What your patients do not want to hear

[Dr. Pacik]

I am in the process of writing a Clinical opinion for one of the journals which will include a Table outlining what is offensive to patients looking for advice or treatment. The following table represents some of the more common condescending remarks. Please add to this list negative experiences that you encountered to make the list complete.

Table: What your patients do not want to hear (condescending remarks)
“Don’t be a baby”
“Can’t you just relax”
“It’s all in your head” (very common)
“Come back when you are more relaxed”
“Have a drink” (also common)
“You need to practice stretching your vagina”
“It’s just first time jitters”
“It will get better with time”
“Let me recommend some lubricants”

[Heather34]

I had trouble keeping my legs open for any gynecological examination due to severe anxiety. My ob/gyn became immediately frustrated and told me that my muscles were unusually tight and she had never seen such strong muscles.

Other comments, in no particular order:

“You know what, I’m going to use the baby speculum” (which never worked)

“There’s nothing physically wrong with you”

“There must be something wrong with your relationship”

“Just tell yourself sex won’t hurt and it will be okay”

“I won’t examine you again until you receive sex therapy. Here is the name of a sex therapist that I recommend. After you see her, you can come back to try an exam.”

[Nakitalab]

“The pain will go away after you have had sex a few times. You will get used to it.”
“You need to take a valium before you come for an exam. It’s just because you are nervous.”

[missa05200]

“You need to just chill out.”
“Quit worrying about it.”

[23years]

*you have Vulvodynia not Vaginismus (wrong)
* you have penis envy
*you may be sexually confused
*you need to read and meditate more
*have you ever read the bible?
*wow you must be Desparate (when considering Botox)
*heres some lidocaine ointment to help you have sex with your husband
*there are lazor treatments that are available by the GYN experts, it’s not a cure but it makes it “better”

[kelseroo]

“Just drink some wine”
“Just do more foreplay”
“If you masturbate that will help.”
“That lube didn’t help? try this one.”
“Try this anti-anxiety medication.”
“Just keep practicing.”

[Allie]

“You must of been sexually abused.”

[Dr. Pacik]

Your comments were included in Table 2 of the published Clinical Opinion paper as noted below.

I have been sending a copy of this paper to new inquiries so they have a scientific basis for understanding vaginismus. I am also encouraging new patients to send a copy of this paper to their doctors both to get a more meaningful referral for treatment (which helps with insurance reimbursement) and so the doctors themselves can better understand this condition. I thought it would be worthwhile to make this publication available to anyone who would like an electronic copy. Just contact Cynthia or Lisa at my office and they will forward the file to you. I will also have them send a copy of a published Letter to the Editor explaining how vaginismus is still not taught in medical school, residency training and at meetings. Ask for the CLINICAL OPINION paper and the Letter to the Editor.

Here is the table that was published. I was somewhat surprised the journal included this Table!

Table 2
What your patients do not want to hear (condescending remarks)

“Don’t be a baby”
“Can’t you just relax”
“It’s all in your head” (very common)
“Come back when you are more relaxed”
“Have a drink” (also common)
“You need to take a Valium before you come for an exam. It’s just because you are nervous.”
“You need to practice stretching your vagina”
“It’s just first time jitters”
“It will get better with time”
“Let me recommend some lubricants”
“You need to stop believing that your vagina is messed up because you are the one causing this and stopping yourself from having a normal sex life.” (This comment after successful treatment of severe vaginismus but crying because of the speculum exam.)
“The pain will go away after you have had sex a few times. You will get used to it.”
“You know what, I’m going to use the baby speculum” (which never worked)
“There’s nothing physically wrong with you”
“There must be something wrong with your relationship”
“Just tell yourself sex won’t hurt and it will be okay”
“I won’t examine you again until you receive sex therapy. Here is the name of a sex therapist that I recommend. After you see her, you can come back to try an exam.” –

I’m still shaking my head in disbelief!

[Dr. Pacik]

The easiest way to request a reprint is to complete the contact form by linking to http://www.vaginismusmd.com/contact/
Let my staff know that you would like the reprints titled “Clinical Opinion” and the Letter to the Editor.

[Dr. Pacik]

The article is now available by linking to http://www.vaginismusmd.com/vaginismus-resources/publications/
At the bottom of the page you can click on the article Understanding and Treating Vaginismus which will take you to the published article. I find that physicians and therapists get considerable educational information from this article and are better able to write letters of referral which helps with insurance coverage. It is also helpful for vaginismus suffers, and though scientific, can be understood by most of the women on the Forum.

[Heather34]

Quote:

Quote from Dr. Pacik on August 28, 2014, 15:37
Your comments were included in Table 2 of the published Clinical Opinion paper as noted below.

I have been sending a copy of this paper to new inquiries so they have a scientific basis for understanding vaginismus. I am also encouraging new patients to send a copy of this paper to their doctors both to get a more meaningful referral for treatment (which helps with insurance reimbursement) and so the doctors themselves can better understand this condition. I thought it would be worthwhile to make this publication available to anyone who would like an electronic copy. Just contact Cynthia or Lisa at my office and they will forward the file to you. I will also have them send a copy of a published Letter to the Editor explaining how vaginismus is still not taught in medical school, residency training and at meetings. Ask for the CLINICAL OPINION paper and the Letter to the Editor.

Here is the table that was published. I was somewhat surprised the journal included this Table!

Table 2
What your patients do not want to hear (condescending remarks)

“Don’t be a baby”
“Can’t you just relax”
“It’s all in your head” (very common)
“Come back when you are more relaxed”
“Have a drink” (also common)
“You need to take a Valium before you come for an exam. It’s just because you are nervous.”
“You need to practice stretching your vagina”
“It’s just first time jitters”
“It will get better with time”
“Let me recommend some lubricants”
“You need to stop believing that your vagina is messed up because you are the one causing this and stopping yourself from having a normal sex life.” (This comment after successful treatment of severe vaginismus but crying because of the speculum exam.)
“The pain will go away after you have had sex a few times. You will get used to it.”
“You know what, I’m going to use the baby speculum” (which never worked)
“There’s nothing physically wrong with you”
“There must be something wrong with your relationship”
“Just tell yourself sex won’t hurt and it will be okay”
“I won’t examine you again until you receive sex therapy. Here is the name of a sex therapist that I recommend. After you see her, you can come back to try an exam.” –

I’m still shaking my head in disbelief!

Hi Dr. P. I am stunned that the journal included this but it also makes me so, so, so, so happy that they did. It is so very sad but so many women have heard and continue to hear these remarks concerning vaginismus. This is an excellent teaching tool for clinicians to read in order to further understand the condition and, as you stated, what patients DO NOT WANT TO HEAR.