Fears of a GYN Exam

The thought of a GYN exam is especially nerve racking for most vaginismus patients especially those suffering from the more severe forms of vaginismus. The idea of a GYN exam can provoke intense anxiety. Though this is a non-sexual event, for many women any form of penetration is impossible. Penetration fear can range from tampon use to the insertion of a “Q tip”, finger, dilator or speculum.

How do you feel just knowing you will have a GYN exam?

Below are some typical stories, or remarks, of what patients have shared as they fill out the questionnaires. They are asked “How do you feel just knowing you will have a GYN exam? Please elaborate.” The severe reactions, which provoke a “fight of flight” response (palpitations, hyperventilation, sweating, trembling, nausea, vomiting, wanting to run away, wanting to attack the doctor), are the reasons for classifying them as a Lamont/Pacik level 5 vaginismus.

Of importance are the mock GYN exams that we help the patient with at the time of post procedure counseling. We have the time to work with the patients, allow them to feel the 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. It may seem impossible but patients who have been treated with the Botox program are able to have success with a GYN exam.

Patient: 29 years old. Lamont level 5 primary vaginismus, 5 years. Never had any form of penetration.

“I’ve never been able to receive a full GYN exam or pap smear. Although, whenever I know I have to attempt an exam, I usually dread going to the appointment. I get extremely nervous, especially once I have entered the exam room. I begin to sweat a lot, and I also begin to shake. I also feel embarrassed that I feel this way and that I usually jump and pull back before the doctor even touches me. Sometimes I cry as well. I feel like I’m overreacting, but I can’t make it stop and I can’t explain why I feel this fearful?”

Patient: 26 years old. Aware of her vaginismus for 6 years

“Very nervous – Vaginal muscles begin pulsating/clenching, hyperventilating, break out into hives, legs begin to shake, feel nauseated, feel like I am going to faint, legs close without reminder to keep them open, start crying and moving myself to the top of the examination table unknowingly, etc. I have gotten to the point to when I even think about vaginal penetration that my vaginal muscles begin to clench and spasm.”