First time pap smear and past CSA..help??

So... I'm 21. Never had a pap smear done before...Nothing like that. The only time a Dr had to go "down there" was when I went to the hospital as a kid because of a yeast infection.. and I bawled my eyes out in panic. My mom had to be there, I outright refused a male doctor, and still sobbed while the female Dr examined me. Ugh. Flashbacks of that. Not fun. ;-;

I went through some sexual abuse when I was 3-4...and it's never "left" me...I briefly touched upon this with my T but we haven't gone in depth yet, trying to get anxiety under the control first..

I thought I had 'overcome' it but in reality I just pushed it away for years.. Now I have to face one of my worst fears regarding medical decisions and I have no clue how to handle it. I just started seeing my PCP and I've only seen her 2 times so far, today being the 2nd. First was to review lab tests and get referral for T, 2nd was to follow up on another test and then decide what to do from there.

I'm getting put on BC pills to help manage my weight and menstrual irregularities, and she mentioned that she's going to have to do a pap smear within 6 months. I freaked. She tried to tell me it's not painful, everyone has to do it, you'll be fine. I just shook my head- she doesn't know about the CSA. I don't know how to tell her. I don't know how I'll be able to handle the exam safely. I'm scared to lose it in there. I'm going to break down, I know i will. I did it when I was a child, I'm even more sensitive now emotionally because I'm not really emotionally stable lately. I'm terrified. I don't want anyone down there. I even had trouble with my BF during intimate times- which has only happened a small handful of times within 2 yrs.

I need help on how to safely talk about this without breaking down into a panic attack. How to get through the appt. I don't know what to do. ;.;

I do not regard pap smears as pleasant but still they are necessary. When one has undergone sexual abuse, it is even more scary. I think I would talk to your therapist first and then let your doctor know of your concerns. If they are aware of your situation they will be a lot more supportive and helpful

I think the best way to do it is to be straight forward about it. If you have a competent doctor they will be sensitive to your anxieties. I had the same problem when I had one. I had an NP do mine and she was great with dealing with my anxiety and freaking out when it was going on. I do suggest letting your doctor know before going in for that day. Also, your Doc gave you a six month window. I would use that time to get to know her better so you will be more comfortable with her. Find reasons to go in to get to know her (assuming you can afford it). I don't know what reasons that would be, but I'm sure you could come up with some. Let your doctor know that is what you want to do. Good luck.

She initially wrote 6 weeks but I said hell no. :/ I'm going to probably have to write her a note, I can't talk about it aloud without it hitting me hard.

(((((sila)))))

drs here actually have a lot of understanding and awareness of women who have gone thru CSA. here if you make your doc aware you're scared of having a pap because of past abuse (that's all you gotta say or write here) they let you know you can bring a female relative/close friend if you wish and a sedative beforehand can usually be arranged.

hope it all works out ok for you

Tell your doc, in a letter or note is fine. Due to anxiety and pain issues my dr, will usually suggest/prescribe Xanax or something similar. If they know you are scared, most will talk you through the process step by step as they go, so you know what they are doing and what to expect. You are also welcome to have someone in the room with you if that makes you more comfortable. If you do decide to take a sedative or extra anxiety meds make sure you have someone drive you just to be on the safe side.

I'm not able to drive, so my mom or my bf would be driving me anyway. I think my best bet is a sedative of some sort, anti anxiety or something.. Thank you all for your replies. I think if they tried to explain the process it'd trigger me worse. Distraction generally works best for me.