Terrified of Gynecologist, Need Advice (please)!

[mikeyisscared]

I'm 22 years old and have never visited a gynecologist before. This is mostly due to the fact that I have a genuine, diagnosed phobia of them, and I struggle severely with the mere idea of going to one. I'd probably never go to one if I had the choice, but that's obviously not a good idea. I've been experiencing concerning period symptoms since my very first one when I was 11, and I'm worried I may potentially have endometriosis. I've always had really painful periods, and my cramps have caused me to miss school, music lessons, and leave hang outs with friends early. Often, common pain relief recommendations like Advil, heating pads/hot showers, exercise (I try to do weight training and cardio 3x a week, so it's not like I'm doing nothing!!), and dietary changes do not help me. I experience painful urination every period that correlates with how painful my cramps are (ex: if I have bad cramps, it'll feel like I'm being stabbed in a straight line up my lower abdomen with 100 tiny knives when I try to pee. if I have no or very mild cramps, it won't hurt to pee). I get digestive issues around my period, and it's very uncomfortable. I track my period every month with an app, and it says my cycle variation is at 10 days, which is outside the normal range. Additionally, I often experience nausea, dizziness, and pretty bad fatigue/muscle weakness on my period. It feels like getting the flu for three days every cycle.

Obviously, I'm not a doctor, so endo is only an educated guess on my end. In order to find out what's actually happening to me, I know I *need* to face my fear and go to a gynecologist. I also should just go to one to better take care of myself, since I know my reproductive health is *very* important. This is really, really hard for me. I've been doing exposure therapy for years, and I've only recently been able to start typing out the real words instead of using euphemisms (ex: "lady doctor" "down there") or censoring words (ex: "6yn3c01061st" "v@g1n@"). I still can't say the words out loud, but I'm working on it. I'm trying to be patient with myself and understand I have a genuine anxiety disorder, but I can't help but feel really silly for having this problem. I've never had sex/been sexually active in any way before and I've never been assaulted or touched inappropriately, so I don't even really know why I have this phobia since nothing has ever happened to me. It also makes me feel guilty since I haven't gone through any sort of trauma to "justify" this level of fear. Do other people randomly feel this way, too?

Online, most advice boils down to "suck it up, buttercup!", which is much easier said than done. I've entirely vetoed the idea of bringing a support person, because it honestly makes me feel worse. I don't think I can handle someone else being in the room while I try to describe what's going on with me or someone else seeing me get/knowing I'm getting a pelvic exam. It makes my skin crawl and I feel like crying just thinking about it. I know people also recommend learning about what happens when you visit a gynecologist, so I've done a lot a research. I've read plenty of articles about what happens when you go for the first time, all about endo and the steps taken to diagnose and treat it, and I've even watched training videos meant for medical professionals that show demonstrations of pelvic exams and the different types of them! As scary as it is, I do find the things I learn kind of interesting (lol). I've considered listening to music or bringing a comfort item like a stuffed animal, but I'm worried I'll "contaminate" them and forever associate the item or music with the experience. I'm also worried the doctor will judge me for being so scared since things like pelvic exams are so common and logically nothing to be scared of.

How does everyone else calm themselves down and work up the courage to see a doctor? Are there any techniques that help you get through things like physical exams? Should I tell the doctor before hand about my phobia, and if yes, what's the best way to go about this? If you've been dismissed by a doctor, how did you find the courage to keep going and get a second opinion? Also, I've heard of "trauma-informed" providers being talked about online. Would it be wrong/bad if I tried to find one of those? Since I haven't had any sort of sexual trauma, I don't want to take resources from anyone who has, but they seem like a good fit for someone with a situation like mine.

I'm not expecting anyone to have all the answers to my questions as I understand I have a unique situation, but any sort of advise anyone can share is greatly appreciated! Additionally, if anyone has any positive stories related to visiting a gynecologist, I'd love to hear about them! I often only hear about the super negative ones, and that makes dealing with my phobia harder since I start to think those bad things will happen to me, too. I'd love to hear about some happier ones to use as "evidence" against my brain!

(Also a disclaimer: I am currently looking for a new therapist since my old one retired! I know I need professional help! I'm more asking this here to see if anyone else has delt with anything similar and to see if I can find any new coping strategies while I wait to get an appointment with a new therapist. I know an online forum can only do so much, LOL)

[Sam W]

Hi mikeyisscared,

It sounds like you're really taking a lot of steps to try and address this phobia, or at least manage it in a way that doesn't prevent you from getting healthcare, which is something to be really proud of!

I do think that trying to find a trauma informed provider, or a provider who notes they have experience helping patients with a history of assault could be helpful. Even if you don't have that history, a provider with that background will likely have experience helping people through an exam when it could potentially set off panic or other fear for them.

Regardless of the provider you go with, I do think talking with them ahead of time about your fear is a sound call, if only so they can be prepared to offer you the correct kind of support. I would explain the situation to them, as well as what plans you have for trying to manage the fear on your end, and if there are specific things they can do to help you out. This also gives you a chance to see if they have any recommendations for how to make the appointment less nerve-wracking.

Since you're in the process of getting mental healthcare for the phobia, have you done anything besides exposure therapy? That can be useful in a phobia context, but it might also be helpful to talk with your therapist about strategies for managing that phobia in the moment if you have to be around the thing that triggers it. That way, you can start working out things you could do during an appointment that might make it feel manageable to you.

I do want to say that, as someone with anxiety, that "suck it up" advice can be such a double-edged sword. Because on the one hand, sometimes there are things that our anxiety is screaming about that we need to do, because if we don't do them that will just create more problems, so we do have to grit our teeth and get through them. But on the reverse side, if we push to hard, we can end up creating a situation where we're in such a panic that we can't get done what needs to be done AND we're freaking out the whole time. I guess my advice on that boils down to context, and what tools we have in place into manage the anxiety or quiet it for long enough to let us get things done.

[mikeyisscared]

Hi Sam,

Thanks for the reply!

Hearing you say it's a good idea to look for a trauma-informed provider makes me feel a lot better about looking for one. Even though I knew it was a good idea, I always felt guilty about going to one. And I'll definitely tell them about my anxiety. Do you think it would be better to tell them when booking the appointment or to try and see if any providers would do a sort of "consultation" visit first where I can talk to them about things more without having to do any kind of exams? I know they do these kinds of visits for younger first-time patients, but since I'm 22 I don't know if that's an option I have.

I haven't really done much outside of exposure therapy/exercises so far. I was really scared of talking about this phobia so I only had the courage to bring it up to my old therapist about three months before he ended up leaving the practice (he left in June, so I only started working through all of this in March). I have a similar (though nowhere near as intense) fear of dentists, so maybe I could try using some of the techniques I use to get through dentist appointments/procedures in this context.? I don't know how well they'll work, but I'm okay with trying it if it might help.

I also really do like the idea of using music or bringing a comfort item to the appointments. I'm on the autistic spectrum, and I use music to regulate my emotions a TON, so I feel like it would be a good thing for me to use here. I just get worried I'll forever associate whatever song I'm listing to while everything is happening with all of that, so I'm hesitant. I don't want to link my favorite artists with my phobia like that because then I won't be able to use them to help me in other contexts anymore since it'll trigger that same fear response. With the comfort item, I've thought about it a little more, and I think maybe if I get something SPECIFICALLY to help with going to a gynecologist it won't upset me as much. Like, if I got a teddy bear or something who's "job" would be helping me get through appointments, it wouldn't "ruin" any of my other bears or make me feel scared/bad to be around them. Do you think a doctor would judge me for that? People often view me as a child due to being on the spectrum, so I'm just scared the doctor will see that and treat me like a baby, too.

And yes, I do agree with what you're saying about the "suck it up" advice! I know that no matter how much I work on this fear, it's never going to really "go away" if that makes sense. I'm always going to be scared and I'll probably always have trouble with it, but that's just kinda life lol. I will have to just grin and bear it. At the end of the day I know my fear is really irrational, so I try to remind myself that even though it feels like I'm gonna die or something, I'm not actually going to. I was more kind of upset about that advice because it's often given online without any other recommendations or tips for dealing with the anxiety. I posted on reddit once a few years before I ever brought this up with someone irl, and all of the comments I got were just things like "cope" or "everyone is scared, get over it."

I'm trying not to rush myself or push myself too hard in regards to all of this, but I really do want to get help for my period problems. I don't want to live the way I have been for the last 11 years anymore (because it kinda sucks!), and I also want to do all of this sooner than later in case it is something like endo so I still have my parents' insurance to help me pay for it.

Thank you for letting me talk about this!

[Sam W]

I think asking about the consultation option is a great idea! While it is generally for slightly younger patients, you're still brand new to these visits, and you're dealing with a situation where having the consultation could make the process less stressful for you, which is sort of the purpose. If you want help figuring out how to have that initial conversation, that's something we can for sure brainstorm!

If you've had luck with some techniques for getting through dentist appointments, I think it's worth trying them in the context of gynecological exam, especially if your phobia of one has some features in common with the other (for instance, if both involve fear of something being inserted into your body). That would also be the way to go if you ended up having to have your appointment before getting to work on this any more with a therapist, which sounds like the way this is going. I agree that you'll want to see someone about the symptoms sooner rather than later, especially if you have good insurance through your parents right now.

I think assigning a bear or other comfort item to the job of helping you at the gynecologist is a good idea as well! I'd hope the average gynecologist wouldn't be weird about it or judge you for it; certain healthcare can be intimidating or scaring for people, even without a phobia in the mix, so I'm betting any provider who has been working awhile has seen people take a variety of approaches to soothing those fears.

[mikeyisscared]

Sorry for the late reply!

That would be helpful! I'm guessing when I eventually book the appointment I'd probably just put it down as a consultation instead of something like annual visit. I think I'd probably have to split it up over two visits, tbh. Like, I'd use the first one just to talk with the doctor about everything and kinda get to know them in that sense, then the next visit would be where I'd try to do any exams I'd need. This way they'd feel like less of a stranger to me, which I think might make me feel a bit safer.

My goal is to be back in therapy by October (insurance willing)! Although I *really* want to try to power through and just go to the doctor first, I unfortunately don't think I'd be able to safely handle it right now. I'm hoping to be okay-ish and ready to try booking an appointment before my next birthday as a sorta "soft" goal, but I guess it all depends on how well everything goes. I know I'm going to have a rough time no matter what so I think it would be a good idea to have a sorta support team in place before doing this in case I react really badly or something goes wrong.

I'm a little worried I'm going to lose the progress I made with my old therapist since it's been a while since I last saw him, so I'm just trying to come up with little ways to keep working on everything. The brainstorming comment you made actually gave me an idea I want to try! I'm going to make a google doc or something and try to come up with realistic things that I think might help me feel better/more comfortable during an appointment! I'm also going to keep an eye out for a small plushie or other item to give the role of "emotional support friend" to, hehe.

Thank you again for responding to this post. Talking here has helped me get out of panic mode and think more logically/rationally about the situation and how I can help to make it easier on myself. Genuinely thank you so much for your time!!!

[Sam W]

No worries, we always figure users are responding to us at the pace that works for them! And I'm so glad talking here has been helpful!

I agree that this is likely to be two visits, one that's the consultation and one that's an actual exam. When you have that initial conversation, or when you schedule the consultation, I'd aim for being direct yet polite. So, explain the basics of what's going on and why you need accommodations with your appointment (you could borrow the ways you explained it to us here if that helps). I would make sure to actually say that you have a diagnosed phobia; ideally they'd take your needs seriously regardless, but using language that emphasizes this is an intense reaction will likely help you get the care you need.

I think setting a soft goal for when to schedule, and trying to get as many supports in place as possible ahead of time is also a good plan, as is making that googledoc! With that fear of losing progress, I think practicing what skills you can from your old therapist is good plan, and I would be ready to share what those skills are, and what you know about what has, and has not, been helpful in therapy with your new therapist. Too, the more you brainstorm, the more you might realize that you might be in the position to go to the appointment, or at least the consultation, sooner than you thought, which would be ideal. I'd actually see about scheduling the consultation now, if only because, depending on your location, there could be a wait of a month or more for that appointment alone (too, at that consultation, they might be able to advise you on your symptoms without an exam, at least to some degree, meaning you could start addressing what's been happening during your periods).