A woman who says she was denied a hospital test due to being a "virgin" ended up in A&E due to painful cysts.
The 26-year-old, who asked not to be named, was suffering severe abdominal pain that was just getting worse at the end of January. It was so bad she said she almost passed out in the Royal Liverpool Hospital's A&E department, where she said clinicians gave her codeine, suggested it was a gynaecological problem and told her to get an ultrasound at Liverpool Women's Hospital.
She spoke to her GP about arranging this, but they thought it was a ruptured ovarian cyst with pain likely to fade on its own in a few days. The student told the ECHO: "The pain didn't go away, it just kept building, it was just that constant pain.
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"Monday I went to the Royal, and by Thursday it had got so bad I decided to go to the Women's Hospital. At that point I couldn't really stand up. My housemate helped me walk to the hospital."
There, she said she was asked if she'd previously had a pap smear and about her sexual history before booking her in for an ultrasound just a few days later. When she arrived, she said she was told she'd be having a transvaginal ultrasound, a type of internal examination.
She said: "They asked me to go to the toilet and empty my bladder, so I did. Then they had me sit down on the table and asked when the last time I had sex was. I told them I never had, and then they just said, 'You can't have a (transvaginal) ultrasound, we're not allowed to give it to you'."
Liverpool Women's Hospital (LWH) is among 32 NHS trusts in England and Wales which don't offer transvaginal ultrasounds to people who are sexually inactive or "virgin", according to a recent VICE World News investigation. The examination allows doctors to look inside the body at organs like the ovaries or womb, assisting in the diagnosis of conditions like endometriosis, which causes chronic pain. The trust which runs the hospital says its policy is being revised to remove sexual history from the official eligibility criteria for transvaginal ultrasounds.
The 26-year-old said: "I couldn't understand why because I had a pap smear, which is an equally invasive test. There's no 'virginity' aspect to it, so there was no logical reason."
LWH has since started offering the test to people regardless of sexual history after a change in British Medical Ultrasound Society (BMUS) guidance. BMUS updated its policy in October last year, saying "the concept of virginity plays no part in the clinical decision making for transvaginal ultrasound".
A spokesperson for LWH said its goal is to have the policy change formally ratified by April. The hospital gave her an external ultrasound, which has improved imaging when performed on a full bladder, though the woman had just emptied hers.
The woman said: "I left the hospital thinking it'd stop in a day or two, but it didn't stop. It just kept building, and it ended up bad enough I wasn't leaving the house and I'd taken a month off university."
The student said that based on the hospital's report, her GP thought the pain might be caused by irritable bowel syndrome (IBS) and arranged further tests, insisting it wasn't a gynaecological problem. But the 26-year-old thought "it clearly was".
The codeine wasn't helping, and the pain was worse around her periods, according to the woman. It was so bad, she ended up back in A&E. She said: "We know our bodies. When something is wrong, you can tell that something's wrong."
Eventually this March, with her parents' help, she paid more than £4,000 for a private gynaecologist who suspected she had endometriosis. The woman said: "That was absolutely terrifying because that's a lifelong condition. That was something I didn't want to think about because it is just awful."
During abdominal surgery to see whether she did have endometriosis, the gynaecologist found something else entirely. She had two cysts on her fallopian tubes, the largest of which was 12mm, which the doctor removed on the spot.
If left, there was a risk they could rupture, leading to internal bleeding or severe pain, the woman told the ECHO. Now they're gone, it should have no lasting effects on her health.
She was "so happy" when she woke up from surgery, saying: "It was one of the greatest feelings that I wasn't crazy. Up until going into surgery, I was second guessing myself and questioning everything."
Both the pain and self-doubt are now gone. The 26-year-old said: "Just waking up, that massive pain - tearing your leg off kind of pain - wasn't there. Part of it I guess was painkillers, but even two days out of surgery, I stopped taking the pain medication because I didn't need it."
This week was her first week back on campus since the pain forced her to stay home. She said: "This week has been amazing. I saw a friend the other day who had last seen me a few days before the surgery and her comment was, 'I can tell that you're already so much better, I can hear it in your voice, you look and sound happy, less pale, not in pain and no longer look like you're about to pass out or bust into tears at any moment'."
She said: "I feel like if this was a male problem, they wouldn't say you can't do this because you've never had sex."
Liverpool Women's Hospital is in the process of removing sexual history from the official eligibility criteria for transvaginal ultrasounds. A spokesperson told the ECHO: "Complex changes to any policy or standard operating procedure can take some time to ensure that the full range of clinical and support teams have been consulted and are aware of the changes being proposed to any clinical practice.
"Our goal is to formally ratify our revised policy by April 2023. However, the Trust has changed its practise to reflect BMUS guidance whilst our revised policy is awaiting ratification. We hope that the change in guidelines and our revised policy will provide reassurance that all people now have access to the same range of services regardless of sexual history."
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