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Going To The Gyno: An Introduction

I visited the gynecologist this morning, like I have done many times before, but for some reason on this visit I was reminded of my very first trip, and how far I’ve come since then in being able to achieve comfort in the gyn’s office ““ even with my feet held high and wide by a set of stirrups.

As I considered all the little tricks and tidbits I’ve picked up in the last decade plus, I thought about how it would have been nice to have known some of the info I have today when I went in for my very first pap.

So I decided to write a guide for first time pappers as well as for those who have had many annual lady business exams but who still find themselves uncomfortable, or even frightened.

I present to you, in no particular order, the best pieces of annual pap advice I have to offer:

1. Wear socks. This might not seem like such a big deal, but trust me, having your feet covered will actually make you feel less naked. When you’re already topless (except for a paper vest) and pantsless (except for a paper sheet) why leave your ashy heels exposed? Bare feet have a way of making people feel vulnerable. And if you’re prone to self-consciousness, having your un-pedicured toes mocking you from a pair of chilly, unyielding stirrups isn’t going to help. Besides, the stirrups are a combination of metal and smooth plastic and, yes, they are cold. Cover those tootsies.

2. You are not gross. During your first visit to the gyno your anxiety addled brain might try to tell you that there’s something weird or icky about your lady business, there isn’t. And even if there is something out of the ordinary going on with your lady business, like an infection or an unexpected discharge, your doctor has seen whatever it is before. And she’s seen worse. And she won’t react badly.

3. Your doc doesn’t care if you landscape, but if it’ll make you feel better, do it. Your crotch is of purely scientific and medical interest to your doctor, so please know that she won’t care whether you’ve been recently waxed or not. But if being buffed and trimmed up will make you feel more comfortable, it’s worth putting in some prep a few days before your appointment. Don’t, however, do your bikini area grooming on the day of your appointment, because a) if any irritation occurs you’ll be less comfortable than you would have been otherwise; and b) irritation could potentially be mistaken for a non-shaving/waxing related ailment.

4. Don’t be embarrassed to ask for a woman doctor. First of all, women still get short-changed in the medical profession, so there’s nothing wrong with instituting a little grassroots support for women MDs. And, second, you have every right to choose the doctor you want to see. Don’t let anyone tell you it’s juvenile to seek care from women gynecologists, or physicians in general, exclusively. Your comfort level is personal to you. Ask for what you need. That said, if you do see a male gynecologist, he, like the grooming-ambivalent doc in the previous paragraph, is interested in your genitalia for purely scientific and medical reasons.

5. Use the language that’s normal for you. You may have noticed that up until this paragraph, I had not used the word vagina. It’s not because I think vagina is a dirty word or because I’m in some way ashamed of my body or my reproductive bits, it’s because vagina is not the first word that comes to mind when I think about my, well, vagina. Whether it should or not, the word vagina sounds more detached or formal for me than say, lady business, does. And because “lady business” is the way I talk normally, it’s also the way I talk to my doctor. Once I start concentrating on whether the terms I’m using are the most correct, mature, accurate, appropriate, etc. my focus begins to shift away from asking the questions I need to ask and conveying the information my doc needs. So I choose to unselfconsciously talk like myself when at the gyno. And, basically, at all other times.

6. Find something to talk about during your introduction to the speculum. Now, I’m not suggesting you converse with the actual instrument the gynecologist will inert into your vajay in order to facilitate a physical exam and pap smear (there’s no point in attempting small talk with a speculum, they’re all business), what I am suggesting is that you make small talk with your doctor. Many doctors ask questions unrelated to your exam as a way to help you feel comfortable. But if you don’t have a doctor with this particular bedside manner, there’s nothing to prevent you from having a few friendly and benign questions to ask if and when you’re uncomfortable. “It looks like it’s going to be sunny, I hope you have fun plans for the weekend,” and, “I really like that “˜Hang In There’ kitten poster you’ve got on the ceiling, do you consider yourself a “˜cat person’?” are the type of niceties that can help make your appointment easier on you.

7. Tell your gynecologist the truth. Your doctor is interested in your health and well-being. She’s not interested in whether you’re what mean folk would call a tramp. So when you’re filling out medical forms, don’t feel the need to downplay the number of sexual partners you’ve had or say you’re in a committed relationship if you’re not. Your doctor is probably also not interested in how smart you are, so don’t pretend to know stuff that you don’t. I used to tell my doc that I did regular breast exams, even though I didn’t, because I had absolutely no idea what I was looking for. One day, I said to my doc, “Um, I don’t actually do self breast exams, because I don’t really know what I’m poking around for.” And, wouldn’t you know, she did not mock me. And she showed me how to do a proper breast exam (FYI, I had been doing it wrong, very wrong, what I was going was more like a really poorly executed self breast massage, maybe useful in soft core porn, but not useful at all in detecting unusual lumps). So, please, provide honest and accurate information. Your doctor will rely heavily on what you tell her when making recommendations and even diagnoses. [I feel like this one deserves the NBC “The More You Know” jingle.]

8. Relax. Shit, you’re not the first person who’s ever been to the gyno. Whenever I’m in a potentially awkward or scary situation, I like to, more or less tritely, ask myself, “What’s the worst that can happen here?” The overwhelming majority of the time, even the worst case scenario is not that big of a deal. If you’re not actually worried that there might be a serious medical condition that needs to be addressed at your annual women’s exam but are mostly just worried about embarrassment, it’s important to acknowledge that.  What’s the worst that can happen in that scenario? The doctor may ask you some questions you find uncomfortable; you may experience a bit of physical discomfort, though not likely any pain; and you’ll have to undress. All of this will last no more than an hour. That’s the worst. And if an awkward hour is the worst thing that happens to you this year, you’re doing a lot better than fine. The best case scenario is that your doctor will be easy to talk with, making any Q&A time feel natural and purposeful; you’ll have thought of a great ice breaker for speculum time so that you don’t even notice the discomfort; and your doctor’s office may actually have cloth robes instead of paper, which will make disrobing far less unpleasant. On the other hand, if you are worried about a health complication, it’s important to put that into perspective too. Knowing what is wrong is always better than not knowing what is wrong. Once you know what you’re dealing with, you can put a plan in place, and your doctor will have information you need in order to do that. Besides, a burden is better when shared with someone who cares about you, and in a best case scenario, the people who care about you and your future will include your doctor, who chose a helping profession for a reason. Oh, and me too, I care about you. I realize I don’t know you, but you’re a people, and I like people. And our both having vaginas binds us (I said vagina).

By the way, if my count is correct, though I said vagina a number of times, I managed to say smear only one time in this post (although the mention in this sentence makes two). I was aiming for no smears (that makes three), but I guess that leaves room for improvement for next time.

DISCLAIMER: The author of this post is a lawyer, not a doctor. Which means that everything stated above could be entirely wrong. Although, it seems unlike that this mostly common sense info is entirely wrong, even if it’s partly wrong. Also, because the author is a lawyer, there are more than a few doctors who don’t like her, but she actually likes most doctors she meets and has a great deal of respect for their difficult profession. Oh, and this author has never been a medical malpractice attorney, so doctors really have nothing to fear from her personally anyway. BUT she is not in favor of “tort reform” ““ though that is another post altogether. Talking in the third person has grown tiresome. The author of this post will now cease. Happy papping.

 

14 replies on “Going To The Gyno: An Introduction”

No one teaches us how to go through gyno visits. In my first, the doctor ( a woman) announce that her assistant was male and asked if I had a problem with that (in those words). I said yeah, and she proceeded to roll her eyes, sigh and make a big show of finding a female nurse to assist.

After that experience, I kinda became difficult about my paps, laying out what I expect before de-pantsing (don’t roll your eyes if I’m uncomfortable, don’t just jam the speculum up there because that hurts). My current gyno seems to appreciate my forthrightness, but the last pap doc certainly didn’t. I don’t give a crap if it makes my b*tchy – this is my vagina we’re talking about.

Absolutely. I talk a lot of crap, but in real life, I’m very much a don’t-rcok-the-boat kind of person.

Until it comes to the doctor. I realize I’m dealing with a person who (ostensibly) knows what they’re doing, but it’s MY body and damn if I don’t have ultimate veto power.

This guide is incredibly helpful. But I have another question. How do you even find a doctor in the first place? And know that they are decent? I have never been, but have been aware that I need to go for several years now. Part of my problem is that I don’t even have a primary care physician. Or know how to go about finding one.

I think I am probably more nervous than most people about going to the lady business doctor, which makes it harder to even begin to search for one. I am new to the area, so I don’t even have anyone I can ask.

If you have the money to subscribe, Angie’s List is a good resource. Otherwise, it’s kind of a guessing game. Personally, I prefer to go to a primary care doc at a teaching hospital (I go to an office affiliate with UPenn) -it takes a bit longer, but I also get a resident and a supervisory doctor talking to me about every aspect of my problem.

I’ve always “found” doctors through my insurance, which is an HMO & conveniently packs all its doctors into large rectangular buildings for easy access (in theory at least). But from what I’ve seen the AMA (American Medical Association) and WebMD both have doctor search functions (I’m assuming you’re in the USA here, if not my reply may be totally unhelpful, sorry). Planned Parenthood is a good option if you have no/inadequate insurance, or there’s a chance they may be able to refer you to local doctors. Also rating sites may give a better sense of who’s good and I think you can get some sense of how patients are treated by office staff over the phone (is it easy to get questions answered, schedule an appointment, etc.). If it’s feasible try scheduling an introductory visit first where there’s no exam, you just meet and talk with the doctor.

Sorry to hear that you’re very nervous about visiting a gyn. I was extremely stressed about the idea of a pelvic exam before my first visit & since I wasn’t sexually active I put it off for a long time. When I did finally visit a gynecologist it was totally anticlimactic – not at all traumatic, only uncomfortable in the mildest sense of the word, and not actually embarrassing either. Hope that’s reassuring to some degree.

I’m the rare exception who doesn’t care about wearing socks to the gyn, but I also don’t get chilled easily. And like paperispatient I prefer to have the doctor narrate what they’re doing – I can see how some people would prefer distraction or small talk, I just prefer to be told exactly what’s going on, not just on my first visit but on subsequent visits too. So the only advice I can offer there is go with the conversation that seems best to you & a good gyn should be personable regardless. Also if I have questions I go in with them written down and a pad & paper to take answers, because I know I’ll be too nervy to remember all the questions or the responses if I don’t have it written (actually I do this with pretty much any doctor appointment).

wonderful suggestions! and here’s 2 more:
1. they have a “baby speculum” that is smaller than the usual one. you can ask for it. my first experience at the gyn was painful – i’m a petite person, and i was a virgin at the time. my friend said to ask for the baby spec next time, and it was a lot easier. (after having sex, and especially after having babies delivered vaginally, i didn’t need the baby spec.)
2. use a panty-liner after the visit. goopy stuff is used during the exam, and it drips out later.

i wish i’d seen this article before my first visit! i actually cried then, and couldn’t do it. i was young and scared. but i was lucky to have a nice doctor who hugged me and told me to come back later if i wasn’t ready.

This might sound weird, but I always use my vaginal muscles to squeeze out the lubricating jelly into a tissue while I’m getting dressed once the doctor has left. I don’t like that drippy-after-the-fact feeling, and I can usually get it all out easily so that I don’t have to contend with it later. :)

Great article.
Also, minor cultural differences ahoy! I have never been asked to put on a paper gown at a gynae exam, ever, and similarly blankets, not paper drapes, are used to keep my lower half warm. Also have never had to put my feet in stirrups – just flat on the examining table.
I wonder if this helps with it feeling less clinical – along with not having to do annual exams.

Also I always keep my socks on:)

The last time I had a lady parts exam, it was a surprise. I was all ready for a pants-on BC consultation, when I heard “oops! It looks like you’re due for an annual!” and it turned into a pants-off exam. And thus my nerves went all wobbly with the unexpected.

So what did I do? (There is advice in here, I promise.)
First, I inadvertently made the nurse laugh by asking if I could keep on my boots. It’s that idea of keeping on your socks, only more so. I ended up not doing it (her laughing made me feel a little silly) but somehow knowing that I could keep them on made me feel better, and making the choice not to when I could made me feel braver.

Second (here’s the advice bit) I turned asap to an activity I had in my bag. I had a bunch of notes to write to people, and I started getting through as many as I could. Focusing on a completely unrelated activity while sitting there under my paper drape kept me from having the chance to get anxious, which turned out to be Massively helpful.

So my advice at the end of this story: bring something distracting along so that you don’t have to sit there getting nervous. Heck, if you don’t think you’ll get nervous, bring something along so you don’t get bored! Those waits can be long and chilly.

This reader thought this was an excellent article, and truly enjoyed the author’s writing style…even though she is a lawyer, not a doctor ;). This reader also heartily chuckled at “I realize I don’t know you, but you’re a people, and I like people. And our both having vaginas binds us (I said vagina).” That being said… I used to worry about the landscaping before gyno visits, but then I found out that my mother was taking my 80 year old grandmother (who had senile dementia and wasn’t to consistent with bathing let alone grooming) to the same gyno I was seeing, I thought to myself “there is no way my Cooch could look worse than Gandma’s” and stopped worrying about it.
SOOOOOOOO right about the socks, too!

This is great advice! I’d also add – if you’re nervous (and especially if it’s your first time), remind the doctor that it’s your first time and tell them that you’re nervous. I was horrified before my first gyno exam and pap test because I hadn’t had sex yet and thought it would be the most awkward thing in the world. Now, I prefer it to going to the dentist and it feels very routine to me, but during that first checkup especially I really appreciated how my doctor told me everything she was doing as she did it so I wouldn’t be surprised by fingers inside me, her opening the speculum, etc. I think that can help it seem less scary or less of a mystery if you’re kept informed the whole time about what’s going on.

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