One of the most feared parts of the GYN visit is the speculum exam. A speculum is a device that is inserted into the vagina and then opened to allow for visualization of the upper vagina or cervix. One of its most unnerving features, is the ominous series of clicks that can be heard as the speculum opens. Since speculum exams are crucial for Pap smear collection and the execution of many GYN procedures, I’ve listed some tips for patients to increase the likelihood of speculum exam success.
1. Ask questions. Ask about why the exam is necessary, and what evaluation or treatment is occurring. Understanding the indication can serve as a motivator to see it through.
2. Breathe. Focused breathing has been proven to decrease anxiety prior to procedures. Breathing in through your nose and out through your mouth in a timed rhythm gives your brain something to think about other than your impending exam. Try inhaling completely, holding in for a full “1-2-3”, then exhaling completely, and holding out for a full “1-2-3”. Repeat.
3. Relax. Squeezing your pelvic floor actually makes the exam more difficult by increasing resistance and heightening your sensitivity to touch. When you relax your muscles, the exam is less uncomfortable, and can even be performed quicker.
4. Communicate. Let your provider know if an area is more sensitive, tender, or injured. Also let them know if you’ve had any history of assault or abuse that may make a speculum exam triggering for you. Often times, speculum exams can be delayed or performed in a stepwise fashion to minimize triggering or pain.
5. Speak up. The authority that you have over your body is to be honored in and outside of medical examination rooms. If any point the exam becomes too much to tolerate, say STOP. Yes, that may limit the evaluation, but, as a provider, I would rather limit my exam than violate any of your personal boundaries or make you feel unsafe.
6. Be Proud. Acknowledge the steps that you are taking to prioritize your health. Whether it’s cervical cancer screening, STI testing, or contraception placement, you are taking time to take care of yourself, and that should be praised.
