No woman looks forward to going to the gynecologist. Gynecologists know this, so don’t think we’re offended when you’re grumpy and nervous. And that awkwardness you feel during your exam? It’s normal. (It’d be a little odd if you were comfortable having an examination!) Even though it may be the last thing in the world you want to do, seeing your gynecologist every year is important for your health. So let me try to deconstruct what happens a little bit to make your next visit a little easier.
Your Doctor’s Thoughts
As a gynecologist, my main focus during our time together is your overall health – issues we need to talk about, what screening you are due for, what you are at risk for. During your pelvic exam, I am examining you for infections, abnormal spots or “lesions”, and evidence of injury or problems.
You may wonder, “What is my doctor actually thinking during my exam?” Let me tell you what I do and don’t care about.
I am NOT thinking about your pubic hair. I also am NOT thinking about how you look, including the color of your skin, the size or shape of your labia, or the size of your vaginal opening. The only time I think about these things is if you tell me that they are a problem for you (like your vaginal opening is too small and is painful during sex or that you have problems when you shave or wax your hair), then we will talk about it. If you have piercings or tattoos that I can see during the pelvic exam, I might comment on how it must have hurt getting it done, but then I don’t think about it again.
I do think about things like how long it’s been since your last appointment, your birth control choices and plans, and your sexual history, but my thoughts are about how I can help you. I am not here to judge you and your choices, and I don’t care how you spend your time. I just want you to be safe and healthy, so that’s why I ask about personal things, like how many people you’ve slept with, if they’re men, women, or both, and what kind of protection you use. It doesn’t matter who you are, what you look like, or where you are from – I just want to know if you are at risk for disease or abuse, and I want you to know that I can help.
And when I’m not actively engaged in examining you or asking your questions, I’m probably thinking about picking my kids up from school or what we’re going to have for dinner – I’m not thinking about your vagina.
During the Exam
Okay, you made it through all of the personal, invasive questions and now you’re jumping all over the place every time the doctor touches you. How are you supposed to handle strangers touching you, not to mention look people in the eye afterward?
It doesn’t bother me at all when my patient is jumpy, but it does tell me that I need to talk her through the exam. People are nervous about the exam for different reasons – they might be worried about pain, they may feel embarrassed or, in some cases, the exam may prompt memories of past abuse. No matter why you are sensitive, I will be gentle and will say everything I’m going to do before I do it. I usually will ask before the exam about abuse, but if my patient is very sensitive, I will ask again to be sure.
Most gynecologists are super fast at pelvic exams, since we do them all day long. So once the doctor is done, you are in the clear to close your legs and climb back up the table. You may be uncomfortable and crampy after the exam, which can make cleaning up difficult. The doctor or nurse usually gives you tissues to wipe off the extra gel after you’re alone, so don’t hesitate to get into whatever weird position you need so you can feel clean again.
And don’t worry about feeling weird around the people who work at the office. Yes, they know what just happened in the exam room, but don’t let it make you feel embarrassed – remember: they’re at work. They care about you, but they have more things on their minds than your vagina.
‘Uh-oh’ Moments
Sometimes, despite your best efforts, something truly embarrassing happens. You get undressed and your feet absolutely reek. Your leg hair is in dreds. You fart in the doctor’s face during the exam. The list goes on and on. Here is what will happen if your worst nightmare comes true:
Life will go on!
My advice is to point it out, laugh about it with your doctor, and call it a bonding moment. These things happen. And yes, your doctor is going to remember it and will probably tell their family over dinner (protecting your privacy, of course). But so will you, right? And you should be proud: It takes a lot to surprise a gynecologist.
By Katie McHugh, MD
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