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15 Tips For Acing Your Next Gyno Exam, From Someone Who Teaches Doctors How To Do Them

You don't need a white coat to be the boss of your own vagina.

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So, you’re going to the gynecologist!

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And, if you're like most people, you’re probably not looking forward to it. You might even be freaking out a little. Or a lot! But remember: This is your exam, and you get to feel good about it. And I'm going to give you some tips for how to do that.

I'm a gynecological teaching associate (GTA), which means I use my own body to teach nursing, medical, and physician assistant students to perform safe, comfortable, and empowering gynecological exams. In each session I teach a few students how to do the techniques, what they're looking for, and how to communicate sensitively with their patients. I'm not a doctor or nurse, but I'm highly trained in these exams and probably the only patient these students will ever have who can say, "That wasn't my ovary, but here's what you can do to find it."

What I do as a GTA is all about laypeople taking control of their own bodies and health, and you definitely don't have to be willing to take your pants off at work to start doing that. Here are some ways you can take charge of your own healthcare and feel more comfortable at your next gynecological exam — and who knows, maybe your doctor will even learn something!

1. Use a mirror to follow along and learn what’s normal for you.

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Some providers automatically offer a mirror, but if yours doesn't you can bring your own. Many people find this makes them feel safer and more in control. It means no surprises, and it definitely helps cut down on that startled jerk when your provider makes contact with your vulva and you weren't expecting it. Vulvas come in a wide range, and healthy and normal look different for everyone. This is a great way to find out what they mean for you.

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2. Doing pelvic muscle exercises beforehand can help make the exam more comfortable.

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The most effective ways to prepare your muscles down under for this exam are Kegel maneuvers (squeeze and pull up and in like you're stopping the flow of urine) and Valsalva maneuvers (bear down like you're making a bowel movement).

Kegels tone the muscles of your pelvic floor, which your provider will be checking, to better support your internal organs and increase sexual pleasure. Any time you contract muscles you also want to extend them, so make sure you add some deep squats to your routine to keep your pelvis balanced (think going to the bathroom outside). Valsalvas are very useful during the exam: Any time you feel tense, or your provider is about to place something in your vagina, bear down. It softens all your muscles and opens the entrance to your vagina, which will make things much more comfortable for you.

3. Skip sex the day before your exam.

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You'll get the best, most accurate exam if you don't insert anything into your vagina (or have vaginal intercourse) the day before your exam. You should also make sure to schedule it on a day when you don't have your period, which can interfere with some lab results.

4. Make sure your provider took the time to size your speculum.

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Both metal and plastic speculums come in different sizes. It's easy for a provider to figure out the right size by placing one or two fingers in your vagina to check muscle tone and the depth of your cervix, but many providers skip this step and just use a medium. That's fine for many people, but if you have a shallow vagina (meaning your cervix is low and close to the vaginal opening) this will probably be really uncomfortable. Sizing also allows them to check the location and direction of your cervix, which will tell them where to point the speculum and make insertion much smoother.

5. Ask for posterior pressure before they open the speculum.

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All the stretch in your vagina comes from the bottom wall, or perineum. Ask your provider to apply plenty of posterior pressure to the speculum before opening it; if they pull down enough that they can see space in your vagina above it, you should barely even feel it when they open the bills. If they don't make that space, the bills push directly into your urethra and the roots of your clitoris — so obviously it's going to be uncomfortable!

6. If you want, you can even ask to insert the speculum yourself.

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You just hold the bills closed, turn it upside down so the handle is pointing at the ceiling, and go for it. Different speculums work slightly differently, so your provider can talk you through opening it, or you can check out this self-exam guide. It's actually often easier to get a good view of your cervix when inserting upside down like this, and if it makes you feel safer or more in control, go for it!

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7. Find an exam provider you trust.

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Don't just think OB-GYNs; nurse practitioners are often a great option, and if you love your primary care provider you can ask them if they'll perform your exam (all doctors are trained to provide a gynecological check-up).

Ask family or friends for personal recommendations, and if there's something specific that matters to you (like LGBT sensitivity or kink awareness), try searching ZocDoc to find a provider who specifically mentions it in their profile. Don't be afraid to shop around and ask plenty of questions. If you see someone and don't feel great about them, switch!

8. Make sure you communicate openly with your provider.

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The more you're able to tell your provider about your health history, prior experiences, and needs in general, the better your experience will be. Some providers are good at asking open questions to elicit that information, but regardless it's great to volunteer information that is important to you when you feel safe doing so.

Your sex life is an important part of your reproductive health, and the more freely you communicate with your provider about it, the more they can support you.

9. Ask your provider to use language you feel comfortable with.

Is there specific language you'd like them to use or avoid? If you're trans or genderqueer, you can tell your provider what pronouns you prefer and what words you use to refer to your own genitalia so they can use the language you identify with. If you find certain words triggering ("relax" is one that can be a problem for many people), letting your provider know gives them the chance to help you.

10. Or, if you'd rather NOT have a conversation, tell them that.

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Some people just feel best if they can mentally check out until it's over. If that's you, it's a great idea to tell your practitioner so they don't try to engage with you (even if their intentions are good.) You can say something like: "I'm sure you usually talk to your patients about what you're doing during the exam, but it's actually better for me if you don't. I feel best if I can (close my eyes/listen to music/etc.) until the exam is over."

11. Ask your provider to raise the back of the exam table.

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Having the exam table raised to around 60 degrees means you'll be sitting up and actually able to make eye contact with your provider and see what's going on in the room. It's better for your provider too: When you're sitting up your internal organs sink into your pelvic basin, which is their natural position and makes them much easier to examine. It's also important for them to be able to see if you flinch, both because they want you to be comfortable and because a flinch may be the first sign of certain medical conditions.

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12. Find a position that works for you.

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For some people, having their feet in the footrests with their knees hanging to the sides is very uncomfortable or triggering, and for people with disabilities it can be impossible. (P.S.: We don't call them stirrups anymore — no one is riding any horses here.) There are a lot of options for this: You can pull out the foot shelf and put your feet together in the butterfly position, you can put your feet flat on the table and place pillows under your bent knees for support, and more.

13. Plan ahead so you're ready for your Pap test.

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The Pap test (often called a "Pap smear") checks your cervix for abnormal cells, and it's recommended every three years for women between ages 21 and 65*. If you're not sure whether you're due for a Pap test, ask when you book your appointment. Unfortunately, the Pap test is always going to be a little uncomfortable; your provider will be collecting cells from the face of your cervix and slightly inside the opening (or "os"), and stimulating the os usually leads to cramps.

The test is very quick and any cramps should stop after a few moments, but you can take an NSAID like Advil or Aleve half an hour before your appointment to reduce cramping. You can also ask your provider to tell you before they take any samples, so you can be mentally prepared.

*If you prefer and you're between 30 and 65, you can even just get the pap test every 5 years in combination with an HPV test. Read up on the new guidelines here.

14. Make a note of important facts about your anatomy.

It's a good idea to ask what size speculum is best for you and what position your uterus is in, so you can tell other providers in the future. Your uterus may be anywhere from anteverted (top tilted toward your belly, cervix angled toward your back) to retroverted (tilted back). This is something you can tell a new provider that will really help them give you the best, most comfortable exam possible.

Ask your provider if there's anything else it would be useful for you to know about your anatomy; they can point out things that are normal for you, which you can use as a baseline when you perform self-exams.

15. Work with your provider to make a plan for your health, going forward.

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Recommendations differ on how often to get a full pelvic exam (and even which parts to get), so it's a good idea to talk to your provider to come up with the best plan for you. Their recommendations will depend on your age, your personal and genetic risk factors, your medical history, and your personal needs (like birth control.)

Remember: This is your life, your body, and your exam. You’re in charge.

Whoever you are, whatever experiences you've had before, however you feel about this exam — it's OK. You get to be yourself and feel however you feel, and you get to expect your healthcare provider to respect that. You have the right to control the encounter, you have the right to say no to any part of the exam at any time, and you have the right to do whatever you need to do to feel good about yourself, your body, and your health.

Your body isn't a secret that only a doctor or a nurse can understand. With a little bit of knowledge and confidence, you, too, can be the boss of your own vagina.

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