Gynecological Exam

[pinklytaurus.livejournal.com]

Lately, my mother has been trying to book a gynecological exam with my life long pediatrician. I've been told girls should start going generally when they start their periods. But who wants to see a 8/9-year-old girl getting a Pap smear?

Well, I'm 17 now. And I have to get the exam done so I can go on birth control pills to regulate my period, diminish the excruciating cramps, and minimize the excessive bleeding that I have experienced ever since then.

And I am scared to death.

Can anyone give me a brief (or detailed) description of what goes on during one of those visits, so I can know what to expect? Any advice would be helpful.

My mother offered to go in the room with me during the exam. I'm not sure if that will help, but still, the whole idea of the exam makes me want to cross my legs forever.

I think I will share the same feelings as victorianbeauty-- discussing her sentiments on her Pap smear.

HOLY SHIZNET, AM I TERRIFIED!

Comments

[iris-opal.livejournal.com]

Think Calm! Ok - I am in the UK so it may vary. Here:

the smear procedure is that you lie down naked below the waist, spread your legs so the doctor has access to your vagaina and a metal or Plastic speculum is inserted into your vagina. Imagine something like tongs, but the idea is to spread apart your vaginal walls.
THen something a bit like a long q-tip is inserted to scrape a few cells off your cervix -these are then smeared onto a slide to be looked at under a microscope.
Speculum removed and you get dressed.

Now the reality as I have experienced it:
-First few times I was terrified so my vaginal muscles contracted - this made it difficult to insert the speculum, sadly the only way to overcome this is to calm down and not worry (yeah, right I hear you say!)
-It didn't help that I was lying on my back legs appart, which I found embarassing and the nurse was unsympathetic.
- I have had this done curled up in a foetal position, knees to chest and that helped my confidence, as did a MUCh nicer nurse who was very sympathetic to nerves.
- If you think you may need moral support, take your mum who can yell at the doc/nurse to be nice :) IF you don't like the idea of her being able to see the business end of this procedure, ask her to stand by your head and hold your hand. Don't forget she has had this done too!
- Metal speculum can be warmed by running them under the hot water for a moment - less likely to feel quite so intrusive or cause you to contract due to cold! OF all the places I DONT want something icy cold it is there!
- the scraping is uncomfortable - I won't lie - but not BAD, for me it is like scraping the inside of your cheek with a fingernail.
- DONT put up with a nasty nurse. Yeah, so she is busy and you are another on the production line - you have a right to some care and attention and not to be afraid, worried or denied FULL information and EXPLAINATION of anything and EVERYTHING done to you.
- Don't be embarassed. I don't care if Doc is male or female, or if I have a chaperone. I am unusual in this - I figure I can handle whatever. But I am just old enough to be your Mom :) but also don't forget that this Doc has had his/her hands in HUNDREDS of vaginas and others intimite places and you are no different to the million or so others who have this done wherever.
- I find a quick wash down there before going boosts my self confidence - and a quick pee and soapy wipe if possible once at the doctors helps too!

All the bad bits aside, I am more than happy to toddle along now (aged 36 and 8 smears later) for a chat and reassurance that all is fine 'down there'. And the last time the metal speculum was cold, I was on my back and completely unphased by it.

Good luck, don't worry and be glad you are a woman!

[pinklytaurus.livejournal.com]

Thank you for the information...

I probably would have done better without knowing what they were going to do, now I get to agonize over it, haha. I'm probably making it more than it should be, but I'm a very private person, and the thought of some person poking around down there when I don't even do that myself freaks me out.

[iris-opal.livejournal.com]

Hugs! Maybe have a look and poke with fingers. Sit on the end of the bed with a mirror in your hand and angle it to have a look! Yeah, sounds a weird-o idea but it does help to familiarise yourself with YOU! Touching yourself is not a bad thing to do, nor is self-knowledge!

Ok, I am not quite advocating the strange 'make friends with your vagina, say hello to your clitoris' type stuff, but knowing what you have and what it looks like can take some of the 'erk, strange bits I don't understand' feeling away.

Feeling good about yourself is important - nothing bad down there, nothing weird or off limits - just the same sort of bits as the rest of us females!

Good luck, breath and tell us how it went!

[jpallan.livejournal.com]

I would not ask for birth control pills at this point.

I would be more interested in finding out why you have this excessive discomfort. I finally managed to fix it at age 20 (after experiencing it for 11 years) by switching to Insteads (http://www.softcup.com/), so I didn't have the irritation of disposable pads and tampons, which make me cramp up and far more uncomfortable. But if you go on birth control, you're only masking the problem, unless you actually want the birth control aspect, which is a bit different.

The exams consist of two parts, well, three, actually. The first part is a health history, discussing symptoms, blood pressure, et cetera. The second part is the speculum exam and Pap smear. A speculum is an instrument that looks a bit like a duck's beak:



They will lubricate the speculum and insert it into your vagina (they come in various sizes, and they'll select the appropriate size). They then screw it open, which is not as painful as it sounds. A bit uncomfortable, but nothing much. It just holds the vaginal walls slightly apart so they can get a clear view of your cervix and look for signs of infection or anything else that would indicate a problem. If there is nothing visible, they will take the Pap smear using a swab to collect a few cervical cells. This can be a bit uncomfortable, particularly if you're not used to cervical stimulus, but not painful.

Best advice for this part is to take short breaths in and out (keeps the abdominal wall from tensing), and when they say, "spread your legs", spread them. Your feet will be up in stirrups, and you should really drop your knees as far to either side as possible. It's much more uncomfortable if you don't.

The last part is the bimanual exam. The provider will insert 2 gloved fingers into your vagina and feel your uterus, ovaries, and fallopian tubes for any abnormalities. Once that's done, you're done. This part isn't uncomfortable at all, though they do press on your abdomen, which may not be fun. Keep on with the short breaths and keeping your abdominal wall from tensing.

Don't panic. The gynecologist is not there to hurt you.

I've had wonderful experiences with Feminist Women's Health Centers (http://www.fwhc.org/) and mixed experiences with other gynecologists -- and mixed not based on gender, either -- I've had wonderful male gynecologists and awful female ones, as well as awful male ones and great female ones.

Good luck.

[janedoe.livejournal.com]

That might be the problem you had. But when it comes to regulating your period bc pills are the only way to do it.

[pinklytaurus.livejournal.com]

I know the gynecologist is there to help me. I just am very private, and I don't like the thought of what they are doing.

That picture didn't help much, however....

I will remember to breathe, a lot of people have been telling me that.

[victorianbeauty.livejournal.com]

This might not mean much for I know it didn't mean jack to me when people told me but relax!!! One of the many reasons my expereince was so tramatic was because I was so tense. Maybe bring some headphones or something to listen to so your concerntration goes elsewhere (I wish I would have now and to think I almost did). I found my doctor entering the spectrum more painful than the actual pap smear because once he had me spread open the rest of it felt like they were plugging up a hole. Don't bring your mom into the room for I think that'll make it worse. I didn't bring mine in and I'm glad I didn't for she would have freaked out over all the screaming I did and then probably would have yelled at the doctor or something.

Hope your nurse is nice. I was trying to talk my nurse before hand to try to calm me down but she wasn't any help. She was real cynical about the whole thing saying things like, "Yeah your legs are up in the air, doctor's face near your butt, not fun." I found my doctor more caring because usually he's a real monotone man but once he was done with the pap smear his tone changed. He was real concerned sounding and apologized for the whole thing. He was like, "I'm sorry I had to do that. I wish there was another way for us to look at everything down there without having to do all that but there isn't."

As for the birthcontrol thing: my doctor put me on birth control before I even had a pap smear for he wanted to try to regulate my PMDD. Before he had the pap smear done I just went to talk to him and he was surpised that the birth control wasn't helping my really bad cramps at all (or the PMDD). He's since perscriped me Vioxx 50mg for my cramps and Fluoxetine 20mg for my PMDD. The Fluoxtine has helped my PMDD greatly and my period should start tomorrow so I'll get to try the Vioxx for the first time. The birth control might help your cramps though for they usually do, I'm just one of those weird cases that it didn't help. The birth control did regulate my period and made it shorter so my doctor kept me on it.

Long story short, I wish you the best of luck with your pap smear and will be hoping that you don't have an experience like mine. Let us know how it goes and if you need a shoulder to cry on after it, I'll gladly lend mine.

[pinklytaurus.livejournal.com]

I probably will need that shoulder regardless if it went good or not. I'm a very private person... I don't like the thought of someone tinkering down there when I don't even tinker down there myself. You know what I mean? It's quite unerring.

[moonwalker.livejournal.com]

Have your mother there only if it makes you feel more comfortable. If it does not, go by yourself.

The thing I remember about my first exams is, I got nervous and held my breath, and it caused me to get light headed. Remember to keep breathing normally!

If you have a male gyno, a female nurse will be there, I think that's a law.

It does not hurt. You will feel some pressure when he sticks a couple of fingers in and presses on your stomach to check the position of the uterus. The speculum does not hurt. If you are relaxed, it goes in quite easily.

Good luck to you!

Mary MMM

[pinklytaurus.livejournal.com]

Thank you, I'll need all the luck I can get.

[whatevah.livejournal.com]

My mom went with me for my first exam, and tastefully stood near my head, held my hand and quietly explained what was coming up, and at moments when I was about to get wiggy firmly but lovingly told me to calm down.

I've since found that finding something to focus on (such as a picture in the room or even just an object), being aware of my breathing, and also talking with my doctor throughout helps me to be relaxed, confident in the doctor and completely at ease with the experience. If you are nervous, tell your doctor, and let your doctor know what you need in order to relax. Communicate, communicate, communicate.

Regarding the pap smear - it used to be done with a Q-tip type swab, but is now done with a device that looks a little like a very tiny bottle scrubber. The reason for this is because studies have shown that this device provides a better cell sample for testing than the superficial swab. I find this to be the most uncomfortable part of the test, as it causes a minor bit of cramping for me, but using the same breathing techniques I use for my period gets me through it just fine (pretty much the same breathing techniques used in labor).

Go get your exam. It'll be over a done with before you know it.

[pinklytaurus.livejournal.com]

My mom is trying to make the appointment, she hasn't been able to get through at the moment. She is trying againn tomorrow. My god, I am going to be so nervous it isn't funny. I think there is no doubt that I am going to sob when it happens.

Re:

[whatevah.livejournal.com]

Awww... I wish there was a way to help to alleviate your fears. It really isn't as bad as all that. But maybe you need to figure out what is at the root of your fear? Is it a privacy issue? Does it seem threatening? What about this exam is it that you are really fearful of?

Trust in the women around you, in your mother and in others to reassure you that this experience isn't a horrible one. It's okay to feel shy and private, but important to remember that your parts are not going be any different than any others that a doctor may have seen. Though you may feel private and shy about it, your doctor probably doesn't see it as much different from a foot, and if you've seen one foot, you've pretty much seen them all; perhaps they even get a little boring to look at.

You're going to be okay and live to see another day and tell more tales. This will be a mere blip on the radar. It's maybe akin to getting a shot...the fear of it is much greater than the thing itself, and once it is over, it's forgotten.

[inanna.livejournal.com]

Honestly, different people have different experiences - just like the dentist. If you hear how terrible it is, it is hard not to freak. If you hear that it is annoying at best but not that bad, you will have a better view.

My biggest suggestion is, when you schedule the appointment, tell them that this is your first pap and that you want plenty of time to talk to the doctor and/or nurse BEFORE you get undressed. Let them know at the time you schedule that you are a virgin (if you are) and request the smallest possible speculum. Explain that this isn't an option... you want to talk with them before hand to know exactly what they are going to do and why. Preferably with pictures and diagrams *g*. THEN, make sure the doctor tells you what they are about to do, are doing, and why. Knowlege really is key.

Generally they will first examine your labia (looking and then separating the "lips" in preparation for the internal exam).

They will then insert the speculum (AKA: duck lips) and open it.... it is true... RELAX - meditate, whatever - sometimes i very gently push to keep from tightening. They will then use a little brush to remove some cells from your cervix. It may burn or sting or even cramp a little.

Then they will remove the speculum. They will then insert one or two fingers, lubricated with KY, into your vagina and gently (although, depending on where you are in your cycle it may be more or less tender) press on your abdomen with the other hand and press up with the finger(s) inside you so they can feel your uterus and each ovary. In a complete exam they will then insert one finger into your rectum to examine the tissue between the vagina and anus/rectum.... but i have notice more and more doctors don't do this test anymore.

They will then remove their finger(s) and replace the drape over your pelvis/legs. Make sure you know where the tissues are so that you can wipe up afterwards. You may want to bring a panty liner or thin pad as you may spot a bit afterwards. It usually only takes a couple minutes and, while not fun, doesn't have to be that uncomfortable or traumatic.

i honestly feel that knowlege and preparation and trust in your doctors is key.

[pinklytaurus.livejournal.com]

I better get the smallest speculum. I am a virgin... the thought of that scares me to death. It's going to take a lot for it to go in, ecccch. Thank you for your suggestions and information.

Re:

[inanna.livejournal.com]

Actually, the speculum part is a bit uncomfortable, but not that bad. We are designed by nature to stretch and return to normal. It may feel a bit odd- but if you can get yourself to relax, it isn't that bad. The relaxing part may be a bit tricky - but i have faith in you. *hug*

[whoremoan.livejournal.com]

Just some advice my friend gave me: Wear cotton undies and possibly a panty liner because the lubricant feels a little uncomfy afterwards. Much luck and love is being sent your way<3

[i-feel-broken.livejournal.com]

I definitely feel your pain. Im 19 and im a virgin, though im still sexually active, i just dont have sex. My mom scheduled my first GYN appointment for June 9th and im quietly freaking out about it. Not in a frantic way, but Im real nervous. And im super emotional and just thinking about it gives me a lump in my throat and i feel like im going to cry. its just so invasive. but i really need to go since my cramps have gotten so bad that i cant function for the first two days and i'll most likely be put on the pill. But i totally understand where you're coming from and though I cant help with giving you any information, i can definitely assure you that im in the same exact boat as you are. and its not fun.
good luck
<3333
jami

[pinklytaurus.livejournal.com]

Hey, at least we can encourage each other. I probably am going to cry when the whole procedure happens, I just don't like people entering my private space. I'm a virgin, and I really value my privacy. Its very unerring to imagine someone tinkering down there when I don't tinker down there myself. I'm glad you understand where I am coming from. We can give each other moral support, and we can cry and eat icecream together, how does that sound?

[sulingsi.livejournal.com]

hello there:
i'm sorry to hear your exam is causing you so much worry. you have mentioned quite a few times here how you don't want someone else "tinkering" with it if you don't.
i have a thought- maybe if you did tinker with it some, you'd feel better about it! we fear what we don't know. it's a very nice body part, maybe you should take some time to get to know it. get a mirror, take a look, mess around some? you might find it very beneficial or even fun? i always do. just a thought. i mean you have to live with it your whole life, it seems better if you make friends with it, no?