Whenever I Do a Pelvic Exam My Patients Apologize

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Betty Dodson

Hello Dr. Betty,

I am a relatively new female physician, and I am writing to ask for some advice when providing gynaecological care for patients.

Specifically, my colleagues and I have noticed that whenever we need to perform any sort of pelvic exam, female patients almost always apologize. This usually takes the form of apologizing for their lack of shaving or waxing, any perceived abnormal anatomy, or many times women are just apologetic or ashamed in general. Interestingly, none of us have ever had a male patient apologize when performing a genital exam. Sometimes, I think that women are more worried about what they think their physician/nurse thinks about about "how they look," than the actual pelvic exam itself.

We of course always attempt to put patients at ease before conducting pelvic exams (this usually involves telling them they have nothing to apologize for, this is part of the job, acting professionally, draping to minimize exposure etc.), but I am wondering if you have any specific advice as to how to respond to these situations. I would love to be able to empower/educate my female patients, and ease their fears, while still remaining professional. Any assistance you can provide would be greatly appreciated!

Thank you,


Dear HC,

Finally an aware Gynecologist wanting to address women's insecurity about the appearance of their vulvas. I've spent a lifetime addressing this issue. FIRST women need to use a correct name for their sex organ. It is NOT a vagina which is the birth canal. Then girls need to look at their own vulvas in a mirror under a good light and identify all the different parts and to identify the clitoris.

They can go to our website and view all the drawings of vulvas that I did to show the vast range of vulva styles. (These drawings could be downloaded and used to show your patients before the exam. It would be an opportunity to tune into her main concerns that you could address right then and there. However, this will take up some of you precious time. This is the excuse or reason I've heard from other doctors.

I also have small pencil drawings in my book Sex for One that you could have several copies for patients to view in your waiting room. Or hand out the address of and encourage them to investigate on their own.

Men can't act ashamed because they have to be "butch" and proud. But I'm getting a lot more questions from boys concerned about the size of their penises. Porn hires men who are well-endowed naturally. So they (like girls) make the inevitable comparisons.

We are working on a new video that will be available soon. We see this for all doctors wanting basic sex information. It's a shame, no, a crime, doctors don't get a basic sex education because they are the first group people turn to for sex advice/information. Even therapists know far too little about sexual pleasure that would include orgasms for women as well as the standard ejaculation for men that is NOT necessarily an orgasm when done too fast and hard.

If a girl has only seen porn as an example of female sex organs, most porn stars get their inner labia trimmed. Most male porn directors are convinced that men prefer the "Clam shell" look which is not always the case. I get mail from men who adore long labia. They view as more to love, but the pubescent look prevails

The other problem is vulva grooming. Most porn stars wax their pubes and are totally nude. I only recently did this. Waxing is quite painful, expensive, time consuming and requires an expert technician. So girls shave without knowing how and end up with bumps from ingrown hairs or some awful rash. The smart ones just trim with scissors or stay natural. The same as with media, TV, movies, fashion magazines and now porn, girls want to live up to some unattainable ideal.

We are all victims! Meanwhile is working round the clock to get out solid, pleasure based sex information to our sorry world.

Thanks for asking.

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