"

About: NHS Merton CCG University College Hospital Elizabeth Garrett Anderson Wing / Gynaecology

(as the patient),

For nearly 8 months now I have been experiencing severe vaginal pain. This has made my life miserable, made sexual intercourse with my partner nearly impossible and made my day-to-day life extremely uncomfortable.

At the time the symptoms began, I was registered with a practice in Haringey. I saw three different GPs who each told me it was probably thrush and kept giving me the same antibiotics, no matter how many times I protested that I had already tried these pills and they had, if anything, made me feel worse. I asked the second GP about doing a swab at which point he seemed to panic. The GP said he didn't want to put me through a swab, as he said it would probably just show thrush anyway, and said it wasn't worth it. It became more and more apparent as he continued justifying this decision that it was *he* who didn't want to do the swab, not out of any concern for my welfare, but seemingly from a disgust at the thought of having to deal with female genitalia. I had wanted to see a female GP originally, but had been told that this would entail a three-week wait.

After eventually insisting to the third (female) GP that some tests were done, the swab actually came back negative for thrush or any other such infection. The GP had promised that I would be telephoned to be given the results, but after two weeks I had heard nothing so I phoned the surgery. The receptionist seemed extremely angry that I wanted to speak to the GP about my results, insisting that there was no need for her to speak to me if the tests were negative. I had to repeat myself several times before getting her to (aggressively) accept that negative tests meant that there was still a problem that needed diagnosing.

Eventually, with this problem now having been going on for 4 months, I was referred to a gynecologist at University College Hospital London. It was a 3 month wait for an appointment, during which my symptoms worsened and I was feeling extremely depressed. Finally the appointment day arrived, the gynecologist examined me with a trans-vaginal ultrasound, told me they couldn't see anything on the scan and abruptly informed me that since they couldn't see anything obvious, it would probably go away on its own.

I was momentarily in shock, but before I was ushered out of the consulting room. I managed to protest that it had been 7 months and the problem was most definitely not going away. That I was in severe pain and that it was making my life a misery. The gynecologist said sorry about that (rather patronisingly) but there was nothing on the scan. I probably just had thrush and it would go away on its own. I explained that I had been tested for thrush, been given medication for thrush and tried every over the counter remedy available for thrush and that that hadn't helped. It couldn't possibly be thrush. The gynecologist said that the previous thrush had probably just made the area sensitive and that it would go away on its own. I explained that there hadn't been any previous thrush but they clearly weren't listening.

I was by this point in tears, desperate for something to be done. The gynecologist reluctantly offered to go and ask a consultant's advice. They cam back and told me that I could be referred to the psycho-sexual clinic for counselling. I broke down in tears again, saying that it was not in my head, that up until 7 months ago I had had no problems in that area, had had a very positive, happy sex life with my partner and that this wasn't a problem that needed psychological help. The gynecologist explained that pain during intercourse was often emotional. When I repeated, yet again, that the pain wasn't only during intercourse, that it was all the time, they seemed surprised, as if they hadn't known this previously. Even though I had spent some time at the beginning of the consultation explaining this.

After a great deal of discussion, the gynecologist eventually decided to refer me to the vulva clinic. I am now waiting to see how long I will have to wait for that appointment. If I hadn't pushed for it (with a great deal of help from my partner, who thankfully came to the hospital with me - I would not have had the emotional strength to fight my corner by myself after all I have been through with this) then I would not be getting this further appointment. Although there is still no guarantee that they will be able to offer me any more help than the previous doctors I have seen.

Whilst I understand that some problems are difficult to diagnose, it seems to me that the attitude in the NHS when coming across such a problem is not to try to find a diagnosis but to give up and shrug your shoulders and hope it'll go away on its own. It feels like when the patient is a woman, doctors are extremely quick to suggest it is all in her head. This is not the first time that I have experienced that - I had glandular fever at age 18 which went undiagnosed for 2 years because doctors kept telling me it was in my head. What I have discovered with this issue that disturbs me even more greatly is the complete lack of interest that doctors have shown me with gynecological medical issues. Unexplained, sudden onset, acute pain in any other area of the body would be cause for extreme concern and doctors would (I would hope! ) be working hard to find the cause, not telling the patient it would probably go away on its own. Why, then, when the pain is in the vagina does it suddenly become irrelevant? Why must doctors suddenly become patronising and aggressive and insist that the pain is either entirely in the patient's head or just not important enough to warrant investigation? I'm not sure if I can articulate effectively just how distressing pain in such a sensitive area is, both physically and mentally, or the upset that it causes when you can't make love with your partner, however supportive they may be about it. You expect a doctor to be the one person you can talk frankly to about these issues, but the GPs seemed embarrassed to talk about the area at all and the gynecologist just wanted me out of the consultation room as fast as possible and didn't seem the slightest bit interested.

I am beyond desperate now and entirely miserable, and am now concerned that the rest of my life will now be spent living with acute pain with no diagnosis and no medical assistance. I am not yet 30 years old. I have paid taxes all my life to an NHS that has told me that it couldn't care less.

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Response from University College Hospital Elizabeth Garrett Anderson Wing

As a Trust we take patient comments extremely seriously and would be grateful if you could make contact with us so that your concerns can be investigated. Please contact our Patient Advice and Liaison Service on 020 3447 3042 or by email to pals@uclh.nhs.uk.

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