by Brunilda Nazario, MD
You may not be very excited about your first visit to the gynecologist, a doctor
who specializes in women's health. But you may actually end up enjoying it.
It’s an opportunity to start becoming actively involved in your own health care.
It’s a chance to ask all those questions you have about your changing body and to
pick a doctor you’ll want to talk to about private issues.
Here’s what you can expect at that first visit and at your first pelvic exam.
Preparing for Your First Visit
You should have your first gynecologic exam by the time you're 15 years old.
You may want to take your mom to your first visit for moral support, and to help
answer the doctor’s questions about your family health history and the vaccines
you’ve had. It's your personal choice whether you'd rather see a woman or
man gynecologist. The most important thing is that you feel comfortable with and
trust the person.
You don’t really need to do anything before a visit or exam. But you might want
to write down when your periods started, when your last period was, and how often
you have them. You could also write down questions so you don’t forget them. There
really is no question that is too strange. “We’re pretty impossible to shock,” says
Melisa Holmes, MD, who co-wrote Girlology Hang-Ups, Hook-Ups, and Holding Out: Stuff
You Need to Know About Your Body, Sex, & Dating.
What Happens at the First Visit
Your visit may include:
A conversation in the gynecologist’s office. Before you undress
for the exam, you may sit and talk in the doctor's office. The doctor will ask
you questions about your health and lifestyle. Tell your doctor that this is your
first gynecologic exam.
A physical exam. You probably won't get an internal pelvic exam,
in which the doctor looks inside your vagina. Instead, the gynecologist will examine
your outside genital area -- your vulva -- and your breasts. The doctor will press
lightly on different parts of your breast to feel for lumps. If your doctor is a
man, don't be surprised if he asks for your mom or a nurse to be present during
the exam. That’s common.
If you are having pain with your period, unusual discharge, or abnormal bleeding,
the gynecologist may want to do a complete pelvic exam. If you are not sexually
active and have no problems, you may not need a pelvic exam until your late teens
or later. But you should have one by the time you're 21.
What Happens During a Pelvic Exam
“I love being able to do a girl’s first pelvic, so I can help her realize it’s not
a big deal,” says gynecologist Holmes. “First, I show her the speculum we use on
teenagers -- it’s about the size of a super tampon.”
When it's time for your first internal pelvic exam, you'll lie on your back,
your bottom scooted down to the end of the exam table. You'll put your feet
in two metal stirrups, so that your legs are bent and spread apart. You’ll wear
a paper robe and have a sheet covering you for privacy. There are two parts of the
Vagina and cervix exam. The gynecologist will insert a closed speculum
-- a metal or plastic gadget that looks kind of like tongs -- into your vagina.
Then the doctor opens the speculum to hold the vaginal walls apart, in order to
get a good look inside to make sure the walls, discharge, and cervix look healthy.
If you are 21 or older or it's been about 3 years after first having sex, the
doctor may use a small brush to take some cells from your cervix for a pap smear.
Bi-manual exam. Bi-manual exam. After removing the speculum, the
gynecologist will slide one or two gloved and lubricated fingers into your vagina.
With the other hand, the doctor presses on the abdomen from the outside. In this
way, the doctor can check that your fallopian tubes, uterus, and ovaries are in
the right position, and that there is no swelling or growths. The doctor is also
checking for pain. When you schedule your exam, ask the doctor's office what
you should do if you're having your period. Some doctors may ask you to reschedule
if your period is heavy. Menstrual blood can interfere with the results of a pap
3 Ways to Relax During a Gynecologic Exam
A pelvic exam may be uncomfortable, but it shouldn’t be painful. The key is to relax.
Holmes offers these tips if you have the jitters during an exam:
Do deep, slow breathing.
Let your legs relax open as far as they will go.
Don’t squeeze your butt cheeks together. “If you squeeze your bottom, it
squeezes around the speculum,” she says.
Confidentiality and Talking Honestly
Remember, anything you discuss with your gynecologist about sex, birth
control, pregnancy, STDs, or drug or alcohol use is private and confidential. If
your mom comes with you to your visit, the gynecologist will probably ask her to
leave the room while you talk about some of these things. It's important to be
honest because many things can affect your sexual health.
American Congress of Obstetricians and Gynecologists: “Your First Gynecologic
Melisa Holmes, MD, obstetrician-gynecologist, Greenville, S.C.; coauthor,
Girlology Hang-Ups, Hook-Ups, and Holding Out: Stuff You Need to Know About Your
Body, Sex, & Dating, Health Communications, Inc., 2007.
Jean Curran, MD, gynecologist, Bayspring Medical Group, San Francisco.
KidsHealth: “Breast and Pelvic Exams.”
Illinois Department of Public Health: “Human Papillomavirus.”
by Brunilda Nazario, MD on August
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