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How long can I put off reproductive health exams?

smartblonde asks:

I am a 22 year old female, but I have never had a breast and pelvic exam. I know what happens (I've read your articles as well as other websites), and I'm terrified. I don't like people touching me in general (people sitting right next to me, my parents putting a hand on my shoulder), and the only person who can touch me is my long-term (over 1.5 year) boyfriend. I've discussed this fear with my doctor. I'm also a very private and am not comfortable being around others if I'm not fully clothed, even changing my shirt with my roommate in the room - another problem I have with prospect of the exam.

My boyfriend and I have recently decided we'd like to have sex, so I've gotten a prescription for the birth control pill. However, the doctor said she will not prescribe it year after year without doing a regular breast/pelvic exam; she hopes that after I've been having sex for a while I'll become more comfortable with the idea of the exam, but I'm not. I understand why I should have this exam, so I've even tried just scheduling one to force myself to do it. Unfortunately, after a few hours I began to panic and didn't calm until I cancelled the exam. There is no history of breast cancer or any sort of reproductive problem in my family, and I do a monthly breast exam on myself. How long can I safely put off the breast/pelvic exam from the doctor? My boyfriend will come with me, and the doctor said she can give me anti-anxiety medicine, but I'm still worried even if I go through with it I'll become depressed afterward (I have struggled with depression before). Even though these things would help, I'm still terrified, and I begin to panic whenever I think of it. I know I should have had an exam already, but I'd like to know how much longer I can safely delay it.

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