Why You Need These Exams
The American College of Obstetricians and Gynecologists
recommends that a girl make her first visit to a gynecologist when
she is between the ages of 13 and 15. Not all girls will need a
pelvic exam during this initial visit, though. Many gynecologists
will just do a regular health exam and talk to the girl about her
Yearly gyn visits are important for a number of reasons,
as a routine check.
You'll want to be sure you're developing normally.
to deal with a problem.
There may be a number of concerns that lead to a pelvic exam. For
example, if you have problems with your periods, missed periods,
pain, signs of infection, and worries about development, it's
a good idea to see a doctor.
Also, if you have ever had sex, you are probably going to need a
Choosing the Right Doctor
If you're going to be involved in deciding who you'll
see for your pelvic exam, you have a few choices. Many family
doctors and pediatricians perform pelvic and breast exams and
advise teens on birth control and STD prevention. So you may be
able to see a doctor you already know and feel comfortable with for
your first pelvic exam.
Also, a number of different kinds of doctors and nurses have
special training in women's reproductive health:
are doctors who have been specially trained in women's health
issues. Gynecologists are one of the doctors who can prescribe
birth control and teach patients how to use it.
Adolescent medicine doctors
have been trained in the health and management of teen issues.
They are familiar with the concerns most young women have about
their reproductive systems and can advise them on birth control
and STD prevention.
have had advanced training that allows them to give gynecological
exams and pay special attention to women's reproductive
Whether you want to see a male or female health care
professional is up to you. Some women say that they prefer being
examined by a female doctor or nurse because it puts them more at
ease and they feel like they can talk more openly about women's
health problems and sexuality issues. Other women feel comfortable
being examined by a male doctor or nurse. If the doctor or nurse is
male, he will usually have a female assistant in the room with him
during all parts of the exam.
Making the Appointment
It's best to involve your parents in your health care. If
you want to go to a doctor's office for your exam, you may need
to involve an adult for insurance purposes (it may be expensive
If for some reason you can't involve your parents, you can
take advantage of health clinics like Planned Parenthood or your
local teen clinic. These clinics have fully trained staff who often
can care for you at a lower cost and respect your need for
confidentiality. Each state has different guidelines on which
medical issues teens can get confidential care for. Your doctor
should be able to explain these issues to you.
The most important thing is that you feel comfortable with the
person who is examining you. You want to be able to talk with him
or her about important personal health and relationship issues,
including birth control.
What Happens When You Go for Your Gyn Exam
You don't need to do anything special before going for your
exam. When you make the appointment, try to schedule the exam for a
time when you won't have your period. For many young women,
that can be hard to predict, though - lots of girls have irregular
periods at first. Ask the doctor's office or clinic when you
make the appointment what you should do if you get your period.
Some doctors say it's OK to come for an exam if your period is
just beginning or just ending and it's very light, but everyone
has a different policy.
When you arrive for your appointment, you may be asked to fill
out some forms while you wait. These forms ask questions about any
illnesses or conditions you have, your health habits (like whether
you drink or smoke), any family illnesses that you know of, and
your history regarding sexual activity, pregnancy, and birth
control. You might also be asked for the date of your last period
(or a doctor or nurse will ask during your exam).
When you first go into the exam room, a nurse or medical
assistant will do a few things that your doctor has probably done a
million times before, such as recording your weight and taking your
blood pressure. You'll then be left alone to change out of your
clothes. It may feel weird taking off even your underwear because
you may not have had to undress completely for a medical exam
before. The nurse or medical assistant will leave you a paper sheet
or gown - or maybe both - to cover you. If you're cold, most
doctors and nurses won't mind if you keep your socks on.
After a few minutes, the doctor (or nurse practitioner, if that
is who you choose to see) will knock on the door to make sure
you're in your gown. If you're ready, he or she will come
in and start the exam. The doctor may start by going over anything
you wrote down on your forms, or you may talk about these things
If this is your first gynecologic exam, let the doctor know.
That way, he or she will know to go slowly and explain everything
that's going on. Now is also the time to ask about birth
control or sexuality if you need to. Some doctors like to discuss
these things before the exam, and some like to do it after. Your
aim is to make sure you get your questions answered.
The Breast Exam
During the physical part of the gynecologic exam, you'll be
asked to lie on your back on the table. You'll have the paper
sheet or gown covering you, and the doctor will only uncover the
parts of your body being examined.
The doctor will give you a breast exam by lightly pressing on
different parts of your breasts. After finishing, he or she may
show you how to examine your own breasts. This helps you become
familiar with how your breasts feel so you know which lumps are
normal and which may be the result of a change.
The Pelvic Exam
During the pelvic part of the exam, the doctor or nurse
practitioner will ask you to move down so your behind is at the end
of the table. You'll bend your knees and rest your feet in two
stirrups, which are metal triangular loops that stick out from the
end of the table. These might look a little scary, but they're
just there to rest your feet in and keep you more comfortable. The
doctor will ask you to relax your knees out to the sides as far as
they will go. It might feel a little funny to be lying with your
legs opened like this, but everyone feels that way at first.
The doctor will put on gloves and examine the outside of your
vagina to make sure that there are no sores or swelling and that
everything looks OK on the outside.
The Internal Exam
Next, the doctor will want to look at the inside of your vagina
and will do so with the help of a
-kyuh-lum). A speculum is a thin piece of plastic or metal with a
hinged piece on one end that allows it to open and close. The
doctor or nurse will warm the speculum with water (some offices
keep the speculum warmed in a drawer with a heating pad). The
doctor or nurse will then slide the speculum into your vagina.
Usually the doctor will tell you when he or she is about to place
the speculum inside you so it doesn't come as a surprise.
Once the speculum is in the vagina, it can be opened to allow
the doctor to see inside. Putting in and opening the speculum
should not be painful, although some women say that it can cause a
bit of pressure and discomfort. Naturally, if this is your first
exam, you might feel a little tense. Because the vagina is
surrounded by muscles that can contract or relax, the exam can be
more comfortable if you try to stay calm and relax the muscles in
If you feel like you're tensing up the muscles in your
vagina, try breathing deeply or doing some breathing exercises to
help you stay relaxed. Sometimes humming your favorite song or
making small talk can distract you and allow you to feel more
After the speculum is in place, the doctor will shine a light
inside the vagina to look for anything unusual, like redness,
swelling, discharge, or sores.
Because the ovaries and uterus are so far inside a girl's
body that they can't be seen at all, even with the speculum,
the doctor will need to feel them to be sure they're healthy.
While your feet are still in the stirrups, and after the speculum
is removed from the vagina, the doctor will put lubricant on two
fingers (while still wearing the gloves) and slide them inside your
vagina. Using the other hand, he or she will press on the outside
of your lower abdomen (the area between your vagina and your
stomach). With two hands, one on the outside and one on the inside,
the doctor can make sure that the ovaries and uterus are the right
size and free of cysts or other growths.
During this part of the exam, you may feel a little pressure or
discomfort. Again, it's important to relax your muscles and
take slow, deep breaths if you feel nervous.
A Pap smear may be part of the pelvic exam, although not all
teens need to get a pap smear. Pap smears are used to check for
abnormal cells. The American College of Obstetricians and
Gynecologists recommends that girls should get a Pap smear about 3
years after first having sex and then every year after that. All
women should have a Pap smear by age 21.
To do a Pap smear, the doctor will gently touch the
cervix to pick up cells from that area.
The Pap smear shouldn't hurt, but it might be uncomfortable,
especially if this is your first pelvic exam. The good news is this
part of the exam is over quickly.
The cells that have been collected are sent to a laboratory
where they are studied for any abnormal cells, which might indicate
infection or warning signs of cervical cancer. (Like breast cancer,
cervical cancer is very unusual in teen girls.)
If you have had sex, the doctor or nurse practitioner may test
for STDs. He or she will swab the inside of the cervix with what
looks like a cotton swab. The speculum is then slid out of the
vagina. As with the Pap smear, the sample is sent out to a
laboratory where it is tested for various STDs.
Talk to your doctor or a nurse about how you want to be
contacted with results, and what they should do if they are unable
to reach you. Again, doctors and nurses will do their best to
maintain confidentiality, but they need to be able to reach
After the Exam
Although reading this article may make it seem long, the entire
pelvic exam (the parts involving your vagina, cervix, uterus, and
ovaries) really only takes about 3 to 5 minutes.
Afterward, you'll be left alone to get dressed. Some women
say that they bleed a tiny bit from the Pap smear after the exam,
so they like to put a pantiliner in their underwear as they get
dressed. If you bleed a tiny bit, it's no big deal - it's
nothing like a period and it won't last.
If you haven't discussed your questions before the exam,
now's the time. Don't be afraid of questions that sound
stupid or silly - no question about your body is stupid, and this
is the best time to get answers.
The Pap smear is almost always normal in teen girls. But if for
any reason the doctor or nurse practitioner needs to see you again,
the office or clinic will let you know. Unless you notice any
health problems, you won't need to go for an exam for another 6
months to a year.
It's very important to go for pelvic exams on a yearly basis
- even when you're feeling good - because they help detect any
problems early on. If you don't want to return for another exam
because you didn't like the doctor or nurse practitioner, look
into finding a new doctor or clinic.
And if the physical discomfort of the exam left you not wanting
another, remember that each time it gets easier and easier to
relax. Naturally, no one loves getting an exam, but having a doctor
or nurse practitioner you trust can really help.
Larissa Hirsch, MD
Date reviewed: March 2009
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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