Routine pelvic exams are important for good reproductive health. A woman should have her first GYN exam when she first thinks about becoming sexually active, when she becomes sexually active or when she turns 18.
At the gynecologist, you will have a short general physical exam, including a breast exam. You will wear a hospital gown and nothing else. For the actual pelvic examination, you will lie down on an examination table with your feet resting in elevated “stirrups” (props that support your legs in the air). Stirrups might look a little scary, but they are there to keep you comfortable. Your legs will be spread apart, with your knees falling to each side so that your vagina is exposed. You may feel uncomfortable, but relax and realize that everyone goes through this.
What typically happens during your first pelvic exam:
The practitioner will visually examine your vulva for discoloration, irritation, swelling and other abnormalities, and will gently feel for glands.
There are two parts to the internal exam. The first involves a speculum, a metal or plastic instrument that the practitioner inserts into the vagina. The speculum is shaped like a duck’s bill, and once it is inserted into the vaginal canal, it is gently widened to spread the interior vaginal walls (this is not painful). As the vaginal walls are spread, the practitioner is able to see the walls of the vagina itself, and up the vaginal canal to the cervix. When viewing the vaginal canal and the cervix, the practitioner can look for discoloration, abnormal discharge, lesions, growths and signs of infection. It is possible for you to look at your own cervix during this process by propping yourself up on your elbows and using a mirror. Some practitioners ask if you would like to do this, but feel free to ask to if she doesn’t mention it first.
Next the practitioner will take a pap smear. She/he uses a long-stemmed cotton swab to collect a sample of cells in the cervix. Some women feel a slight cramping sensation when their cervix is touched. The collected cells are smeared onto a slide and sent to a lab for testing and examination. The pap smear is extremely important for spotting abnormalities in the cervix which may indicate infection or disease.
If you are sexually active, the practitioner will test for STDs. The gynecologist will swab the inside of the cervix with a long cotton swab. The speculum is then taken out of the vagina. The samples are sent to a laboratory for various STD testing. The tests will probably take a couple days. Ask when your results will be available so you can call. If you want to be tested for HIV, syphilis, genital herpes or hepatitis you need to have blood taken. They can do that as well, but you will need to ask since it is not usually routine.
The second part of the pelvic exam is called the manual or bi-manual exam. The practitioner will insert one or two fingers into your vagina and press with her/his other hand on the outside of your lower abdomen. They will use a lubricant on their fingers so it is more comfortable. The person can then feel the uterus, fallopian tubes and ovaries, and check for any swelling or tenderness. Once the doctor is finished checking your uterus and ovaries, the exam is complete. The entire pelvic exam (the parts involving your vagina, cervix, uterus, and ovaries) takes 3 to 5 minutes to complete.
Finally, the doctor will give you a breast exam by pressing with his or her fingers on different parts of your breasts. This is necessary to find “normal” lumps (which are quite common and harmless), cysts, or, in very rare cases, breast cancer. Although breast cancer is very unusual in teenage girls, it’s important to learn breast self-exams, since this can help you detect problems later. The doctor will explain exactly how and when to do breast self-exams and answer any questions you have.
Before You Have Your First Pelvic Exam
Before your appointment, be ready with some information about your family medical history. Among the most common questions are:
• When did your last period start?
• At what age did you start menstruating?
• How long does your period usually last?
These question are an important part of your GYN history and may help you to get pregnant in the future if and when that time comes.
The pelvic exam should not hurt and if it does, let the practitioner know. If it is stressful or uncomfortable, try to relax with some deep breaths. As with any other medical procedure, if you become tense, the exam becomes more difficult. If you are informed ahead of time about what the exam involves, there is no reason to be nervous. She or he will most likely tell you what they are doing when they are doing it. Make sure they know if this is your first pelvic exam.
Keep in mind, you do NOT have to be 18 in order to receive a pelvic exam. You may also see a gynecologist without parental consent.
Ask Your Gynecologist
There are many female gynecologists, nurse practitioners and physician’s assistants today if you prefer a woman to provide you with GYN health care. It’s usually easy to find one in the United States and Canada. Of course, many women still use male health care providers or gynecologists for their GYN exams. Whomever you choose, it’s essential that you be comfortable and honest with her/him, and confident that you will receive quality, attentive care. If you are not satisfied with someone you have seen, find someone else.Video