Worst part of your gyno exam

Well for my gf its the TVU exam

Thanks for sharing ladies

For me it's the speculum. It ALWAYS pinches. I don't know if it is too big or what, but it hurts. It makes me sort of jump & have to grab the edges of the table.

Well ms wemblyjones, if men had the same experience the speculum woule change, and I mean FAST! Women, start writing to the ACOG and complaining. Tell them you will not pay their fees if they keep hurting you!!!

Well lets face it, if men had to give birth the human race would have died out millions of years ago, lol.

wembleyjones, it could very well be not the speculum itself, but it's operator. I used to have the same issue you had until I found a doctor who knew how to handle that thing. It made a world of difference, trust me.

Mashie

My girlfriend's worst part of the exam is the pap smear because she says that it's painful.

Mashi, as usual you have a good point about the "operator". All doc's are not as skilled as others.

In most cases where a patient reports that a speculum pinches on insertion, it is due to a lack of lubrication and not the size. It is common practice to avoid lubricating the speculum if a Pap is being conducted, to prevent sample dilution. The physician should note how moist the patient is while performing an external exam prior to insertion of the speculum. While palpating the Bartholin's glands and evaluating the position of the cervix, a thoughtful examiner will bring some of the patient's natural lubrication out of the vagina onto the labia. If the patient has a large labia, the examiner must ensure the labia is carefully retracted and use extra care during insertion to avoid pinching.

Dr J58 makes a good point here about lubrication , and there are a few other things that come into play for both real life and play doctors out there.

As far as lubricant it's really a complaint on the part of the laboratory folks, basically a cover your butt tactic in that thier technicians may make an error. There have been a number of blind studies debunking this thought but it still remains out there. There is some truth - for instance in the thin prep use of lubricants with carbopol polymers may interfere. But even the thin prep manufacturer agrees that use of a quality lubricant will not interfere - surgilube, astroglide and I forgot the others they deem acceptable. I won't go into all the detail on slide vs liquid based paps but suffice it to say that a good gynecologist investigates what works best and acts accordingly. Also I mentioned this in another post - throw out those plastic garbage speculums, even well lubed they often cause painful insertion.

On speculum size , for point of discussion a graves model , a medium size should be right for just about any girl that is sexually active. Giving birth is not a requirement for a medium graves - using a small speculum and then twisting it around to find the cervix is going to be uncomfortable for your patient. Obviously there are instances outside of a virginal patient where a smaller speculum is required but realistically a medium is the best bet for the vast majority of patients. Patient position, depth of insertion and insertion technique round out the requirements for an exam that is not painful

Play doc advice in general - spend the extra couple bucks for gosh sakes on a good quality metal speculum and a large tube of surgilube if you really want your patient to schedule that next exam with you. Get her in the right position - butt off the edge of whatever you use for a table is a must so you have room to angle the speculum properly. Spends two extra minutes before you go at it - warm it up, lube it up, place a single finger in her vagina and press down slightly - these are the muscles she needs to relax for you - insert at an angle if you like turning horizontal as you insert - but don't stop half way as you will not find the cervix, hunting around for it is not going to be comfortable - as you fully insert you should gently apply pressure downwards - that is why the bottom of the handle is curved - it gives you a place to apply pressure - it was not designed this way without a reason - once fully inserted as you open the cervix will sort of pop into view between the blades and you should be able to lock into place with no discomfort. You should have a good idea of cervix position prior to insertion of the speculum so you know which angle the uterus is sitting and which speculum angle will be correct without adjusting -- there are a lot of videos posted out here so spend the time to watch ALL of them to pick up the best technique - the problem with training videos are that they were intended to go hand in hand with in person training - so not all details are covered.

Obvioudly I can't cover all this in a written suggestion and neither can a video or two - so go educate your self very well before performing your first, or next pelvic exam - you and your patient will both get a lot more enjoyment out of a well prepared technique

sarah

Very good advice from Sarah and I'll just add my own thoughts...

One of my first play patients was a real nurse and she gave me some advice and some hands on training of course...

Stirrups fit for purpose are not normally available at most play exam appointments. So put a pillow under the woman's bottom, this raises the hips, makes speculum insertion with the handles facing down easier, and the cervix is much easier to locate. If available, two chairs placed backs against the bed can have the same benefit. Insert the speculum fully before opening it. Unlock the speculum and pull gently out, best not to close the blades inside as that could well pinch the woman, the vagina should close the unlocked blades naturally anyway. Yes medium size is suitable for almost all women. Warming the metal speculum during a play exam? Possibly but in my experience women often prefer it cold and some particularly request that.

Dr Philip - The UK Play Doctor...

I had a g/f say the very worst part(she was very shy!) was when her lips were spread her clit popped out.And stayed out with her legs spread.

Another girl said it was the noise..(that wet.."squelchy" sound) that came from her vaginal area when her legs were spread and her lips spread apart too.

Another said it was being "double penetrated" at the same time.

For me it would have to be the part where they scrape my cervix it causes really bad cramps almost every time! just my 2 cents! -Linda

I don't know why but my least favourite part is getting in the stirrups. I always keep my knees closed until I get told to spread my legs and then I never spread then far enough the first time

I still really struggle with the speculum- last time I was so anxious I was on the verge of tears and the doc and nurse had to try to calm me down before she could open the speculum. She said I was so tense that she physically could not open the speculum. I have no idea what size it was, she kept it out of sight.

The pap smear i have always had bad cramps after

I'm never a fan of the scooting down. The paper inevitably crinkles loudly and I always feel like I'm going to fall off the table. I had a doc let me stand in front of the exam table first, then get on the table by just sitting down and then laying back. So much better.

I've had a few docs be very rough during the bimanual exam. Pressing down on my belly that hard or clumsily grasping at my cervix is pretty uncomfortable.

The worst part of the exam used to be when the physician opened the speculum. It was just an uncomfortable feeling. However, I had an IUD inserted (I've never had a child), and I will never complain about a standard exam again. I almost passed out because it hurt so bad. Now I'm not so bothered by the usual routine. It also helps that I changed providers, and this one is much more gentle than my last physician. I didn't realize how much of a difference a change in provider would make!

For my GF she said it is the rectal exam..

The worst part for me is when the doc cranks the metal speculum and it sounds like when a roller coaster is climbing a big hill and it jolts my spine with each crank. That's just painful.

It's annoying when after a gyno exam, I'm covered in lube and have only a box of thin tissues to use to wipe it off.

The rectal exam

For my gf, it is the total idea of lying naked, exposed and examined there between her legs is embarrasing. she is too shy to expose her intimate areas to someone else. except me and her mom.

Worst part is definitely pap smear. Luckily, in Canada, we don't have to have them done every year any more.

Worst part is definitely pap smear. Luckily, in Canada, we don't have to have them done every year any more.

You never HAD to have them every year, it was recommended.

In other words, humiliation?

Having to empty my bladder then wait nearly naked in a cold room and feeling like my bladder is filling up again before the doc arrives and my exam starts. I tend to bring my own nightgown and wear that while waiting so I can dash to the bathroom to pee if I need to without having to get dressed all over again.

Don't know that I could classify it as the worse part, but sometimes when the light is shining on one's intimate parts it can get overheated and start to feel very warm down there.

Moreso if the exam is prolonged it gets uncomfortable and I am wishing they would hurry up and turn the damn light off!

Oh, I hate that, too. The inner thighs and girly parts are too sensitive for that kind of heat. It doesn't happen often but once is more than enough.

Is the speculum worse for ladies who are petite vs. regular or thick stature ?

Jds4med- In Canada, paps were covered by our health care system on a yearly basis. That is no longer the case. In Canada, it's no longer recommended that paps are done on a yearly basis- with certain exceptions, of course.

My girlfriend hates the transabdominal ultrasound because it's done with her bladder full. She rathers a lor the transvaginal