Gynecological Exams...

[Catlovers141]

I've been having a lot of difficulty with menstruation over the past few years (I'm 24), particularly including worsening cramps and mood issues that lead to suicidal thoughts almost monthly. I'd like to try birth control, but I'm worried because I've heard that doctors usually want you to have pelvic exams if you are on birth control. However, up to this point I have refused pelvic exams. They terrify me to the point where it is essentially impossible for me to cope with even the idea of them. I feel like I'm stuck between a rock and a hard place -- either do the exam (which I feel is impossible), or continue to live with these PMS symptoms.

I'm wondering if there is anyway around this? I'm thinking of a lot of different options but I'm not sure what is possible. Is there a way to get birth control without a pelvic exam? Are there any natural remedies that work? Anything that has worked for other people?

 

[Kintsugi]

You are not going to like my response.

I absolutely empathize with being terrified for pelvic exams. They terrify me, too, and I will do almost anything to avoid getting one.

On the other hand, it will be impossible to live your whole life without developing a relationship with a doctor and feeling you are able to get one. It's simply not practical to go on avoiding being examined forever.

I avoided seeing a doctor for two years (there is only one I trust), and I wound up in the ER this past August suffering from indescribable pain, where I was examined by a doctor and a nurse who were just... terrible, in spite of me disclosing immediately and up front that I was a survivor of multiple sexual traumas and had PTSD from those traumas. I wish now that I had had a doctor I could have seen instead, someone I had some kind of relationship with, instead of having no choice but to go to a hospital that day.

Are you seeing a therapist? Can you maybe work on strategizing how you might feel safe seeing a doctor over a period of time to where you would allow a pelvic exam?

I'm not going to say it's not terrifying, that it doesn't affect me terribly, that I do not dissociate every time I get one... those things all still happen. I just don't want to see someone else in the position I was in, where shit hit the fan and everything was essentially as bad as it could have possibly been.

Hugs if you accept them.

 

[Lucycat]

I am unclear what you mean by a pelvic exam. I take oral contraception for controlling my moods and keeping my hormones stable. My GP insists I have the 3 yearly smear test. That is all. That in itself is not pleasant, but not horrific either. I think the only way to find out what your doctor will insist on is to ask! - oh I also have to have my blood pressure checked every year - no problem!

 

[Broken Dahlia]

I have problems with both pelvic exams and extreme mood swings during my cycle. The pelvic exams I just had to deal with, crying, sweating and shaking, but I had some things that had to be tested to find out what was wrong. I also had a miscarriage and had to have multiple ultrasounds in addition to the exams. They suck, but it was necessary to get a diagnosis.
I found out that in addition to PTSD I have PCOS (polycystic ovary syndrome). The symptoms include depression and anxiety, plus a lot of physical symptoms like weight gain, extra hair, physical pain, etc. Most of the physical symptoms didn't start until my mid to late twenties, but I always had very heavy, painful, debilitating cycles from the age of 13. I also had severe mood swings that were attributed to being an adolescent. These are only starting to get better now that I am getting my hormones balanced with supplements and diet changes. I have noticed a huge difference when I eat sugar after cutting back on it; this was hard to admit because I used to own a bakery. I also started to take supplements specifically for PCOS that are helping tremendously. Birth control made me an absolute wreck, contemplating suicide after two months back on it.
Some of the natural remedies that you could research are progesterone cream, saw palmetto extract, milk thistle extract, chaste tree extract, GABA, L-theanine, plus extra B vitamins. These are things that have helped me, even before I had the PCOS diagnosis. It is a lot to keep up with, but I wish I had done this a long time ago; I thought a lot of things were just me or reactions from PTSD, when there was a physical reason as well. Hope this helps.

 

[twinkle30]

Hello
I have the same issue as you. I have PCOS and have to be on birth control. I have an issue where my muscles cramp up whenever they try to do an exam and does not allow the speculum in. So I worked with a physical therapist that my doctor recommended to not have that issue. I used medical vaginal dialators to help me make my muscles relax. You might look into that and try those for a few months before you go in for an exam. They really do help.
The good news is if you are not sexually active you get an exam every 5 years. If you are sexually active you get an exam every 3 years. It used to be yearly for everyone but that changed.
I hope this helps.

 

[Catlovers141]

@Simply Simon
I agree with you that avoiding it for the rest of my life will not be practical. I do have a therapist that I am working with, and I think that eventually I will be able to work myself up to having an exam, but I don't think I can do that right now. I'm not there yet. I had an external genital exam once and that was bad. I don't want to do that again, especially right now where I'm feeling forced. I want to be in a place where I feel like I am consenting to an exam, not that I am doing it because I feel so desperate. When I had the other exam, I only consented because I was experiencing symptoms I felt were intolerable and that was the only way the doctor would agree to treat me. But it was re-traumatizing and I wish I had not done it. The treatment didn't even work. I'd like a solution in the meantime for my PMS symptoms, at least something to try in the meantime while I work with my therapist.

 

[Catlovers141]

@twinkle86
I've heard of the vaginal dilators. I have not tried them. This is going to sound awkward, but I've tried to practice using tampons, to just get used to that kind of sensation, and working myself up to larger sizes. I think it was somewhat helpful, but I just don't feel ready yet.

 

[Catlovers141]

@Dahlia This is exactly what I don't want to put myself through. I really feel like if I absolutely had to have an exam, I'd have to do so under anesthesia. I'm not even kidding. And I don't think pushing myself to do something if it is going to give me a reaction like yours is going to help me in the long run. I think it will just reinforce some of the trauma symptoms.
I appreciate the other things you mentioned. I might look into them. It's worth at least researching.

 

[Mammo]

Hmmm...is mandating a pelvic exam a U.S. thing? I was never required to undergo any such thing in order to get the pill in the UK or Australia...just as well because I would have a very similar reaction (I cried getting a bikini wax and it wasn't the pain!)

 

[Catlovers141]

Just to clarify, since this post got moved because I didn't mention trauma -- I posted this in the sexual abuse section because this experience is difficult for me given that I am a sexual abuse survivor, and I was thinking that sexual abuse survivors might best be able to help me, and that it might be too triggering for the regular "discussion" section.

I figured the connection between sexual abuse and the exam would be obvious, but I guess not. Honestly, it adds to the sense of isolation that I'm feeling.

Hearing people talk about these exams like they are no big deal is upsetting. I'm grateful for all of the replies I get; I guess it just increases my own self-shaming, questioning myself about why I can't just tolerate it like other people do, when I know the answer to that question anyway. :/

 

[Catlovers141]

Hmmm...is mandating a pelvic exam a U.S. thing? I was never required to undergo any such thing in order to...

@Mammo, I think they used to be required here, but I've heard that they have since taken away that policy, thankfully. However, in my experience, doctors are very adamant about having it done anyway. A couple years ago I went to a primary care doctor for a check-up and almost the whole conversation was about how I should get a pelvic exam. This is before my current symptoms started so I didn't mention any problem in that area. I told her I really could not do it at that time because of PTSD, and the conversation just didn't stop. That's the only part of my body that I'm so sensitive about. We could have talked about anything else but the focus remained there.
I've heard that this is part of the American views of women's health and women's bodies, and that things are different in some other countries, but that's a different discussion altogether.

 

[twinkle30]

catlover you can have just a talking appointment with the gynecologist to see how she wants to help you get through this. That's what I did.
Don't feel isolated because I know exactly how you feel since I went through it myself.