Gynecologist

[PandaValentine]

What exactly happens during one of this lower exams? Do they touch you? Do they just look? Are there tools involved? If it's a male doctor does a female doctor/nurse HAVE to be in the room with you?

I'm terrified about mine enough as it is. I can get through it if it's a guy (I've posted on here before about having issues with female doctors) but the last thing I want is an effing audience you know? My mum said when I was born they had a bunch of students 'observing' the process of a c-section. Obviously that doesn't happen during one of these exams, but one person is my limit! I'll most likely only getting one of these which most surgeons make you get before a hysterectomy which hopefully I will get, until then my actual appointment with a gynecologist (who's trans friendly) will only be preforming an non-invasive exam (ultrasound) and basing my needs for surgery on my pain issues, the complaints with my doctors, the fact I can't work or stand for longer than an hour and can hardly exercise.

But anyways I'm just curious as to what they do during these exams. Thinking about it makes me queazy, but I find as long as I am not shocked by what happens I have a better time getting through the situation.

[LordKAT]

Ultrasounds are not necessarily noninvasive.

[PandaValentine]

I've had the pelvic ultrasound, compared to taking my pants and underwear fully off, it's non-invasive.

[Nygeel]

I will say that my first visit to a gyno I was unprepared. Nobody told me what they did and at this time I had never been penetrated (I was 16, never even tried tampons or anything). It was a male doctor and I think that a nurse was in the room too. He put a speculum in the front hole, pushed it open and took a tissue sample to check for stuff like HPV or cervical cancer. If there's something weird going on they might look around a bit more.

When I switched over to planned parenthood I was a bit more calm. I ended up noticing a growth next to my dick/clit and went in to get it checked out. The woman doing my exam explained what was going to happen and that if at any point I feel uncomfortable and want it to stop I could just speak up and it would be stopped. She probably moved some of the skin to see the growth a bit better and determined that it was a cyst and wouldn't be an issue.

[Noah G.]

Whenever I've had a pelvic exam it's gone a lot like this:

How Is a Pelvic Exam Performed?

During a typical pelvic exam, your doctor or nurse will:

Ask you to take off your clothes in private (You will be given a gown or other covering.)

Talk to you about any health concerns

Ask you to lie on your back and relax

Press down on areas of the lower stomach to feel the organs from the outside

Help you get in position for the speculum exam (You may be asked to slide down to the end of the table.)

Ask you to bend your knees and to place your feet in holders called stirrups

Perform the speculum exam. During the exam, a device called a speculum will be inserted into the vagina. The speculum is opened to widen the vagina so that the vagina and cervix can be seen.

Perform a Pap smear. Your doctor will use a plastic spatula and small brush to take a sample of cells from the cervix (A sample of fluid also may be taken from the vagina to test for infection.)

Remove the speculum.

Perform a bimanual exam. Your doctor will place two fingers inside the vagina and uses the other hand to gently press down on the area he or she is feeling. Your doctor is noting if the organs have changed in size or shape.

Sometimes a rectal exam is performed. Your doctor inserts a gloved finger into the rectum to detect any tumors or other abnormalities.

Talk to you about the exam (You may be asked to return to get test results.)

Source: http://www.medicinenet.com/pelvic_exam/page2.htm

Minus the rectal exam, but I figured if some do it then I'd include it as a "just in case" since you want to be as prepared as possible. There could also be an external exam. If you're apprehensive or anything don't be afraid to talk to your doctor about what will be happening before it happens. Most doctors won't mind, at the least, and will be happy to put you at ease.

I just did some looking around, and I don't know how reliable this information is, but...it would seem that a male gyno/obgyn is required legally to have an assistant present but apparently there's nothing about whether that assistant is required to be male or female. Again, this could be wrong. Maybe you could contact your doctor/office before the exam and see if you can find out if it's possible to have a male assistant? I don't know if it would help to disclose your anxiety, but who knows, they might more readily oblige your request if they understand its source.

You could ask then as well what would be involved in the exam if that's easier than asking in the exam room.

[PandaValentine]

Hmm, you know I thought I would be freaked about the exam....and I was completely right, apparently learning about this one just caused me more anxiety. I guess I had this warped idea that some dude looked at your crotch gave it a poke or two and all was done, but... this is just way scary.

Okay here's another question. Does it hurt? My sister had this 'cervical cancer scare' and I remember she had given birth a few months prior so it's not like she was a virgin, so why did it hurt for her? I'm thinking, maybe it was just because she had stitches down there, but now I'm wondering, do these exams actually hurt? Does inserting the speculum hurt? Now I am a virgin, but I have experimented with that part (but I get no actual pleasure from it) so it's not like it's never been 'opened' but it's not like I use it...ever since then, meaning nothings stretched. So it's not like Paris Hilton's, you can't just walk right in you know?

Also do they like lubricate it or something? Since being on T I don't have much of that -natural- lubrication going on down there...you know? Wow this is way to much information, but I don't know, I guess I'm curious beyond my own comfort zone. 

[Adio]

Okay here's another question. Does it hurt?

It's more like an uncomfortable pressure.

Also do they like lubricate it or something?

Yes, liberally.  This is a bit TMI, but the gel used to lubricate the instruments, gloved finger(s), etc can be very difficult to wipe/wash off afterward.  So, yes, the doctor uses a lot of lubricant.

[Noah G.]

So it's not like Paris Hilton's, you can't just walk right in you know?

First off: that part right there was awesome, haha.

As to the "does it hurt?" question: it's not supposed to and it shouldn't. Uncomfortable, yea, but there shouldn't be any genuine pain. Of course, if you can't manage to relax either it can increase the chances of things being more uncomfortable or worse. Unfortunately.

Adio addressed the question about lubrication better than I could.

The exam is, obviously, not fun. It's not going to be unnoticed, either.

Once again, see if maybe talking all of this through with the doctor helps you out. Maybe they can answer your questions and put you at ease about the whole process more than we might be able to here. Maybe talking to the doctor about your concerns and hearing from him exactly what will be taking place is the best route for you to go if this is just freaking you out more?

[FinnBear]

For me it was painful. I mean not like bawling my eyes out but they did water a little. Not the exam so much but when they have to do a pap smear; if they are going to do one; it feel really weird and hurts kind of like... a bad cramp and a scratch at the same time.

[insideontheoutside]

If you're not having sex or some really wacky menstrual problems then you shouldn't even have to go in.

[FinnBear]

If you're not having sex or some really wacky menstrual problems then you shouldn't even have to go in.

Not true. Starting from the age of 18 you should really have regular exams. A common myth is that you don't need them unless sexually active. Pap smears allow doctors to read the cells from that area and help detect certian kinds of cancer. Even having never had sex or having never inserted anything before you can return an abnormal pap. You wouldn't ignore any other sort of exam and you shouldn't ignore this no matter how embarrassing/uncomfortable/dysphoric.

[PandaValentine]

Not true. Starting from the age of 18 you should really have regular exams. A common myth is that you don't need them unless sexually active. Pap smears allow doctors to read the cells from that area and help detect certian kinds of cancer. Even having never had sex or having never inserted anything before you can return an abnormal pap. You wouldn't ignore any other sort of exam and you shouldn't ignore this no matter how embarrassing/uncomfortable/dysphoric.

Couldn't agree more. Though I probably would never even think of doing it if I wasn't attempting to get a hysterectomy.

[kyril]

The Pap smear is quite painful. The rest is just uncomfortable.

[Cindy]

Cervical cancer is one of the most easily and successfully  treated cancers.  If you were born with female parts get examined until after you have a hysto, also of course do breast examinations.  It is never worthwhile to die from embarrassment. BTW this equally applies for people born with male parts, get checked for testicular and prostate cancer.  There are very good therapies available but they work best if the cancer is detected early. NO doctor should embarrass you deliberately, if they do report them. No ifs or buts.

Cindy

[FinnBear]

Sorry if I sounded preachy. I work in a medical field and am constantly seeing people get hurt or die because they ignored something routine out of ignorance or embarrassment. I couldn't, in good concious, let that go without pointing out the facts. I'm glad you agree JayValentine. I dodge and dread mine as well but you gotta do what you gotta do. I had to have a lower exam before I started T. Is that the norm?

[Bahzi]

I had to have a lower exam before I started T. Is that the norm?

I have no idea, but my GP who prescribed me T did ask when my last pap smear was, to make sure it had been under a year, so maybe that is routine.  I only had the one done last year because I was having issues, and it was my first and last, except as necessary to get a hysterectomy, and even then, I'm going to need Zanax to get through it.

I started the series of HPV shots recently, since almost all cervical cancer is caused by HPV.  That's my preventative measure, not that it'll matter for much longer, as I intend to get the hysterectomy done in the next year or so.

[insideontheoutside]

Not true. Starting from the age of 18 you should really have regular exams. A common myth is that you don't need them unless sexually active. Pap smears allow doctors to read the cells from that area and help detect certian kinds of cancer. Even having never had sex or having never inserted anything before you can return an abnormal pap. You wouldn't ignore any other sort of exam and you shouldn't ignore this no matter how embarrassing/uncomfortable/dysphoric.

Hell I ignore all sorts of exams. I've been to that type of doctor once in my life ... I think when I was about 24 or so ... and that was 14 years ago (I should also note that my own mother hasn't had that type of exam in over 30 years - she's 70 at the moment). I've been to a number of MD's over the years and they all have something a little different to say when it comes to those types of yearly exams. Some are really pushing for them, some arn't. They all ask, "Are you sexually active? ... Do you have any odd symptoms? ...Is there a family history of reproductive cancers?" The last doctor I saw a little over a year ago said she could do an exam but that if I hadn't had sex of any sort in years and have had the same "symptoms" all my life then odds are I'm ok. Perhaps I'll go in just for the hell of it ... besides it might be good for a few laughs in making medical people feel uber awkward having to deal with a "female" who has a dick.

The reality is that science has isolated a number of things that cause abnormal cervical cells (that is the only thing the "pap smear" is testing for - the overall pelvic exam is a visual and palpitation test checking for abnormalities such as lumps, etc.) - infection or inflammation, viruses (there are over 40 varieties of the HPV virus, all of which have been tracked down to being sexually transmitted), even if you've had sex close to the date of your exam or used any kind of douche or anything can cause abnormal results (which is why they tell you not to do those things before the exam). Having a family history of reproductive cancers is certainly a risk factor as well. If you've got abnormal pain, bleeding or other symptoms it's certainly a good idea to go in for an exam. If you're young, do not have sex and do not have any unusual symptoms I personally think going every year is overkill and there are MDs who say the same thing.   

Everyone else can do whatever they want, and I certainly don't need a lecture on this topic, I'm just saying that even within the medical profession there are some doubters to the "must-have-exam-every-year" mindset.

[Adio]

Pap Smear Guidelines from the CDC:

You should start getting regular Pap tests at age 21, or within three years of the first time you have sex—whichever happens first. The Pap test, which screens for cervical cancer, is one of the most reliable and effective cancer screening tests available.

The only cancer for which the Pap test screens is cervical cancer. It does not screen for ovarian, uterine, vaginal, or vulvar cancers. So even if you have a Pap test regularly, if you notice any signs or symptoms that are unusual for you, see a doctor to find out why you're having them.

In addition to the Pap test—the main test for cervical cancer—the HPV test may also be used to screen women aged 30 years and older, or women of any age who have unclear Pap test results.

If you are 30 years old or older and your screening tests are normal, your chance of getting cervical cancer in the next few years is very low. For that reason, your doctor may tell you that you will not need another screening test for up to three years. But you should still go to the doctor regularly for a check-up that may include a pelvic exam.

It is important for you to continue getting a Pap test regularly—even if you think you are too old to have a child, or are not having sex anymore. If you are older than 65 and have had normal Pap test results for several years, or if you have had your cervix removed (during an operation called a hysterectomy), your doctor may tell you it is okay to stop getting regular Pap tests.

[Jigsaw]

My personal experience is.... YES they hurt.   One of my docs in the past has helped me somewhat though.  I don't know why or anything, but I have a lot of pain if a person does a regular pap on me.  When they use the speculum, they use what is considered "infant" size.  If you think it will be painful, ask them to consider using that size.  It still hurts me, but not to the point I am full out crying and about to kill people.   If that hurt too much, I have had doctors just do a swab sample, but the results are normally not as good.  So they can still do what they need to do most of the time and keep you from being in pain.

[Alex37]

my experience is that the pap smear hurts, particularly when they pull the speculum out- it's kind of a pinching feeling.  but the rest is just unpleasant.  i know it's a mind ->-bleeped-<-, but the more you relax, the less it seems to hurt.  good luck