How to Make Pelvic Exams More Comfortable
There is probably not a person in the entire history of ever who looked forward to pap smears and other vaginal exams. It can be really awkward and make you feel super vulnerable. The process and tools were not made with comfort in mind (If you ever want to be scarred for life just look up the history of gynecology, that’s some horrible stuff). It can be extra terrifying if it’s your first time, you have anxiety about it, or you have a condition like vaginismus that causes any kind of vaginal entry painful. It can also be difficult for transgender people who experience dysphoria related to their genitals. It can be difficult for people who have experienced abuse, especially abuse from medical personnel like in the case of many intersex people.
So what can we do to make pelvic exams not suck? The first step is communication and finding a doctor that makes you feel safe. Talk to your doctor about any problems you have. Request a smaller speculum to be used and request it to be warmed up. They can be sure to low down and use more lubricant or you can even insert the speculum yourself. Tell them what makes you feel better; if you need every step explained as the do it, if you need conversation, or if you need to have headphones on with music playing. If you have any “off” feelings about the doctor, trust your gut and try to find a new one. I know that’s easier said than done if you’re not insured, your insurance doesn’t cover a lot, or if you live somewhere there aren’t a lot of options when it comes to gynecologists. It’s important that your boundaries are respected. You deserve to have your needs met and to feel like you are being heard. Don’t feel like you shouldn’t shop around or request a doctor of a certain gender or anything else that would make you feel more comfortable.
This brings me to my next point: self care. Dress in comfy clothes, you aren’t out to impress anyone. Remember that these doctors have seen everything. You don’t need to primp or be self conscious of your body. It can also be helpful to have a person go with you. They can distract you with conversation, hold your hand, or just be a friendly presence. I firmly believe that we need support doulas for every gynecological experience, not just birth and postpartum. Also that way you can treat yourself to a fun day with a friend, or just go home and relax if you can. Depending on the situation it can also be nice to have someone available to drive you.
Another thing that can help a lot is practicing relaxation techniques and meditation. There are plenty of tutorials out there if you want to find out what works best for you. A really basic one starts with paying attention to your breath. You breathe in, counting to seven, hold your breath for count of seven, and slowly breathe out for count of seven. After doing that a few times you focus on relaxing each individual part of your body. Start with your toes, then your calves, thighs, belly, and so on. Continue with slow breaths and relaxing. Some people also find it helpful to imagine you’re somewhere else like floating in a pool, laying on the beach, or any other place that brings you joy.
The last bit of advice I have is to educate yourself. Learning more about the procedure and guidelines help demystify it. You may not be aware that guidelines have recently changed in regards to regularly getting a pap smear. The age you should start getting them is now 21. Exams should be every 3 years as long as no “abnormal” cells are found. After age 30 you can go to exams every 5 years. Over age 65, as long as you’ve had regular screening in the last 10 years and haven’t had any serious pre-cancers found in the last 20 years you no longer need pap smears.
Now when it comes to parenting teens, even though they don’t need to get pap smears yet, I think seeing a gynecologist can be a great idea. This gives them a chance to talk to a professional and ask questions they might be too embarrassed to ask a parent. Plus it means their first time in an exam room won’t be for an infection or other unpleasant problem. Definitely talk to kids about vaginal infections. Anyone of any age can get them and it’s important they have the language to talk about them. The basic symptoms of anything in this category are itching, irritation, inflammation, change in discharge, change in odor, and discomfort or pain with urination. Sometimes symptoms can be really mild so it’s important to really get to know your body.Although first instinct can be to reach for the monistat, bacterial infections can have similar symptoms and anti-fungals wont do anything. In that case it can be easier to just get an exam and diagnosis to be sure.
There are many, many reasons one may need to see a doctor for a vaginal exam. They’re important and necessary for your health. It can be easy to just put it off and suffer in silence but this can lead to serious conditions that can cause permanent health issues. Hopefully, you now have some tools to make it easier to make your next gynecologist appointment.