A 40-year-old woman reports pain with penetration. She is an…
A 40-year-old woman reports pain with penetration. She is anxious about pelvic exams due to prior painful intercourse. On exam, Q-tip testing is minimally tender, but she has marked involuntary pelvic floor tightening during attempted speculum insertion and cannot voluntarily relax the pelvic floor despite coaching. Which initial intervention is most appropriate?