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@sexlessinseattle The problem is there is not really that much a gyn can do about it, besides sending you to a pelvic floor therapist. Yes, they can use a smaller speculum, go slow, etc… and I agree you should tell the gyn about your condition so he/she is aware of the issues… but at the end the exam still has to take place. You can make it easier, but you can’t avoid it. That’s what I meant with “suffer through it”. If you’re still in the process of dilating, or worse, you didn’t start therapy yet, and you can’t have sex with your partner, an internal exam WILL be difficult. No matter what your gyn does. You have to be honest about that too.