'I Used To Nearly Pass Out During Pelvic Exams'
my gynecologist asked as I scooted back on the pelvic exam table, the crinkly white paper bunching up under my bare butt.
I was recoiling at the sight of the cold speculum she was wielding, and my reaction wasn't specific to this appointment. I had been seeing her for years for my annual pelvic exams, STD testing, and birth control prescription when I lived in Iowa, and we did this song and dance during every visit. My aversion to the speculum was so strong that she suspected I was dealing with some sexual dysfunction or former trauma.
“Sex isn’t painful for me, actually,” I said. “I’m sorry, this just makes me really anxious.” She asked me to slide toward her once more, open my legs wider, and loosen my pelvic muscles. “The more relaxed you are, the easier this will be,” she encouraged me. It felt impossible.
She slid the speculum in and cranked it open wider so she could examine my cervix. I gripped the table hard, digging my fingers into the padding as I felt myself getting light-headed.
I tried to concentrate on anything else—a dot on the foam-tiled ceiling...anything. I tried taking deep breaths but nothing would keep my thighs from bracing and abs from clenching.
As she scraped around inside me with various swabs, I could feel the blood rushing out of my head. I felt like someone was accessing a part of me deep inside that should never be touched. She was only in there a few minutes, but it felt likes ages.
Just as I thought I might lose consciousness, I heard, “Okay, all done.”
My doctor mercifully slid the speculum out of me. She still had to feel my ovaries from the inside with her gloved fingers, but that portion of a pelvic exam never bothered me. It wasn’t exactly comfortable, but it felt human and familiar enough.
It was the speculum that terrified me and felt downright painful. Shuffling into the bathroom in my paper gown post-exam to wipe off the lube and put my clothes back on also just seemed dehumanizing; I knew I’d feel somewhat violated and uneasy for the next few days. The only solace I had was the fact that I probably wouldn’t have to come back for another year.
My first visit to the gyno at 13 to get birth control pills for my period and start HPV vaccinations was hard, and they were an anxiety-filled struggle for years, even more so when I started getting pelvic exams a few years later (more on how I've helped deal below). I’ve never been uncomfortable being exposed to a doctor, but for some reason, I have a deep fear of foreign, non-human objects being placed inside me.
It’s hard for me to wrap my head around the fact that it’s a non-issue for many women. (I envy them!) But for me, the thought of a speculum going inside me makes me incredibly tense, which in turn, makes the process even more deeply uncomfortable than it would be under normal circumstances.
Turns out, I’m not just a massive baby: Gyno anxiety is a real thing. “I encounter it almost every day in my practice—it’s incredibly common," says Kate White, MD, associate professor of obstetrics and gynecology at Boston University and WH advisory board member.
"I think it's one of biggest reasons women don’t go to the gynecologist," she adds. There are several reasons people may feel anxious about the appointment, she says, whether it's about the physical exam itself, feeling exposed, hearing negative test results, or feeling judged for their sex life or sexual health.
The thing is, you can’t just stop going to the gyno, even if you absolutely despise it, like me. And my fear of not getting checked for cervical cancer or STDs is greater than my fear of the speculum, so I diligently visit every year.
When I moved to New York City in 2014 after attending college back home in Iowa, I was tasked with finding a new gyno. I took my time reading reviews, asking friends for referrals, and considering different options that worked with my new job’s insurance.
My former gyno was a local doctor near my hometown who my mom knew, and occasionally I would visit gynos at urgent care when I was at school a few hours away. It wasn't that they were bad, but there wasn't really any reason I was seeing them other than convenience.
I ended up picking my current gyno based on a review that mentioned how quick she was—basically the single-most important thing to me during a pelvic exam. She’s indeed speedy, as well as gentle, sweet, non-judgmental about my anxiety, and does a good job of distracting me during the examination.
Her demeanor helps to calm me down. Even the color palette of her office—bright green and white—makes me feel happy and doesn't register as a cold, sterile doctor's office.
Before, I used to feel like I was being a pain if I had any complaints about the exam. I thought there was something wrong with me, and I certainly didn’t feel empowered to speak up about my fear without profusely apologizing first.
I've become more confident in communicating my needs throughout appointments so my doc can help me out. I think that fortitude came with maturity, talking with other friends who have revealed they also dread gyno visits, and working as a health reporter. I've realized that I have every right to speak up and request the care I need.
Now, I explicitly ask for the things I know will help me through the exam. I schedule them in the early morning so I have as little time as possible after waking up to build up anxiety about it. I ask the nurse for the smallest speculum they have available—and if it's in another exam room, I request that they go get it.
Also, while some people find comfort in hearing exactly what their doctor is doing during each step of the exam, I know that I don’t want to see or hear about anything that’s happening down there (other than an "almost done!").
Thinking about it in detail just makes me more nervous. I’ve told my current gyno this, so when she’s examining me she tells me about her most recent vacation. I’m not put on the spot with questions about my life, but I have something to focus my attention on.
For example, if you'd like more control during the exam, ask if you can sit up at a 45-degree angle, Dr. White says. "This doesn't impact the exam and allows you to see what your doctor is doing. You can also ask to place the speculum yourself." I had no idea this was an option!
When it comes to test results, ask for how you'd like to receive them, says Dr. White. "Often you can review them in a digital patient portal, or you can ask to discuss them over the phone or in person at a planned time. That way, you can have a friend there to support you if you'd like." Above all, remember that you're not being a burden by asking for care in a specific way, she says.
Despite getting more comfortable with my gyno, I still don’t look forward to scheduling my yearly visit, and I have never once un-reluctantly scooted down on the table.
But my anxiety about pelvic exams is leaps and bounds better than before. I wish I would have realized sooner that the nervousness I experience isn't uncommon, and that seeking out a different doctor because of it is totally okay. During those appointments, I'm worthy of not only good medical care, but emotional support, too.
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