Gynecology Appointment Fear

*Content Warning for Sexual Abuse*

I have C-PTSD due to multiple sexual abuses and various levels of molestation throughout my childhood and adolescence. I'm sure some of you can relate.

Well here's the issue. My fiancé and I have recently become sexually active. That in itself has been surprisingly easier than I expected because I thought for sure that would be triggering. But I'm guessing that since he is my safe person and we have a lot of trust and open communication intimacy isn't too difficult.

Neither of us want kids, at least not for a long, long time, if ever. I can't take normal birth control pills because one of my medications makes them inactive. Also I don't entirely trust condoms since they only have, on average, about a 70% success rate (they have to be used perfectly). So we decided on an IUD. I'm all for it...except the procedure to have it placed.

I've heard that it can be quite painful, especially if you've never been pregnant before. I already have a hard time with normal gynecology visits and pap smears. I don't do well with having a stranger between my legs, sticking things in me, and causing pain.

Because of our work schedules my fiancé can't come with me. I have to do this on my day off since I need time to rest and have the space to mentally breakdown if it's too much to handle. Our days off rarely coincide enough for him to attend (I work days and he works overnights). He says he wants to attend but because of scheduling it's just easier to go alone.

I know that if you inform your doctor of your abuse history they generally handle things in more gentle way and give you more control over the situation. My problem is I have a hard time bringing it up or asking for help. And because I have to go by myself I can't take any anti-anxiety meds because I need to be able to drive.

I'm scared. I want this IUD. But I'm still scared.

I can relate, many hugs LittleLeah

I know this might not work, but I would express to your fiancé that you really need him on this one and he may have to take the day off or call in sick. This is very important and you need to feel supported. I know he's not being an asshole in not going but maybe he doesn't realize how intense this anxiety is for you and once hearing your request for help he'll be there no matter the consequence.

If that still isn't an option, I think talking to your doctor before the appointment when your anxiety isn't heightened would be best. Call the office and ask the receptionist to have the doctor call you, something simple like you have some concerns over the procedure and would like to discuss them before the appt. Once the doctor calls back just be honest. You don't have to give details, simply... this procedure is bringing up a lot of anxiety around past abuse. I know this is what I want to do I just need you to know so you can understand if I'm having a difficult time the day of and help me navigate through the procedure calmly and gently.

I hope this helps! Good luck. This will definitely be difficult but know that you will be ok.

Do you have a friend who can go with you? I had one with me last time I had an exam, who then hung out with me afterwards, until my scheduled therapy appt, specially scheduled because I was going to have the exam. She drove me, and got me a milkshake from Sonic right after. Her driving also allowed me to take a Lorazepam before hand.

And I agree, talking to the Dr. and in the barest possible terms explaining that you have anxiety related to abuse would be very helpful. I did not give my doc details, but I think it helped her knowing had something happened in the past...

I appreciate your responses.

My best friend can't because she has to work. She's a teacher so it'd be extremely hard for her to make it. Other than that I don't have anyone who really knows about my abuse enough for me to be comfortable with them comforting me. I have one friend who knows what's going on and has even offered to come but she's the type who will minimize my suffering so she can increase her own drama. I don't have the energy for that.

Also, the more I've thought about it the less I'd actually want my fiancé with me. Our sex life is new and going really well. But I'm afraid that if he's there I'll associate his attempts to calm me with the pain going on between my legs and make things a whole lot worse. Considering that most of my early sexual abuse was filled with phrases like "it'll be okay" or "it won't hurt that much" I don't think he could help much. I don't want to later be having sex with him and it trigger a domino effect of trauma. I'm not really sure if I'm making any sense at all. Basically I don't want for him to become associated with my trauma through accidentally making a trigger worse. We're still learning to navigate all of my C-PTSD and this is one thing I'm not entirely sure he can help with.

This still brings up the issue of telling my doctor. I like what some of you have said about calling the office but it wouldn't make much difference because I forgot to mention that it's first thing Monday morning. I might look into seeing if the local sexual violence center has any available advocates. But again, it's the weekend and my appointment is Monday morning. But maybe they'll at least have some practical tips for talking to my doctor that's less intimidating for me.

I really wish it was standard on the preliminary paperwork to have a box that you could check for any history of past/current sexual abuse, molestation, and/or assault. That way they know before they even meet you and I don't have to be the one stuck trying to figure out how to bring up something I've spent a lifetime avoiding talking about. The nurse who was going through my chart during the consultation even read out loud PTSD while listing off my medical conditions. You'd think that they'd know that one of the most common causes for PTSD in women is sexual assault and since they work in OB/GYN that they would ask to confirm. The doctor I had for the consultation was very nice and helpful with choosing the IUD but she's not the one performing it since she'll be out of town. It'll be someone I've never met. That could be a very good thing, they might have more sense to ask. Or it could be the same or even worse. I don't know. And I don't like not knowing.

Search online for visualization relaxation audio scene location such as Rainbows or beaches or other places non-body or trauma related only. Something "outside" and away from your physical body and space. Listen until you find a calming and relaxing easily "accessible" picture to represent a safe place. download to use with ear buds. Relaxation only not "healing" trauma or body visualizations. Those tend to suppress trauma as a quick fix which causes more complications in the long run.

Listen to relaxation audio multiple times so you enter visualized place and relaxed state sooner.

At check in, hand a note and request both the nurse and doctor read prior to procedure. Example of perimeters. "As result of sexual trauma related PTSD I am going to listen to a relaxation audio during the procedure. I request any talking done prior to entering procedure room or after procedure. I request a few minutes to listen to audio prior to start of procedure. "

Set up personal perimeters based on your comfort. Perimeters place you in control of the environment. You can choose to watch the procedure or close eyes and listen to audio.

I agree, being able to set some boundaries around the procedure will probably help you feel a little safer. For example, even if you could just ask, "Please don't tell me 'it's almost over," you might feel more in control of what's going on (and for the record, I hate it when doctors tell me that, too. It's SO triggering.) think about what things might make it a little less overwhelming and ask for those. It will still be tough, but asserting your needs can help you feel more powerful

Think also about how you can take care of yourself and feel soothed after the procedure. Can you go home and crawl in bed with your favorite movie? Have your best friend come over later? Have the less supportive friend bring you lunch?

I will be thinking of you.

I think you are incredibly self aware to realize bringing him for support could adversely cause him to become an association. I think that's a smart choice then. I think your best bet is too plan to either give the note before the appt or find the courage to open up before the procedure starts. I think what we feel to remind ourselves because we are so ashamed of our history is that these people won't judge your character for giving them this information. Unfortunately that's what we do to ourselves. Number one, they are professionals so at the very least they will feel sympathy, hopefully they are stellar professionals and will give you empathetic care. Nonetheless giving them the information and boundaries to keep you safe will make their job of caring for you easier. And that alone will be appreciated by them.

And maybe forming a mantra to keep in your during the procedure... Something like "I am safe, this is only a medical procedure" to repeat and keep you grounded in the moment.
My therapist also gives grounding techniques like look for 5 things you can see, 3 you can hear, 2 things you can touch, and at least one thing you can smell. Continue to go through this list to keep your mind in the present so if you are feeling triggered it can help combat getting lost in a flashback.

Good luck! Please keep us updated. Will be thinking of you.

For whatever it may be worth, most gyne doctors are very familiar with PTSD effects in women and would not bat an eye if you were to tell them. My own doctor knew I had vaginismus before I even knew what vaginismus was.

Also another way to look at it, is as a fair warning to the doctor. I warned my doctor about my trauma before my first exam (prior to being diagnosed with vaginismus), because I wanted her to know that if she didn't go slow and careful, there was a chance that I would violently kick her in the face. >_>

Feeling a little better about giving a doctor a black eye now

I have a hard time with any doctors, psychiatrists, etc. I am always hiding how I really feel, think, etc.

It's fear that my past of being raped will make me appear unstable. That it'll make my constant pain appear that I'm making it up or seeking attention.

My intimacy level is very low. I love the man I'm with but sex has always been painful, physically, for me. Orgasms cause horrendous cramps. That started after I gave birth to my son 10 years ago.

I had s Mirena IUD, it hurt the whole 5 years I had it. Only positive was that it stopped my period all together.

Do you have a low cervix? If you do, I recommend not getting an IUD. You'll feel it when you have sex and it can cause a lot of discomfort in cramp like ways.

If you decide to do it, make sure to take some pain medication. Anti-inflammatory type like aspirin or ibuprofen. Don't get up too quickly, you might feel light headed after insertion. Make sure to take cranberry pills or drink lots of water. UTI infections are common after placement. The reason why I kept it the whole time was because periods were an utter nightmare pain wise. Slightly worse than my IUD pain. Weighing out the pain, that was my only option at the time unfortunately.

If you don't like the IUD, remember you can always take it out. It'll be okay. =)

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Thank you everyone. I feel so much love and support from you all. I think I will just tell them when the nurse takes me in. I can't listen to music because I need to know everything going on around me. The suspense and not knowing when pain is happening will only increase my anxiety. Maybe that's just my hypervigilence but I need to know what's happening every step of the way. I don't handle surprises well.

Before my appointment I'm making a nest around the couch so I can just come home and curl up with my laptop, netflix, heating pad, and comfort foods. My seroquel too if I need some help calming down. And then tomorrow night I am getting together with a friend. She knows about my past so she might be able to comfort me if I'm still struggling at that point. We have an easy craft night planned. I still kinda wish my fiancé had the day off so I could curl up on the couch with him but he's just not able to make it work even though he wants to.

It'll be a rough day but I'll survive it.

Let us know how you are feeling tomorrow. =)

That heating pad is a great idea. Oh and if you take something for period cramps like Midol, that'll help with adjusting your cervix to the device.

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I survived! There is a whole range of curse words I'd like to use for how my uterus and cervix feel at the moment but there was no emotion fallout. But owww!!!!

Wish I was that brave, I cancelled my app...
Well done on getting through it, proud of you

It'll ease up. Just take something for the cramps. It'll help your cervix adjust to the device.

=) Glad you made it through it.

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