Disposable Vaginal Speculum When women become post-menopausal, their estrogen levels drop and, as a result, their vaginal lining can become thin and fragile. The medical term for this problem is vulvovaginal atrophy. Many women experience this as dryness, irritation, or pain with vaginal penetration. Although vulvovaginal atrophy does not usually improve with time, it is very treatable.
One way to lessen the discomfort with gynecologic exams following menopause is to begin a daily routine of using oil at the opening of the vagina. Different oils have different properties, but unfortunately, these aren’t well studied for vulvovaginal atrophy. Nevertheless, commonly recommended oils are vitamin E, mineral oil, and coconut oil. I tend to recommend organic sunflower oil, for its skin healing properties.
Women should start this daily routine ideally at least one month prior to the exam: place two to three drops of oil onto the pad of their thumb, Disposable Vaginal Speculum then inserts their thumb about one to two centimeters into their vagina, focusing on the outer, bottom half of the vagina and gently massage the oil into the skin for 10–15 seconds.
This technique is called a perineal massage and targets the most problematic area for most women with vulvovaginal atrophy. Oils should not be used in conjunction with latex condoms, as these oils can degrade latex, and lead to condom breakage.
What can I do during the office visit to lessen the fear and pain?
If you commonly experience pain during gynecologic exams, it’s okay to tell your provider about this issue. In fact, you should tell your provider if you feel uncomfortable, and you can both collaborate on ways to help you feel more comfortable, such as:
Bringing a friend or loved one for support
Adjusting your body positioning for optimal comfort
Asking your provider to explain what they’re doing, as they’re doing the exam
Using a lubricant to reduce pain
It’s a human reflex to tighten up when we’re anticipating that something—like a pelvic exam—will hurt. But when our pelvic floor muscles contract and tighten, it can lead to more pain during the exam. A way to prevent this pain is to ‘bear down’ during the early part of the internal exam. ‘Bearing down’ is a technique that involves pushing by using the same muscles that are used in a bowel movement.
All tips, tricks, and techniques aside, what’s most important to remember is that it’s acceptable to tell your provider to slow down or stop. You should always feel safe and in control during your gynecologic exam.