How to handle a GYN exam in this situation?

[Anonymous]

Never ever lie to a doctor. They cannot give you good medical care without accurate information.

OP, this is a huge deal to you. It will not even cause the doctor to blink an eye. Be straightforward and tell her. Also say that this is your first pelvic exam and you are nervous. I'm willing to bet the doctor will be very thoughtful and you'll walk out feeling like it wasn't a big deal.

[Anonymous]

Anonymous wrote:Have you considered meeting with a midwife instead of an OB/GYN? Most midwives schedule more time for individual appointments and tend to offer a more sensitive approach. I recommend the MFA midwives who practice at GWU and have offices in Foggy Bottom and Bethesda.

I would advise you against lying to your healthcare provider about your experience (both with intimacy and prior examination). You might consider requesting an office consultation prior to examination. This would afford you an opportunity to inform your provider of your circumstance, ask questions about what to expect, and be sure that you are comfortable with this provider prior to an exam. If you find that you are not comfortable, you are under no obligation to allow someone to exam or treat you. Be sure to request that they explain the procedures in advance and again as they are performing the exam so that you are prepared.

For the record, a speculum exam will likely not break your hymen. Neither will tampons, as another poster suggested.

Best of luck to you!

I totally recommend going to a midwife practice. They will be very sensitive, they will talk a lot to you about your health, and they are really into educating you. I find it much more pleasant and much more informative.

[Anonymous]

Anonymous wrote:I was in your situation and chose to go to an OB/Gyn practice who saw many "religious" women (not nuns, just lots of very conservative catholics and the like). My experience was very positive. I was honest about it being my first exam and never having any sexual partners. The NP was very kind and undestanding and didn't look at me like I was some strange anomoly. I would recommend them without reservation. I drive 45 minutes for my appointment because i love them so much. The practice is Tepeyac Family Center.

This. Quite honestly OP, despite all of the people saying GYN's won't bat an eye, I was in your situation. I initially went to Kaiser and the GYN treated me like I was a freak and hurt me. IE spoken with a tone of total incredulity "YOUR 30 years OLD AND YOU"VE NEVeR HAD A GYN EXAM BEFORE:

I switched to Tepeyac. Much better. I love them.

[Anonymous]

Anonymous wrote:I was in your situation and chose to go to an OB/Gyn practice who saw many "religious" women (not nuns, just lots of very conservative catholics and the like). My experience was very positive. I was honest about it being my first exam and never having any sexual partners. The NP was very kind and undestanding and didn't look at me like I was some strange anomoly. I would recommend them without reservation. I drive 45 minutes for my appointment because i love them so much. The practice is Tepeyac Family Center.

This is my practice. I was going to recommend Tepeyac, specifically Dr. Anderson, a female.

The practice is especially compassionate; I got to this practice only through my insurance years ago and initally went seeking treatment for postpartum depression and anxiety. No exaggeration that the practioners here saved me through their wonderfully gentle and kind approach (I also had a cocommitent medical phobia, too). Beleive me, if they could handle me with all of my issues and problems in a nonjudgmental and pragmatic way, you'll find that you are most welcome here. They are in Fairfax. Lots of hand holding if you need it, but they take the time to get to know you and your background. Great holistic approach, too.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I was in your situation and chose to go to an OB/Gyn practice who saw many "religious" women (not nuns, just lots of very conservative catholics and the like). My experience was very positive. I was honest about it being my first exam and never having any sexual partners. The NP was very kind and undestanding and didn't look at me like I was some strange anomoly. I would recommend them without reservation. I drive 45 minutes for my appointment because i love them so much. The practice is Tepeyac Family Center.

This. Quite honestly OP, despite all of the people saying GYN's won't bat an eye, I was in your situation. I initially went to Kaiser and the GYN treated me like I was a freak and hurt me. IE spoken with a tone of total incredulity "YOUR 30 years OLD AND YOU"VE NEVeR HAD A GYN EXAM BEFORE:

I switched to Tepeyac. Much better. I love them.

This. While I agree that this SHOULD not be a big deal and people SHOULD be sensitive etc., the reality is that people -- even drs. and nurses aren't always kind. I have definitely been to people who I think may not say anything to OP but would have a "yeah you're a virgin, right" reaction or generally be surly with OP esp. if she's in pain, flinching etc. -- anything that adds to how much time they need to spend. I have an Indian friend (who moved here from India), never went to a GYN because it isn't done there until you're pregnant, got pregnant and went to an OB-GYN, was asked when her last exam/pap was, said "never," and the nurse acted like she was some kind of circus freak with the whole "you're 35 and have NEVER had an exam . . . ."

OP I have a feeling these are the reactions you're scared of, and I think the PP above is being honest -- there are GYNs in the big practices, who will act like this or their staff will. I don't say that to scare you, but I say it to emphasize that you pick the right dr. Go for a female who has an excellent reputation for beside manner. If you don't want to ask people you know, look at things like zocdoc or yelp and go for the ones people are complimenting for being kind and caring and stay away from the ones that are being touted for their efficiency or short wait times. Honestly I think a small practice with a female GYN will be much better for you than an industrial practice like Kaiser that just wants people in and out every 15 min and is not going to be pleased if they need to ask you to take a breath a few times to relax.

[Anonymous]

Just tell your GYN that you have not had partners. They've seen everything. I mean, EVERYTHING.

You're worried about something that is a minor blip in the worlds of doctors and nurses.

[Anonymous]

Anonymous wrote:Just tell your GYN that you have not had partners. They've seen everything. I mean, EVERYTHING.

You're worried about something that is a minor blip in the worlds of doctors and nurses.

While this might be true, minimizing the OP's feelings is not helpful to her.

[Anonymous]

OP, I'd think that a good gyn-- someone who is compassionate and skilled-- wouldn't bat an eye at your situation. Gyns see everything, and as others have noted, there are other women out there who have not been sexually active. Find a good doctor and she will make sure that the exam is comfortable for you.

[Anonymous]

Agree with all PPs and another voice for don't lie to your doc.

In addition, by lying, you'll open yourself up to a lot more questions. Your doc will likely start asking questions about STDs and potential testing -- things that are not relevant if you're not sexually active. Save yourself the headache and awkwardness and just be honest. A good provider won't judge you.

Don't underestimate the awkwardness of a speculum exam. While it is ultimately done with instruments, you are in an incredibly awkward position, your doctor is touching the outside of your vagina, and even for a sexually active woman who has been getting exams for 15 years - I find it uncomfortable. I remember my first early exams when I started going to a GYN and they weren't horrendous or super painful, but they were awkward, so another reason to just be honest with your provider.

As another PP mentioned, you'll be getting a full breast exam as well as an abdominal exam.

[Anonymous]

OP here -- You've definitely convince me not to lie. I didn't even realize that there would be more questions re STDs, partners, intercourse etc. if I said I was sexually active. And yeah -- I don't want to feel like I need the stress of continuing that act that whole time.

Given that I'm not 17 and I understand what all of this entails, it's not like I need someone to hold my hand through the tears, I just want someone to be a bit gentle and realize that I may need an extra min here or there that someone on exam no. 15 just does not need anymore. I will look at the practices mentioned and also online reviews for great bedside manners. I definitely want to go to a woman. I believe that for the right provider this isn't a huge deal; I know when my regular dr. asked about sexual activity a few yrs ago and I said no and that I had never been to a GYN, she encouraged me to go but did not bat an eye. I just have heard too many stories of hurried, snarky GYNs and their nurses who aren't so kind and really take the tone of "yeah right you're a virgin" or "WTF is wrong with you" or just don't care that it's your first exam and don't treat you with the same care that they'd give to a teen/20 something bc you're so "old."

At the end of the day, it doesn't matter if they do take a tone or look down on me, as I don't have to go back there; but it's a stressful thing to me right now and I'd rather not have some provider's attitude that I'm a freak make me feel more nervous.

Has anyone ever had the pap smear/bimanual first and then the breast and abdominal exam? While I think all of it will be uncomfortable, I'd really want to get the harder parts over with first rather than having to anticipate the bimanual the whole time. Though given that I'm not 17 yrs old, I really don't want to ask them to do me a favor and do the exam out of order.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Just tell your GYN that you have not had partners. They've seen everything. I mean, EVERYTHING.

You're worried about something that is a minor blip in the worlds of doctors and nurses.

While this might be true, minimizing the OP's feelings is not helpful to her.

I don't think it's helpful to OP to feed into her worry by agreeing with her that this is a big deal.

[Anonymous]

OP again -- is there one part of the exam that is by far and away considered the worst esp the first time? Or is it different for everyone? Have you found anything to make that part a little easier on yourself or do you pretty much just have to grit your teeth and bear it?

[Anonymous]

Anonymous wrote:OP here -- You've definitely convince me not to lie. I didn't even realize that there would be more questions re STDs, partners, intercourse etc. if I said I was sexually active. And yeah -- I don't want to feel like I need the stress of continuing that act that whole time.

Given that I'm not 17 and I understand what all of this entails, it's not like I need someone to hold my hand through the tears, I just want someone to be a bit gentle and realize that I may need an extra min here or there that someone on exam no. 15 just does not need anymore. I will look at the practices mentioned and also online reviews for great bedside manners. I definitely want to go to a woman. I believe that for the right provider this isn't a huge deal; I know when my regular dr. asked about sexual activity a few yrs ago and I said no and that I had never been to a GYN, she encouraged me to go but did not bat an eye. I just have heard too many stories of hurried, snarky GYNs and their nurses who aren't so kind and really take the tone of "yeah right you're a virgin" or "WTF is wrong with you" or just don't care that it's your first exam and don't treat you with the same care that they'd give to a teen/20 something bc you're so "old."

At the end of the day, it doesn't matter if they do take a tone or look down on me, as I don't have to go back there; but it's a stressful thing to me right now and I'd rather not have some provider's attitude that I'm a freak make me feel more nervous.

Has anyone ever had the pap smear/bimanual first and then the breast and abdominal exam? While I think all of it will be uncomfortable, I'd really want to get the harder parts over with first rather than having to anticipate the bimanual the whole time. Though given that I'm not 17 yrs old, I really don't want to ask them to do me a favor and do the exam out of order.

I honestly don't know if there is a pattern in what they do first. Usually the nurse checks you in and does the normal blood pressure, temperature, etc exam. She then hands you the gown and asks you to get undressed, so you're hanging out on the table waiting for the doctor. I feel in some exams we've started with speculum and in others we started with breasts. Honestly, the breast part goes pretty quickly (like 1-2 min max in my experience) and abdominal is even faster, so I don't think you need to worry about an extended wait. Once you're up in stirrups, speculum exam comes first (the pap smear swab may feel like a sharp pinch) and then the manual exam. Honestly, after having the plastic speculum with lube in there, having a doctor's two fingers actually doesn't feel so uncomfortable. The whole time, they will remind you to "relax" (because no one is relaxed for this!). Total time for the speculum and manual exam is usually about 5 minutes.

I think it sounds like you have a pretty realistic expectation of what to expect, and I think you're looking for the right things. I'd encourage you to find a practice that you could see yourself sticking with for years to come, though you are right -- if you have a bad provider this year, you can find another one next year.

[Anonymous]

Anonymous wrote:OP again -- is there one part of the exam that is by far and away considered the worst esp the first time? Or is it different for everyone? Have you found anything to make that part a little easier on yourself or do you pretty much just have to grit your teeth and bear it?

It's not a big deal to ask for them to do one thing before another - go for it.
FWIW, I get extremely uncomfortable and ticklish when my stomach is manhandled - it goes best if I put my hands on top of the doctor's while they do it. I don't know why, but it does.

[Anonymous]

I third the suggestion to go to a midwife! While you will find many very sensitive GYNs, midwives are truly trained in bedside manner. You will be able to call her by her first name, tell her how uncomfortable you are, and ask her to things in whatever order makes you most comfortable. I highly recommend all the midwives that practice in the rockville location of midwifery care associates!