6 Ways to Tackle the Gynecologist when You Have Vaginismus

The gynecologist’s office – for those of use with vaginismus, this can be a place often associated with fear, pain, and dread. We’ve all heard the horror stories, and for some, we’ve even experienced it. Between the infamous stirrups, the crisp paper gown, and the ominous cold metal speculum, it seems more like a scene from a horror movie than a routine doctor’s visit. But despite the image of fear we’ve constructed in our mind, it doesn’t have to be this way.

Pap smears and well-women’s exams are essential components of comprehensive women’s health. I understand the apprehension; I used to dread and avoid these appointments. Unfortunately, a history of menstrual challenges led me to the stirrups starting at 13 and my mom used to take me to get ice cream afterwards to try to console the tears and pain. However, as someone who has fully healed from vaginismus, I can attest that these experiences can become tolerable with the right approach (I doubt any women would call them enjoyable).

The best way to make well-women’s exams more tolerable is to heal from vaginismus. Being able to trust your pelvic floor muscles to not panic and freak out will ultimately make the biggest difference. This takes a level of pelvic floor control as well as some good nervous system regulation. But no matter where you’re at in your vaginismus journey, creating a psychologically safe environment is going to greatly improve your experience.

Here are some creative suggestions to make the gynecology experience more manageable:

1. Seek Out a Trauma-Informed Gynecologist: The nature of gynecological exams can be inherently anxiety-inducing and it’s surprising that trauma-informed care isn’t the norm in this field. However, finding a provider with this approach can make a world of difference. A trauma-informed gynecologist is more likely to go slowly, be understanding, genuinely listen to your concerns, and offer compassionate care. A quick Google search can help you identify such professionals in your area.
2. Wear a dress: Wearing a dress can potentially help you avoid the the sterile, awkward, crunchy drape/gown they give you. Ideally, you’d only need to remove your underwear for the exam. Sometimes a provider wants to do a breast exam, its possible to lift up the dress and bra to allow for this as well. Not only does this offer a more comfortable alternative, but it also allows you to maintain a sense of familiarity and control. If your doctor questions the choice, a simple statement like, “I would feel more comfortable and relaxed in my dress,” should offer enough of an explanation.
3. Ask the doctor to communicate: This also should be a no-brainer, but many providers and medical professionals kind of check-out when their just doing their thing. They fail to communicate what they’re doing, when you’re going to touch you, and what you might feel. Start the appointment out with expressing your desire for your doctor to go slow and communicate everything their doing so you can feel aware and in control.
4. Request a pediatric speculum: Insist on your provider using a pediatric speculum and, if comfortable, ask if you can insert it yourself. This will help you maintain a level of control throughout the exam, which can be reassuring and give us a sense of safety. Express your preference for a slower pace and the importance of doing things at your own comfort level to ensure a successful examination. This proactive approach can significantly reduce anxiety and create a more empowering experience.
5. Ask for the speculum to be warmed up: Cold shocks the system (especially in your intimate areas) and can create an even more exaggerated bracing/clenching experience. It’s perfectly reasonable for you to request your provider to warm the speculum. Even running it under warm water can be enough. Ideally the lube would be warmed as well!
6. Come in regulated: If you’re like I was, you might spend the day building yourself up in anxious anticipation for the appointment. Try scheduling your appointment first thing in the morning to minimize the build-up. Then spend the morning regulating your nervous system to make sure you’re in as much of a parasympathetic calm state as possible. Invite your partner or a trusted friend along to be with you to help, if this helps you remain more relaxed.

I know for some of you, you’re thinking you could never ask all of these things of your doctor. But I promise, you’re not being a burden, you’re not being over-bearing, and you’re not being annoying… you’re prioritizing your healthcare needs and advocating for yourself. And this matters a lot.

The trajectory of your vaginismus journey can be shaped by how a gynecological exam goes. If you don’t feel safe or comfortable or if the pain is too much, you have every right to stop the exam. Your health and recovery matter more. Request to come back when you’ve made greater progress in your vaginismus recovery. Don’t sacrifice your recovery by pushing through a gynecological exam.

I’ll say it again, don’t sacrifice your recovery by pushing through a gynecological exam.

Remember, you’ve got this! Trying these steps requires bravery, and even if your appointment doesn’t go exactly as planned, celebrate the fact that you took a step toward prioritizing your health, because really, this is the hardest part!

I have an entire training series in my Mind-Body-Sex Reset Vaginismus program on how to confidently tackle the gynecologist and so many of my clients have had positive experiences! Your health matters! If this is a struggle for you, consider Scheduling a free 30 min consultation with me to see if this program is a good fit for you!