The GYN Exam: Fear of the Dreaded Speculum

GYN exams are an important part of a woman’s comprehensive health care. ALL women, regardless of their sexual orientation or their level of sexual activity, should have regular GYN exams. GYN exams allow women to maintain an up-to-date knowledge of their reproductive health, to become familiar with what is normal for their body and in turn to be able to identify future health problems.

Having regular GYN exams can:

  • Prevent illness
  • Detect cancers such as cervical, uterine and breast cancer at an early and potentially more treatable stage
  • Detect sexually transmitted infections (STIs) before they cause infertility or other damage
  • Provide health care before, during and after pregnancy

Typically, a GYN exam involves a medical history, brief physical exam, breast exam, pelvic exam, and lab tests and counseling.

The speculum used in the GYN Exam

The speculum is usually a plastic or metal device. Speculums come in all sizes and usually a GYN physician will choose a speculum based on the size of the vaginal opening, the length of the vagina and the elasticity of the vaginal walls. The speculum that the physician chooses to use may be a completely different instrument for a 40-year-old woman with 3 kids, the woman who is well into menopause or the short woman versus the tall woman. The opening of the speculum can be adjusted, so if you feel pain or discomfort, let your physician know so s/he can adjust the speculum for greater comfort. It is important to note that this part of the exam usually only takes a few minutes.

For our vaginismus patients, the speculum is a dreaded device!

Time after time, I hear from my patients that the GYN exam is simply dreaded and avoided if possible. Many times, exam appointments are made and then cancelled. If an appointment is kept, often the exam cannot be completed because the patient is in tears with high levels of anxiety and the pelvic muscles have involuntarily contracted into “keep out mode” to protect themselves from the agony of the exam.

It’s important for patients to dilate prior to a GYN exam and insert their own small speculum, if they feel comfortable, to ease anxiety.

Successful GYN exams are possible post-Botox treatment for vaginismus

It may seem impossible but patients who have been treated with the Botox program are able to have success with a GYN exam. One of our patients wrote a story, titled “Dreaded GYN Exam” that describes this woman’s experience with her GYN exam post-procedure. An excerpt of this story follows:

“Now it was time for my exam, usually at this point I am sweating, panicked and so filled with anxiety that I can’t relax and just cry. Today, I was talking to my doctor as she inserted the speculum and in a matter of seconds my pap smear was complete! She gave me a big hug and said that I did very well.”

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