I haven't had an exam in almost two decades. The first time I did, the woman doing the exam used the metal speculum and just shoved it in. Being a virgin, it was excruciating. I also tilt to the side and it ended up causing some bleeding for a couple of days. It's been about 13 years since my last sexual encounter, and I haven't been back. That first visit has be terrified that someone is going to be careless, again and cause some real damage.