Afraid of Pelvic Exams

Suzzane, California

Dear Dr.Patti,

I am 24 years old and was molested and sexually assaulted by my older cousin when I was 11 & 12. I never told any doctor when I was under the financial assistance of my parents. Last year I moved back to the city and state I graduated from college and found a new doctor. During my first visit, my MD offered to have another female MD or nurse practitioner perform my first pelvic exam. After I thought about it for a while, I realized that I'd just rather have one person taking care of me all the time.

So in June 2015, I had my first pelvic exam ever. But when my MD clicked the speculum into place the pain was so severe that I called him a bastard and swore. Laying there brought me back to when my older cousin forced me to have intercourse for the first of several times. After it was over my MD came back into the room. I was a bit shaken but ok. I was fine then. But soon my life spiralled downwards, I began cutting again (after not having done so for 18 months), I was working 80 hour weeks, I went to visit my parent's house...and over the next 10 months, up until now... I've survived and gotten my life somewhat back on track. But the pelvic was the brink that pushed me to the edge last summer.

Last week when I saw my MD, I asked him if I could delay having the exam for maybe a year or two. But after carefully questioning me, he said no, we couldn't wait two years. My MD has never done or said anything that I would even question, and I trust him implicitly. He did sincerely state that he will do anything to make the exam more manageable this August.

But how do I get through the exam when every part of it reminds me of something my cousin did to me; whether it's vaginally penetrating me and staying inside of me and pressing his full weight on my body or how I had my first orgasm when my cousin digitally entering my body and masturbated me?

I've acknowledged and slowly have worked through the abuse in small steps over the past six years. I can't find the answer that I need for this august...and I've searched the internet, book stores, and Lexus Nexus/Info Track for information to my question:

How do survivors of sexual abuse manage to get through pelvic exams? Do you, or a knowledgeable resource of yours have any concrete ways that I can get through it and not have those memories invade my mind/memory? Is there anything that an MD can do to make the patient feel safe?

………..Suzzane

Dr. Patti responds: 

Dear Suzzane,
We talk about pelvic exams in the third edition of Invisible Girls - and about all the girls that were abused by Larry Nassar. We go into detail about the exam and what to expect. First of all, of course, I am so sorry about your sexual abuse. Most women prefer women to be their gy ns. I recommend that. Also, there are ways to get through it. Read "Invisible Girls" and perhaps get some therapy to begin to process your abuse in ways that you can get through it. Interview your doctor in her office before the exam. Look into her eyes. Tell her you have a history that prevents you from being relaxed during the exam. Have a loyal friend in the room with you holding your hand. Breath deeply, when the exam starts recite to yourself a poem you remember. It is very normal not to be alright with pelvic exams. Also, many survivors do not like the dentist and can not be put under because they are terrified that they will be out of control and hurt. As far as the cutting, if you had not cut for 18 months, you can stop cutting now. When you want to cut, put a rubber-band on your wrist and snap it, hold an ice cube until it melts, go for a run, call a friend. 18 months is a very long time; you can stop again. Also, you can ask the doctor to constantly ask you "Are you alright." You can have your friend or a gentle nurse hold your hand and let you squeeze their hand during the procedure. You can also tell yourself you are alright and this is not your cousin, almost a mantra when you need it. After you do get through the exam give yourself a treat, get a manicure, buy a new lotion, something to pamper yourself. Please read "Invisible Girls" and let me know if this helps. 

................................xoxo, Dr. Patti.