Gyn exam - Oh! My! GOLLY!!!

My advice about getting pelvic exams and paps is to ask the doctor to use a pediatric speculum.  It makes a difference on the pain level.  I actually have no discomfort for such exams.  However, I do have vaginal stenosis.  I think you doctor is wrong about why you were in pain.  I would say it's most likely vaginal stenosis from the radiation, not a muscle issue.  You probably do have dry tissue in the vagina.  I use a dilator on a regular basis and am on Vagifem vaginal tablets (prescription) to treat the vaginal dryness.  I've begun using coconut oil on the dilator recently and it does seem to help add moisture and flexibility to my vaginal canal.  I would suggest getting a small dilator and some good water-based lubricant, such as AstroGlide.  If the dilator will not go in, buy a box of small tampons and begin with those.

My doctors always use the pediatric speculum.  I didn't know to ask but the first time my gyno did an exam she told me about it.  I also am not sexually active and am 13 years post-menopausal.  I know I have issues with dryness for which I use estrace cream twice a week.  Lately I've had some pain when using my dilator which also sometimes tears tissue a little.  It's quite painful at times and I plan to ask my doctor about it next week.  Frankly, I wonder what your doctor knows about pelvic radiation and vaginal stenosis.

Ouch_Ouch_Ouch said:

Disappointed

jcruz: "Frankly, I wonder what your doctor knows about pelvic radiation and vaginal stenosis."

From the above replies you've all posted, I'm wondering, too. My primary MD (not the oncologist) owns one of those big practices and has 4 gyns on staff. I tried to get through to him to ask for a recommendation as he doesn't hesitate to recommend a specific doctor, even outside of his own group if he thinks it's in a patient's best interest, but the receptionist wouldn't let me leave him a message. When I scheduled, I asked for someone with experience with pelvic cancer and got the appointment with this woman.

Since the post-treatment phase started, I've had a yellow vaginal discharge, something new. Also, my upper inner thighs remain grey/brown-ish (I am of European descent, so it doesn't match). I asked about these things and was told briefly, "They will go away." She said if the tests come back showing disease, that I'll need a colposcopy, but "it will be very hard to do on you".

How does one go about getting dilators? Are they by prescription? Do you obtain them from a medical supply store? If the discoloration doesn't go away by itself, are my bathing suit days over?

Thank you all so much for your support. I wish I'd asked about the gyn exam before I went. >_<

Hi, I am able to have my pelvic exams by a gyno-oncologist per referal by my onc that treated my anal ca. He is WONDERFUL!

I believe this is the site I ordered my dilators from   http://www.vaginismus.com/

It was a couple years ago but I think it was the one Martha had recommended so maybe she can verify.

They come in graduated sizes and I just insert in the shower every morning (or every other or so), it just works best for me but some prefer to be lying down. Before getting them I began with a small (the tiny junior size tampons) but its much easier to use lube (water based) with the dilators.

My rad onc had mentioned using them after treatment but then she moved and no one ever mentioned it to me again until this forum. It was a little uncomfortable at first but sooooo much easier now.

Hope this helps.

katheryn

Ouch_Ouch_Ouch said:

Disappointed

jcruz: "Frankly, I wonder what your doctor knows about pelvic radiation and vaginal stenosis."

From the above replies you've all posted, I'm wondering, too. My primary MD (not the oncologist) owns one of those big practices and has 4 gyns on staff. I tried to get through to him to ask for a recommendation as he doesn't hesitate to recommend a specific doctor, even outside of his own group if he thinks it's in a patient's best interest, but the receptionist wouldn't let me leave him a message. When I scheduled, I asked for someone with experience with pelvic cancer and got the appointment with this woman.

Since the post-treatment phase started, I've had a yellow vaginal discharge, something new. Also, my upper inner thighs remain grey/brown-ish (I am of European descent, so it doesn't match). I asked about these things and was told briefly, "They will go away." She said if the tests come back showing disease, that I'll need a colposcopy, but "it will be very hard to do on you".

How does one go about getting dilators? Are they by prescription? Do you obtain them from a medical supply store? If the discoloration doesn't go away by itself, are my bathing suit days over?

Thank you all so much for your support. I wish I'd asked about the gyn exam before I went. >_<

I didn't have to get the dilators on my own.  About 2 weeks after the end of treatment my rad onc handed me two, one small and one medium and gave me instructions for how often to use, how long, when to go from small to medium.  I guess I'm lucky.

Ouch_Ouch_Ouch said:

A forum blog that describes dilators...

I came across this informative blog post right here in this forum: http://csn.cancer.org/node/178477

However, the gyn told me that since I had cancer, I couldn't use a vaginal cream containing estrogen in spite of what the article states. Unless she's mistaken???

I'm sure the vagifem that I use contains estrogen.  I've had two gynos prescribe it for me with no concerns.

It may be because all Pelvic cancers do not have pelvic radiation as a treatment protocol that you got this doctor. 

It seems to me that she is in no way qualified or even interested enough in what is going on to be seeing you. 

Other than that, everyone's suggestions are terrific here, as usual.

I'm still fuming.

Sincerely,

Sandy

Ouch_Ouch_Ouch said:

Finally saw a gynecological oncologist.

After a lot of confusion between MDs, I finally got a formal referral to a gyncological oncologist. I went today to the Womens Cancer Care Associates in Poughkeepsie, NY.

The doctor I saw was very kind and felt that the gyn I previously saw had no pelvic radiation experience (agreement!). He said that he rarely does any Pap smears at all on his pelvic radiation patients because with the inflammation, the results are always screwy. Instead, he does a colposcopy every 6-12 months and did one on the spot. He said that I'm fine and do NOT need a biopsy. The exam wasn't painful at all.

What a relief! One more to-do item off the checklist and in a non-painful way, too! I'm so grateful.

I've seen a gyn oncologists and two gyns during this period (2 1/2 years) and never heard the word colposcopy.  I'll have to ask about that the next time I see any of my docs.  I've had 3 or 4 paps since treatment but no one has mentioned inflammation.  Another question to ask.

Janet