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.

Vaginismus and the dreaded GYN ExamHaving 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. SThe Dreaded speculumpeculums 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.

Practice sessions with a speculum post-treatment for our vaginismus patients

During the post-procedure counseling, we have the time to work with our patients, allow them to feel the smoothness and bluntness of the speculum, and teach them the needs of dilating prior to a GYN exam and how they can insert their own small speculum.

The following appeared as a post from one of our patients on the VaginismusMD Forum:

Vaginismus MD Forum

“Post lunch, Dr. Pacik gave us a speculum that OB-GYN uses, just to touch it and get the feel of it. There is so much history for all of us not being able to have a GYN exam in the past so just looking at it brings tears to our eyes. In the past, I have gone through so much that I sometimes felt like I have fallen into a deep grave so deep where no one can hear me. Looking at that dreaded device caused all the episodes of my pain of not being normal to flash back. It was truly an emotional moment and I could hardly keep my tears inside.”

Another patient writes on the VaginismusMD Forum:

“I panicked when Dr. Pacik showed us the speculum, even when I had Mr. Blue inside me. The panic went away little by little with the help of Dr. Pacik who asked me to touch it and assured that it wasn’t sharp at all (even when the metal looks like it will cut you). Then, I took Mr. Blue out and proceed with inserting the speculum. This was so easy that I barely could believe it!!! Dr. Pacik was great at explaining every step and helping me to know that everything was going to be just fine. A couple of months later, I had my first successful OB-GYN exam at a regular doctor’s office! I could not stop smiling on my way home while driving, I wonder if people thought I was crazy, LOL!!”

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.”

I cannot stress enough the importance of this story to all women suffering from vaginismus. This patient’s story contains many helpful hints on making your next GYN exam successful and pain-free! Please take the time to read this story in its entirety.

Contact Us

If you have any questions about our Botox treatment for vaginismus and progressive dilation under anesthesia, please contact Dr. Pacik’s office at 1-603-669-0290 or 1-800-640-0290 (US only) or via our contact us form.

Dr. Pacik

About Dr. Pacik

Peter Pacik, MD, FACS is a recognized pioneer in treating patients with Botox for vaginismus and the author of When Sex Seems Impossible: Stories of Vaginismus and How You Can Achieve Intimacy. He has been in practice for over thirty years and belongs to a small group of prestigious surgeons who are double board certified by both the American Board of Surgery and the American Board of Plastic Surgery. In 2010, Dr. Pacik received FDA approval to continue his study to treat vaginismus using intravaginal injections of Botox together with progressive dilation under anesthesia.
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