dxmedstudent:

modernathenamd:

wayfaringmd:

Anonymous said: So I haven’t gotten a pelvic exam or any exams of my lady junk. I’m 23 and my doctor always brings it up every time I go in for anything. I am absolutely terrified because I was sexually abused as a child and I don’t even feel comfortable letting my partner look or touch down there. I feel like I’d need my therapist there to stand by my head and hold my hand just to feel a tiny bit better. Do you have any advice?

Ok first find a doctor you are comfortable with. This is huge. 

Your doctor needs to be patient and understanding of your situation and be willing to help you get through the exam as uneventfully as possible.

Once you’ve found a good doctor, make an appointment specifically to talk about your abuse and your anxiety about having a pelvic exam. Tell them about what was done to you as a child if you feel comfortable so they can understand your fears. This is unfortunately an all-too-common situation, so I doubt your doctor will be shocked by anything you say. Remember that the focus here is not to degrade you or make you relive any trauma. The focus is to help you be more comfortable with your body and to help you take good care of yourself.

At that visit, ask them to walk you through the process of a pelvic exam verbally if you think it will relax you. Find out who will be in the room during the exam and if there is a nurse you are more comfortable with, request that they be the one who assists. Know that the nurse or assistant often stands by your head or side and doesn’t have to view your “lady junk,” but depending on room setup it may be unavoidable. If you think asking questions about the exam will make you more nervous, skip it. Ask your doctor if they feel comfortable prescribing you some sort of anxiety medication for one-time use on the day of your exam to help you get through it easier. We will do that occasionally (like when people are terrified to fly), so I don’t think it’s an unreasonable request.

Schedule your exam just a few days after this initial appointment. Don’t give yourself much time to agonize over it and keep changing your mind. On the day of your appointment, bring whoever you want with you for support. It’s 100% okay to have someone come with you and stand by your head and hold your hand. Wear clothes that you feel comfortable and confident in. 

Bring headphones and listen to music during the exam if that makes you more comfortable. And don’t worry about any special cleaning or grooming. That’s not necessary.

After the exam, 

Additionally, check out these old posts on how to make your pelvic exam not hurt and this one on current US guidelines for the frequency of pap smears and pelvic exams so you will be better equipped to advocate for yourself at your doctor’s office.

And finally, 

Remember that rules of consent apply to pap smears too. 

If you decide halfway through that you’re uncomfortable and you want to stop, speak up. Your doctor should stop. Nobody can do a procedure or invasive exam on you without your consent.

Important

I like to tell people if there’s anything they should know for future exams; for example if we needed a very small (or very long) speculum, or if the cervix was in a hard-to- reach area. Just because it allows people to come to the next one better prepared and able to tell future clinicians that they need a long speculum and their cervix is tricky.

Obviously with reassurance that all these things are normal but I think demystifies the examination is important.