I had my first exam a couple weeks ago. This is pretty accurate to my experience, except that my doctor did do the bimanual exam. That part was more uncomfortable, but none of it was painful. I would say worst parts were the bimanual, how chilly the gel was, and some situational discomfort. I would assume that cases of more severe discomfort would stem from difficulty relaxing, from roughness on the doctor's part, or from the sort of medical difficulty the examination is looking for (in which case, at least it helps to fix the problem).