Pap smears (maybe TMI)

Ok, I'm posting this here and not in health and support because I want advice from the people who mostly post here.

Ok... this is extremely embarassing and difficult for me to talk about but I gotta talk to someone and where better than on the internet? lol

I have endometreosis and PCOS. I have never had sexual intercourse (willingly). Me and my husband have tried everything but it's like there is a wall there. I haven't had a pap smear done since I was 17 years old. I've only had it done twice, but when I was in the hospital at 16 for abdomen pain I was probed by countless nurses. It hurts. Alot. It burns. Is it supposed to burn? It feels like someone has a lighter to my genitals while they're ripping it open. Q-tips to tampons to bigger... nothing FITS. Everything hurts.

When I had my first yeast infection (I didn't know what it was) the doctor did a swab test to see what it was, and that swab HURT SO BAD. And all it was was a long q-tip. I mean... wtf. :(

I want to have sex and be a normal girl but for some reason it's like mother nature doesn't want me to. :| Are fingers supposed to hurt? Can't even get my own pinky finger in without wanting to scream in pain. =/ I'm not exaggerating either. When I had my pap done at 17, I screamed. D: I was in pain for days down there after.

I've been having some problems and I've got a pap exam thingie next month and I'm terrified. Not of the procedure, I don't even feel awkward or anything, it's the pain I'm afraid of. I do get a bit mentally distressed when it's over but I do want it done because I'm afraid something could be wrong.

I'm pretty sure it's not normal to have SEVERE cramps after an orgasm (either from myself, husband or a DREAM) and then bleed after (sorry if TMI :().

I want to know if there is a way I can lessen the pain or make my insides freakin' relax and allow stuff to enter. I even tried to get drunk with my husband (was all very lol-worthy) but even then it didn't work. :/

I have told my doctor about all of this (except the cramps part cause I was afraid of having an exam done =/ I want an exam done but so scared...) and they tell me to see a therapist. Okay. So there is one sex therapist in all of rhode island and she charges $300 a session without health insurance (she also doesn't accept medicare... I don't have it, but that's what the woman on the phone said).

I'm wondering if it's PCOS related, Endometreosis related, or past trauma related. I've pretty much resolved the whole past incident but I guess it could still be there?

On top of all this I've lost my sex drive and I'm dying to get off the depo... but I have to have a pap done (and a physical) before I can switch. Argh.

Someone help me/give me advice. I don't know what to do. :(

Tell a Doctor about your experiences in the past with EXTREME pain, and explain that you are afraid of pain from exams, so he/she needs to know that and try to not examine you inside with giving you a local first.

You SHOULD be examined though, it's dangerous not to be...But having them administer a local and giving you a prescription for pain afterwards might help.

I'm so sorry that it's painful for you...It really shouldn't be. I've never heard of anything like this, so I have no idea what could be happening.

Ugh - sorry to hear you have such a tough time. I've never had any of these symptoms and don't know any friends who have either ... but then again I don't have PCOS or endometriosis.

I highly recommend you ask for a referral to a OBGYN and tell them about all your symptoms.

I have PCOS and have never had any problems with pain down there - neither has my oldest friend who suffers very badly with endometriosis. Sorry to say it honey but I think it's more likely to be a trauma-related psychological issue.

Although, actually, now that I think about it - if I'm about to get my period (maybe one or two days before it starts) I can get VERY severe cramping after an orgasm. It feels like very intense period cramps and I have to get up and walk around, doubled over, until it subsides. It sounds insane, but I always just accepted it as a sign that my period was on its way (they're incredibly irregular, so I have to be constantly on the look-out for any warning signs!) I was so content to use it as a warning sign that it never even occurred to me that it could be caused by the PCOS... hmmm! Now I have something to ask my doctor about next time I go...

Could it be your hymen? Some women have to have it surgically removed if it's too thick.

Definitely go and talk to someone. I know it's not a fun situation to be in, but just remember they've seen just about everything.

Sounds like the endometriosis, honestly.  Just tell your Girl-Parts-Doctor up front what you need.  You're paying for service, you should get what you want/need.  Tell them to use pediatric instruments if that's what it takes--my doctor specially orders instruments that are at least two sizes smaller than what's readily available (many won't do this because you have to have a functional autoclave--they aren't disposable instruments).  Anyway, I'd just call around until you find someone ready and willing to do what you need.  Don't be shy about it. 

I'm sure that if you keep looking, you'll find something that helps.  You're right, that isn't normal, and you deserve answers. 

Dude, that's effed up.  Brains can do some wacky things but I don't think they're capable of making your vag bleed after an orgasm.  A shrink won't stop that from happening.  Do you have PID?  Could be your hymen like Jblarg wrote.  Have you had an ultrasound?  Do you have any masses?  Cysts?  What about your colon?  Colon problems can cause vaginal problems.

What about your natural lubrication?  I dried up when I was on birth control and it made penetration painful, very painful.  It was difficult to get anything in there.  It was like having the Mojave between my legs.

You need a consultation with a very good OB/GYN. It sounds like you might have vaginismus as well as your other known problems. The cramping after orgasm and bleeding are probably due to the PCOS and endometriosis, respectively, and both of those conditions are almost certainly not helping the pelvic pain situation either. Your past trauma probably also plays some role but I wouldn't automatically assume it was the primary problem, considering your definite physical symptoms.

There are (hopefully near you) gyns who have experience and training dealing with sexual assault survivors, who can make an exam the least traumatic possible for you. There are techniques that are taught in order to do this: give the patient clear and immediate verbal control of your actions and let her insert the speculum herself; avoid the lithotomy position, instead having the woman basically semi-reclined so she can see everything and is above you; ensure that the doctor is sitting down on a low stool, not standing or in any way above the patient; position a mirror so she can see exactly what you are doing at all times; lots of lubricant and lots of time, obviously; pediatric speculums that are smaller; etc etc. What you don't want to do during the exam: listen to music (whatever song is playing will be associated with pain in the future), or have anyone touch you without asking first (even to try to comfort you). Some doctors might also be able to give you muscle relaxants and anxiolytic medication to make it easier.

If your doctor is just shunting you to a therapist, that sounds to me like "I don't want to change my exam protocol for you, so fix yourself before coming to me". Find another doctor if you can. Or wait three years till I'm done residency and then come up to Montreal and I'll see you. :)

Listen to trustwomen, she is on it.  There are very real, very disabling vaginal pain disorders THAT ARE NOT IN YOUR HEAD.

Some of the issues-- the cramping after orgasm, for example, can be normal.  Bleeding-- maybe, but a pap smear is a VERY good idea and you should have a pelvic ultrasound (be aware, this will be both vaginal and abdominal and even those of us without vaginal pain issues, its very uncomfortable... its like a dildo cam.  Ask for some valium before hand and take advil or tylenol before hand too.  Bring a pad for after-- both for the lube and I dont know about other people, but I bleed after-- vascularized cervix.)

Stop letting your embarassment or whatever it is stop you from seeking help.  Find a dr who listens... no matter how many it takes.  Its a damn shame that women have to fight to have someone listen to them, but every guy on the street can get a viagra-- and have it covered by insurance.

Good luck... and I hope you find the answers that you need-- which will probably be multidisciplinary.  You can do this-- just keep telling yourself that.  I believe it.

I really cant help much but just wanted to say its not due to PCOS (which i also have). 

I also cramp after an orgasm when I have my period.  It usually goes away within abotu 10 minutes. 

You definitely need to get this sorted and find some answers. 

Original Post by cptbunny:

I haven't had a pap smear done since I was 17 years old. I've only had it done twice

On top of all this I've lost my sex drive and I'm dying to get off the depo... but I have to have a pap done (and a physical) before I can switch. Argh.

Someone help me/give me advice. I don't know what to do. :(

 I was told that you have to have your pap smear once a year in order to stay on the depo. o_O That it can't be continued beyond the one year mark without a yearly. Women have to get one in order to receive birth control too,ect. It's possible to be on the depo without doing your yearly? Where? For what length of time?

This isn't a problem that's in your head in my view. It's not normal to be having actual pain like this,ect. It sounds like your doctor isn't treating the problem because of psychological issues. Treatment is important as is screening you to find the source of the problem. He/She should treat/screen you for the issue at hand. Period.

 I would suggest that you find another doctor. Go elsewhere. Plan Parenthood,ect. I've never had someone from plan parenthood act as judgemental as other places. I wouldn't put this on the back burner it sounds serious. Ovarian cysts can cause pain during sex as well as abnormal bleeding. I'd imagine it could be due to many different things.  

Do not let doctors treat you like the pain is in your head. Period.

They can't feel your pain. 

^ That's a simple fact you need to remind them of apparently. Some doctors are more inclined to judge people than treat them. :( 

A random individual other than your doctor could say they feel you're exaggerating. Or: Say " I think it's in your head." Ect  A doctor: Should do everything within reason to offer an actual diagnoses. Based on the issue at hand not past trauma/psychological issues. Did your doctor say that to you because you refused an exam? or testing? or something of the sort? It just seems so out of line for a doctor to suggest that,imo. Wow. I can't believe they didn't suggest some form of actual testing. That way they could mark certain potential problems off their list... To help you find real answers.

 It sounds very painful but consider the pros of having an exam/testing. I hope you haven't decline exams/testing that you actually need. As difficult/painful as the process if for you...Remember: It will hopefully find the source of the concern. That way your problem will be solved through proper treatment. The pros outweight the discomfort. Otherwise: This is a lasting problem that could grow more severe. It sounds like you've endured enough pain already. I just can't imagine being in this kind of pain long-term. :(

Please, please, please... See another doctor! For your better of your health, sex, and life.

My best friend has both Endo and PCOS and tells me the same as you arem therefore I have to disagree with the posters that say that it can't just be a physical issue. 

Of course only you know if you are recovered from past issues but you say that you are married so I am assuming that you are in a very seecure, happy, trusting relationship with a man that suports and understands you and knows all about your past.

I'm not sure what to suggest really, I just wanted to post because I know that my friend feels so alone sometimes, it helps her to know that other people are experiencing the same things.  She is unable to ahve sex for the same reasons that you say, severe cramping, her PAP smear put her on her back and drugged up for 2 days, she finds it impossible to have anything inside her without a bleed, fingers, tampons, and to date no Dr has been able to help with that. 

My only suggetsion would just be to try and take the pressure off, agree with your husband no sex but see how turned on you can get, just stroke, kiss, massage, stay outside, get really really turned on, and then stop, do it again the next day, and the day after, and the day after, and every day until the sexual feelings that you create are something that you enjoy and look forward to and not something that you fear because of the pain.

The book "The Camera My Mother Gave Me" by Susanna Kaysen is a true story of the author's struggle with pain like yours.  You might find it interesting and/or helpful. 

I think the term she uses for the condition is "vulvodynia"--maybe do an Internet search on that and see if it matches up to what you're experiencing so that you have some terms to share with your doctor.

Also, I agree with TrustWomen.  Find a new doctor who's willing to work with your needs.  It's NOT "all in your head."

Google the term "vaginismus"--this condition sounds a lot like what you are experiencing.

I hope you find some help, bunny! Get better soon! Tell your doctor everything you told us, the more she/he knows the more they can help and make things easier for you.

Original Post by apophenia:

I think the term she uses for the condition is "vulvodynia"--maybe do an Internet search on that and see if it matches up to what you're experiencing so that you have some terms to share with your doctor.

 

I asked my mother about this and she said my GP when I was 6 suggested I may have this condition. The symptoms certainly match up to what I'm feeling. =/  When I used to get checked (not a pap or any penetration, more like a eyeball check of the outside) I used to flinch because it hurt when she just touched me (my mom used to be in the room... I was 5-6 afterall). I barely remember it but I do remember hating that part... but what girl likes it? lol

I also thought about vaginismus but the doctors ruled it out because I was able to still have a pap smear even though it was insanely painful. She was able to put 2 fingers in with "no problem" at the end of the exam to feel my ovaries, it hurt like crazy but the pain is just at the "entrance". It's impossibly painful, I can't even describe it other than "I'm on fire". Feels like a lighter is held to me down there.

Thank you all SO MUCH for your posts. I was actually really embarassed I couldn't bring myself to reply but after a few days I feel less embarassed. My husband and I don't have sex and he is ok with that, there are other ways to achieve the same results.

My main concern is the extreme cramping, it hurts more than any menstral cramps I've ever had. I had yet another naughty dream early this morning and woke up with the worst cramps ever. They don't last long, but they HURT. No bleeding, but I don't always bleed.

I do want to have sex though. =/ Having the 'virgin wife' title is not a nice one to wear.

I find it a bit ironic or... sadistically funny (?) that I'm also infertile, have 2 conditions that make you infertile (PCOS caused it), and I'm unable to have sex. I'm pretty sure mother nature made sure that not only can I not have a baby [of my own] but made sure I don't even attempt to! ><

I have a pap appointment in June, but I'm going to make an appointment this month for my yearly physical and talk to that doctor. The one that's doing my pap is a nurse (I never met her ><) that also has PCOS, they gave me her so she can "empathize" with me. I don't know why they won't just numb the area where it burns, inside it doesn't hurt, it feels like alot of pressure, it's uncomfortable but tolerable.

As for past trauma, no one is 100% over such a thing, but I feel I am 98% over it. It doesn't effect my life or even enter my thoughts unless I'm talking about it. I was 13, I'm 24 now. I really wish I didn't bring it up to the doctors so they wouldn't use the "see a therapist" card.

This place is a planned parenthood type place. Planned parenthood won't see me because I am over 21. The place I go to sees you on a sliding scale based on income. If I could find another place like this nearby I'll go there and leave out the past incident and see what they say. =/

I just want to cry. =/

Argh.

Vulvodynia from wiki:

Patients often will describe the touch of a cotton ball as extremely painful, like the scraping of a knife.

Many sufferers will see several doctors before a correct diagnosis is made. Many gynecologists are not familiar with this family of conditions, but awareness has spread with time. Sufferers are also often hesitant to seek treatment for chronic vulvar pain, especially since many women begin experiencing symptoms around the same time they become sexually active. Moreover, the absence of any visible symptoms means that before being successfully diagnosed many patients are told that the pain is "in their head".

This is exactly it! I'm writing this down so they can atleast check to see if I have that. I mean, the symptoms are the same as what I feel but you never know.

I kinda hope and kinda don't hope that this is what my problem is in regards to penetration pain. It's nice to have a "cause" but it sucks if it is cause it's just another issue for me down there. I'm 100% sure my genitals and reproductive system hates me. =/

I *think* my cramps may be because of endo, because I googled "severe cramps after orgasm" and endometreosis seems to be the cause. But why all of a sudden? I worry. =/ I've had it since I was 16.

As for the ultrasound and the dreaded wand thing, I was able to avoid it for the 3 ultrasounds I've had for these issues. I was 16 and 17 though. But they can't stick anything in me that I don't want... right? =/ If they put me out I'll gladly do it though. >.<

It sounds like vulvodynia/vaginismus.  I'd bring it up with your doctor and go from there.

The cramps and bleeding after orgasm sounds like the endo.  And for some stupid reason it does come on suddenly- I've had it all my life and only in the last year did the cramps after orgasm come on.  Maybe an adhesion has formed which gets pulled on during the contractions and leads to the sudden cramps?

Original Post by cptbunny:

 

I also thought about vaginismus but the doctors ruled it out because I was able to still have a pap smear even though it was insanely painful. She was able to put 2 fingers in with "no problem" at the end of the exam to feel my ovaries, it hurt like crazy but the pain is just at the "entrance". It's impossibly painful, I can't even describe it other than "I'm on fire". Feels like a lighter is held to me down there.

I don't buy that it's not vaginismus and I think you need to find a different doctor.  The pain from vulvodynia could have also caused vaginismus and even though she could force her fingers in doesn't mean jack.  Hell, she could have made it worse.

Sorry, doctors like that just drive me nuts.

Original Post by cptbunny:

Planned parenthood won't see me because I am over 21.

Wow. That's regulation by what state for Planned Parenthood? That's odd.

I've used two Plan Parenthoods in two different states.... On both occasions being over the age of twenty-one. I've never seen anything suggest you had to be under 21 for Planned Parenthood.

These were recent visits to be exact one last year and one the year before.