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Question:
I need birth control, but I don't want to go through a physical exam.My
boyfriend and I both feel that this would be an invasion of my privacy and
person, and to me it would be the equivalent of rape.If someone who wasn't
an m.d. was touching me or putting things into me, it would be sexual
assault or rape, and I feel this same way about a doctor doing this to me.I
DO NOT WANT ANYONE but my boyfriend touching me. I am not really concerned
about the health benefits at all. I just want some birth control. I have
searched all over the internet and asked the same question to planned
parenthood about five times, but nobody will help me.I hope you will. I am
nineteen years old and i do not want to get pregnant. I need to know how I
can get birth control(such as the pill or depo provera) without going
through a physical exam. I live in florida. Please help me.
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Answer:
by Susan Ludwig: (05/19/2004)
Dear Reader,
I am so glad that you have written with your concerns about a pelvic exam.
I know that having a pelvic exam can be scary -- however, the consequence
of not having this important exam are even scarier! Every woman needs to
have this done when she is 19 years old or becomes sexually active -- which
ever comes first! And a Pap smear is usually done every year (more often
if there are problems) until a woman is in her 60's. It is the single most
important way to reduce the likelihood that you could die of cancer of the
cervix -- a tragic disease that claims the lives of far too many women
today!
Lets take a look at your concerns and see if we can shed some light on some
of them. Maybe if you know more about a Pap smear, you will feel less
concerned about it. First of all, a Pap smear is done by a qualified
professional -- either a physician or a nurse. You will be covered with a
sheet or a paper examining drape -- only your vulva needs to be exposed.
The examiner will examine your labia for signs of infected hair follicles,
warts and other conditions that may need to be treated. You can watch this
in a mirror -- and see what it is that the doctor or nurse is checking for.
Sometimes when I am performing this examination, I find a mole that I feel
is important for the individual to watch!
Next the examiner will slide a speculum into your vagina. The speculum is
rinsed in warm water to make it slip in more easily. A speculum is a
slender tube like instrument that holds the walls of the vagina away from
one another. Remember that a vagina is not really an opening -- it is a
potential space -- much like a pocket. If there is nothing in it, it is
closed up on itself. With the speculum in place, you will be able to see
your cervix in plain view. While inserting the speculum, it helps if you
breathe deeply and smile! That smile makes your pelvic floor relax -- and
I have had speculums actually slide in by themselves when the woman I was
examining smiled! That makes it quite comfortable for the woman who is
being examined!
While sliding the speculum in place, the examiner is looking at the walls
of the vagina and the secretions from the cervix. He or she will use a
sterile cotton tipped applicator to collect samples of the woman's vaginal
secretions. These will be sent to a laboratory to be examined to be sure
that the woman doesn't have a sexually transmitted disease. When you think
that some sexually transmitted diseases don't have any symptoms, it makes
you realize how important these swabs can be to a woman's sexual health.
The final part of the examination is the actual Pap smear. To do this, the
examiner uses a wooden spatual that is shaped to fit the woman's cervix.
The examiner gently sweeps the spatula in a circular motion around the
cervix -- taking with it the cells that the cervix has discarded and will
eventually allow to drop away. Next the examiner will use a small soft
brush -- similar to a mascara brush -- and gently sweep the opening of the
cervix -- for the cells that have been discarded there. These cells are
smeared on a glass slide and sprayed with hair spray to set them so the
doctor in a laboratory can examine them.
At this point the speculum is removed -- carefully so it doesn't pinch.
The examiner will put a lubricant on one gloved finger, and slide it into
your vagina -- pushing up on your cervix with one finger and pushing down
on your lower abdomen with the other hand. This helps the examiner to
assess the position and the size of your uterus. It also lets the examiner
check your ovaries -- to be sure that they are not enlarged or tender.
With that, the examination is finished. The examination should never feel
rushed to you -- and you need to feel like your comfort and sense of
security are the most important thing to him or her. If you have any
questions or if you want the examiner to wait a moment before going on to
the next step -- well, remember, that you are the boss! If you have any
questions about anything, it is important to ask them.
I don't know of any doctor who would prescribe a method of birth control
and not insist on a pelvic examination. This is an important aspect of
every woman's health -- especially those women who are sexually active. It
is up to you to find a place where you are most comfortable and feel well
supported. I hope you are able to do this so you can get the birth control
that will help you avoid a pregnancy until you feel you are ready for one!
I also hope that you can come to see a pelvic examination as something that
is important for your personal health, also.
Sincerely,
Susan Ludwig, R.N., B.Sc.Reviewed by Sexual Health Editorial Team
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