Let’s Get This Over With: Making Pelvic Exams Suck Less
No one’s ever said, “You know what I’m excited for? Getting a speculum inserted by a stranger.” And honestly? Fair. Pelvic exams can be awkward, uncomfortable, or just deeply not on your to-do list — especially if it’s your first time or you’ve had a bad one before. But here’s the truth: it doesn’t have to be awful. With the right provider, a little prep, and a few good tricks, it can be quick, manageable, and actually empowering. Let’s break down what’s happening, what’s normal, and how to make it way less sucky.
What Even Is a Pelvic Exam?
A pelvic exam is a physical check-up of your vulva, vagina, cervix, uterus, and ovaries. It might include:
- A visual exam (just looking at the outside)
- A speculum exam (inserted tool to see your cervix)
- A bimanual exam (gloved fingers inside, pressure on your abdomen outside)
- Possibly a Pap smear (read our article about Pap smears to learn more!), or other swabs and testing as needed
You might get all of these or just one — depending on why you’re there.
When Do You Need One?
- When you're due for a Pap smear (these typically start at age 21 — timing varies based on age and past results)
- If you're having symptoms (pain, discharge, irregular bleeding, etc.)
- During pregnancy or fertility care
It’s Not All in Your Head (But Your Head Still Matters)
If a provider has ever told you it’s “just in your head,” we want to be clear: that’s not okay. But there is a connection between your brain and your body — and that connection can crank up discomfort.
Think about it: when your crush walks by, you feel butterflies in your stomach. (And no, there aren’t actual butterflies fluttering around in there… we think.) That’s your nervous system reacting.
So if you’re walking into a pelvic exam already anxious, already expecting pain, and maybe not feeling 100% safe with your provider? Your body goes into protective mode. Muscles tighten. Sensation heightens. Pain gets worse — not because you’re weak, but because your brain’s trying to protect you.
Some tools that can help short-circuit the spiral:
Play music or calming sounds
Bring earbuds or watch TikToks
Try meditation or white noise
Bring a stress ball or something to squeeze
Talk to a friend during the visit
Bring a support person
Ask your provider ahead of time for a one-time anxiety medication (totally normal and valid)
You Don’t Have to Do It on the First Visit
Meeting a new provider? You can totally say, “I just want to talk today.” You don’t owe anyone a pelvic exam at Visit #1. Build trust first, then book the exam when you’re ready.
Let’s Talk Comfort Tactics
You’re Allowed to Set Boundaries
You can say:
- “Please explain what you’re doing before each step.”
- “Use the smallest speculum available.”
- “Let me insert it myself.”
- “Stop if I say stop.”
You Can Ask to See the Tools
Some people feel better seeing what’s about to be used — like the speculum. Others… not so much. You can ask to see it, or say, “Please don’t show me.” Just tell your provider what works for you.
Positioning Can Make a Big Difference
Scoot your butt down until it’s slightly off the table. Yes, really.
And the more your knees can fall open (think: distance between them), the more your pelvic floor muscles relax. That means less resistance and less discomfort.
As counterintuitive as it sounds: the more exposed you are, the less likely it is to hurt.
Can You Use Numbing Gel? Yes.
Some offices offer a topical anesthetic like lidocaine or benzocaine. But not all do — so it’s okay to ask.
And if they don’t have it, ask your doctor to prescribe some that you can bring to future appointments. This is totally reasonable and it helps.
Let’s Talk Trauma and Triggers
If you’ve had a bad experience — medical or otherwise — pelvic exams can bring that up.
You are allowed to say, “I’ve had a hard time with exams before, and I need you to go slow.” Or: “I’ve experienced trauma and need to be in control.”
Your provider should meet you with compassion — and if they don’t? You have every right to leave and find someone better.
You Don’t Have to Be Chill About It
Feeling nervous? Totally normal. Feeling tense? Also normal.
You’re allowed to say this makes you uncomfortable.
You’re allowed to joke.
You’re allowed to cry.
You’re not overreacting — this is an intimate experience, and you’re doing your best.
This Article Covers Routine Exams Only
For more invasive procedures like IUD insertions, biopsies, or colposcopies — check out our separate article all about why those shouldn’t be as painful as they often are (and what we can do about it).
TL;DR: Pelvic Exam Pep Talk
You’re allowed to ask questions.
You’re allowed to set boundaries.
You can bring your own numbing gel, a playlist, or a whole-ass friend.
You can delay the exam until you’re ready.
You can say no at any point.
And you can absolutely get through this.
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