Women’s Health and the American Congress of Obstetricians and Gynecologists (ACOG) teamed up on an exclusive survey that revealed how much women know about their own anatomy. The answer, sadly: Not a whole lot. To help you better understand your nether regions, we created an all-inclusive guide to your private parts in our November 2014 issue. This article is part of that package.
Before you book your regular appointment, read on for important information about exam guidelines, common issues, and how to be more proactive about your vaginal health.
New Rules for Pelvic Exams
Used to be, you got a yearly pelvic exam, rain or shine. Now new government guidelines call for a drastic reduction in the look-sees, in which your M.D. shines a flashlight and feels around inside you. (A pelvic exam is not the same thing as a Pap smear test that screens for cervical cancer, though a Pap can be done during a pelvic exam.)
Experts say that a personalized exam schedule—basically, your doc will determine if and when you need one—will cut rates of costly misdiagnoses. Not everyone is thrilled. Forgoing an annual scan can make some women nervous. But rest assured, those at high risk or who are just uneasy can still request the test. Insurers do take cues from guidelines, so call first to make sure you’re covered.
5 Common Gynecological Troublemakers
Polycystic Ovary Syndrome
The world’s most widespread reproductive disorder is also the most common cause of female infertility. Polycystic ovary syndrome, or PCOS, is likely caused by high levels of “male” hormones that can lead to cysts, missed periods, or skipped ovulation. Type 2 diabetes and obesity skyrocket your risk.
Killer period cramps are the hallmark of this fertility-hindering condition that hits some 176 million women worldwide. It happens when the uterine lining sheds up instead of out, glomming on to the ovaries, GI tract, even lungs. Surgical treatments can be highly successful.
Sexually Transmitted Infections
Just 7 percent of you knew that nearly every sexually active woman will get the human papillomavirus (HPV) in her lifetime. Yup, 20 million new STI’s of all kinds are diagnosed each year. Some, like chlamydia, can be curable hassles; others like HPV aren’t curable but are treatable if ID’d early.
These uterine growths range from microscopic to the size of a football. Around four out of five women will have one at some point, so look out for symptoms such as painful sex and irregular bleeding. Most docs take a “watch and wait” approach before—if ever—scheduling surgery.
Despite much media hype, infertility rates—even those in women over 35—are actually falling. Still, one in 10 couples has trouble conceiving and, generally, the older you are, the higher your risk. If you’ve been “trying” for more than six months without luck, talk to your doc.
How to Do a Self-Check Down There
Squeamish? Get over it. Giving your bits a yearly once-over is the number-one way to stay safe. Here’s how:
1. Squatting makes it hard to get a good glimpse. Sit in a chair or on the floor, open your thighs, and elevate one leg.
2. Using a handheld mirror, note the size and color of your labia and clitoris (this might involve some touching), as well as any bumps or rough spots (chill—no one’s skin is perfect down here, either).
3. Train your eyes on your vaginal opening, then on your anus—you shouldn’t see tissue peeking out of either.
4. If you ID any major changes, blisters, open sores, or protruding tissue, call your doc. Otherwise, put your big-girl panties back on and pat yourself on the back.
More from Women’s Health:
Everything You Need to Know About Vaginas
How Your Vagina Changes in Your 20s, 30s, and 40s
5 Hormones That Mess With You Every Month
- 7 Things You Should Always Discuss with Your Gynecologist
- Low Libido
- Your First Gynecologist Appointment
- Your First Appointment With The Gynecologist
- When should you start your gynecologic checkups?
- What will happen at your first gynecological appointment?
- What are gynecologic exams?
- How should you prepare for your first appointment?
- 1. You don’t need a reason to schedule your first appointment.
- 2. Being nervous is normal…but you don’t need to be!
- 3. You don’t need to wax or shave before your appointment.
- 4. You can bring someone with you, or you can have them wait outside. It’s up to you.
- 5. Be prepared for honesty.
- 6. If you have your period, it’s a good idea to reschedule.
- 7. Drink some water before you show up — you’re going to pee in a cup.
- 8. You don’t need to give a blood sample.
- 9. If you’re under 21, you don’t need a pelvic exam yet.
- 10. You can get the birth control pill without having an internal exam.
7 Things You Should Always Discuss with Your Gynecologist
While having a low libido is more common than many women realize, it’s important to speak with your gynecologist to discover the cause of your concern. Libido can sometimes be affected by medications you take, or it may be a sign of an underlying medical condition or a side effect of a known condition. In these situations, your gynecologist can determine what medical interventions may be necessary.
For other women, though, their low libido may be related to the nature of female sexuality — sometimes, your desire to have sex or be intimate can be affected by things outside of your control, like stress or work. Women in long-term relationships are also less likely to be spontaneously aroused compared to the early stages of their relationship.
In these circumstances, your gynecologist can make recommendations to help you naturally increase your libido and/or refer you to an appropriate counselor. Lawson explains: “I tell my patients that the more frequently you attempt to have sex, the more frequently you will want to have sex because of the endorphins released during intercourse. This will make you feel more intimate toward your partner.”
Your First Gynecologist Appointment
What to Expect at a Gynecologist Appointment
When you arrive at the doctor’s office for the OB visit, you will most likely start by filling out paperwork about yourself for the staff and doctor. Later, the nurse who takes you back to the exam room might ask some of the same questions. Remember, all your answers are confidential. That means they cannot be shared with anyone unless you give permission.
The paperwork you fill out and the discussion with the nurse or doctor could include the following questions:
- Why you scheduled the gynecologist appointment
- Your family health history
- Your personal health history
- Medications, vitamins, or supplements you are taking
- Any surgery you’ve had
- Whether you are sexually active
- Your age when you started having menstrual periods and when your most recent period occurred
- Whether you smoke, drink alcohol, or use illegal drugs
- The name of your primary care doctor or family doctor
- The name and contact information of someone to call in case of an emergency
If your parents or someone who has known you and your family a long time isn’t going to be with you to fill out this paperwork, you might want to do some research ahead of time and ask about health history, both yours and your family’s. Find out if close relatives have had heart disease, cancer, osteoporosis, or other types of chronic conditions, such as diabetes. (If you are going by yourself to the doctor, make sure that you also have any needed information about your family’s health insurance, co-pays, or payment plans.)
At your OB visit, you’ll probably spend time with a nurse first and then with an ob-gyn (obstetrician-gynecologist), a doctor who specializes in the care of a woman’s reproductive system, including vagina and uterus as well as the breasts (the gynecologist part) and who monitors pregnancies and delivers babies (the obstetrician part). An ob-gyn cares for a woman throughout her lifespan, starting with the first appointment. Dr. Trent points out that your pediatrician or family doctor might also be able to perform your first gynecological exam.
Your first appointment will probably include a discussion with the nurse and the doctor about your health and any concerns you might have. This is a good time for you to ask them what to expect from the exams – the physical exam and, if you agree to it and need it, the pelvic and vaginal exam. These exams might include testing for sexually transmitted diseases if you are sexually active.
About OB Visit Exams
From the patient’s point of view, the most worrisome part of a gynecologist appointment is usually the physical exams. You might be asked to take off your clothes and wear a special robe or gown. A nurse will probably be present in the room during the exams. You can ask for a friend or relative to be with you, too. Girls often bring their mother with them, sometimes to hold hands with, during the exam, Trent says.
There are several basic exams that you might have during an OB visit:
- Physical exam. The nurse will take your weight, pulse, and blood pressure. If you have other health concerns, the doctor might address them at this time.
- Breast exam. The doctor may do an exam of your breasts. You may be asked to raise and lower your arms as the doctor gently palpates your breast tissue and nipples.
- External genital exam. The doctor may ask you to lie down and put your legs up in special stirrups and look at the outside of your genital area to determine that you’ve gone through puberty and that your development is normal, explains Trent.
- Pelvic exam. This exam might not be part of your first gynecologist appointment, particularly if you are not sexually active. In a pelvic exam, the doctor will look inside your vagina using an instrument called a speculum. She might also use long cotton swabs to collect samples of cells and mucus to test for infection and as part of a Pap smear, a test for cervical cancer. After she removes the speculum, she might check the position of your uterus, vagina, and ovaries with her gloved hands.
A Time for Your Questions
The American Congress of Obstetricians and Gynecologists recommends that girls have their first visit between the ages of 13 and 15. One of the best reasons to meet with your ob-gyn is to ask any questions you have about your body and your sexual and reproductive health.
During this visit, ask about the exams and tests you will have done and who will call you with the results. “How can I keep myself healthy before I see you again?” is another important question. “No question is inappropriate, no question is stupid,” says Trent, who adds that questions about menstruation are among the most commonly asked.
Going to your first gynecologist appointment may give you butterflies, but starting a habit that provides a foundation for a lifetime of health is one of the smartest steps a young woman can take.
Your annual OBGYN appointment is coming up and by this point in your collegiette career you probably feel like a pro. You’ve driven to the office a handful of times, chatted with the receptionist, and waited patiently while flipping through the latest issue of Glamour. When your name is called, you confidently walk into the examination room like you have done each year before.
For such a routine appointment, it is surprising how many college-age women aren’t familiar with the dos and don’ts of visiting the gynecologist. Not only are there tips and tricks when it comes to preparing for the appointment, but there are certain things to know while you are meeting with your gynecologist. It is always better to be well informed to the point of over preparedness than left in the dark, so here are some dos and don’ts to consider the next time you see your gyno.
DO find a gynecologist who you are comfortable with.
This is probably the most important tip when it comes to your gynecology appointment. If you aren’t comfortable talking with your gynecologist, then it is time to do some research and find someone who meshes better with your personality. You want to find a doctor who you will be comfortable talking to because, let’s face it, OBGYN appointments can get pretty awkward. If you are more comfortable with a female, then find a female gyno. If you would feel more at ease talking to someone closer in age to you, then look for a younger doctor. It is all about making the appointment as comfortable as possible because the more comfortable you are, the more likely you will be to open up to your OBGYN!
Jessica, a junior at Ohio University, is a big advocate of finding a gyno that you can talk to without feeling judged. She shares, “The doctor I see is always open to any of my questions and always tells me what she’s about to do and why, which I really appreciate. It makes an uncomfortable process a lot less nerve racking.”
Along the same lines, Kathryn, a senior at University of Tennessee-Knoxville, shares, “I’ve never felt judged by my OBGYN, only understood. If you aren’t comfortable with yours, find one that you can be honest and open with. You should be able to ask questions and be honest. That’s so important for your health as a woman!”
So where should you look if you are on the market for a new gynecologist? First of all, ask around. Most collegiettes have a favorite OBGYN whose name they will love to pass around. If word of mouth isn’t unveiling any fabulous doctors that fulfill your criteria, then check out Healthgrades. All you have to do is enter the specialty (Obstetrician and Gynecologist) and your zip code. The result is a list of doctors with credentials, experience, contact information and patient reviews.
DO keep track of your monthly cycle.
Life can get pretty busy and doing something as simple as keeping track of your period might slip through the cracks. However, it can be extremely beneficial to monitor when your cycle arrives each month, how long it lasts, and anything out-of-the-ordinary that occurs. Dr. Sara Gottfried, a Harvard-trained gynecologist, explains, “It’s important to get in this habit so that you know if your period is regular. The timing tells you a lot about whether your hormones are in balance or not.”
Technology has made tracking your cycle that much easier. Using iCal is one effective method, but there are also a host of iPhone and smartphone apps. Our personal favorite? Period Tracker Deluxe. It not only has a feminine and girly interface, but it allows you to track your symptoms, mood, weight, and other potentially important factors. The deluxe version is $1.99, but there is a free lite version available for any frugal collegiette trying to save her hard-earned money.
If you aren’t super techy, you can always keep track of your cycle the old school way like Jessica, a sophomore at Hobart and William Smith College. Jessica shares, “I have a mini calendar that I keep in my sock drawer so every month when the time comes I mark down the day I got my period.” This guarantees privacy whereas there is always the possibility of a little sibling playing with your iPhone and maybe seeing something you don’t want them to see.
DO come up with questions beforehand.
Throughout the year, jot down any questions that pop into your head for your gynecologist. Keep this running list saved on your phone, on your laptop, or even on paper. Even if a question no longer applies when the time of your appointment rolls around, ask it anyways! It is always better to be well informed than to be left in the dark.
Some great things to ask questions about are:
- If you ever have pain during sex
- Any irregularities with your period
- Side effects from your birth control pill
- STI and STD testing
During the appointment, don’t be shy! If something sounds confusing, speak up! All doctors appreciate a curious patient as it shows that you are taking your health seriously.
DO know your medical history.
This is important for any kind of doctor’s appointment, but when it comes to seeing a gynecologist, make sure you know your medical history as well as your family’s medical history. If breast cancer or polycystic ovarian syndrome (POS) runs in the family, let the doctor know.
If you don’t know your medical history, then it is time to sit down and have a talk with your mom. As a collegiette, you are making the transition to the real world where you will be responsible for your own health. This means mom won’t be with you at your appointments and she may not be accessible when you are scrambling last minute to figure out any medical problems that run in the family. So sit down and openly ask her if anything runs in the family that you should know about. This medical history will only help you and your doctors to better assess your body and overall health.
OBGYN appointments can be stressful. Doctor’s offices already have a certain stigma, as they are commonly associated with anxiety, worry, and overall uneasiness. The key to avoiding all of these unwanted feelings is to relax. Take deep breaths while sitting in the waiting room, distract yourself by reading your favorite magazine, and get your head in the right place. Once you are called into the examination room, remember that the appointment will be over before you know it. Another important reason to relax is that all examinations – pap smear, pelvic exam, breast exam, etc. – will be quick, easy and more effective if you are calm and relaxed.
Katie, a junior at Syracuse University, admits that she gets a little nervous during her appointments. She advises, “Try focusing on breathing and thinking of something funny instead of what may be going on in the examination room.”
DO get a pap smear once you turn 21.
The encouraged standard by licensed gynecologists is to get a pap smear as soon as you turn 21. Why is this so important? Dr. Gottfried explains, “You want to make sure you don’t have something sexually transmitted, including Human Papilloma Virus. The vaccine only protects you from some of the strains, not all.”
If you’ve never had a pap smear before, no worries! It isn’t as scary as everyone makes it out to be and it will only help you in the long run. As Dr. Gottfried emphasizes, “A pap should never be painful! Tell the examiner to stop if it is painful and start looking for another clinician immediately!”
DO ask to get a urine test for STDs as soon as you have sex.
Most gynecologists will test you for the most common STIs and STDs without you having to specifically ask. However, it never hurts to gently remind your doctor that you definitely would like a urine test. Why do you need a urine test in addition to a pap test? Dr. Gottfried explains, “Some STDs, like Chlamydia are ‘silent,’ meaning they have no symptoms and you don’t need a pap test for them. This is one reason why the urine test is really important.”
DO follow up on your test results one week after the appointment if you have not heard back.
It is always best to be proactive, so if you haven’t heard back after a week, then it’s time to call the office! Doctors’ offices are usually pretty busy (think of all the patients they deal with on a daily basis), so the memo to deliver your test results might have been lost in the daily shuffle. Be persistent and follow up – your gynecologist will appreciate the dedication you show for your own health.
DON’T lie about your social habits or any health information.
If you’ve found an OBGYN that you are comfortable with, then this shouldn’t be a problem. However, remember that lying is only going to hurt you in the long run. Be honest, be open, and don’t worry about what your doctor might think. They deal with hundreds of patients each week and have heard it all, so the gynecology office will be a judgment-free zone.
Dr. Gottfried has these wise words to share with all collegiettes: “You want to be totally honest with your doctors and your financial planners.” Since this article is all about seeing a gynecologist, we are going to focus on what could hypothetically happen if you aren’t 100 percent honest. Dr. Gottfried shares, “If you are addicted to meth and don’t tell your doctor, we may prescribe a dangerous medication for you. If you’ve had sex with ten people and say you’re a virgin, you could have a silent infection, like chlamydia, not know it, and lose your opportunity to treat it completely. Untreated chlamydia can cause many problems from chronic pain to infertility.”
Be honest and in the end you will only help yourself. Why risk taking a potentially dangerous medication or leaving an STD undetected? Your gynecologist has seen and heard it all, so don’t be afraid to open up and reveal anything that might help your doctor to better assess your sexual health.
DON’T have sex the night before your appointment.
Not only does this make things let’s just say a little bit messier for your doctor and potentially more painful for you, but it can also skew the results of your pap smear. Gottfried explains, “First of all, having sex the night before is a bit gross for the examiner. Secondly, the friction, bumping around and semen can potentially change the results of your pap.” You only see the gynecologist (hopefully!) at your annual visit, so you want your results to be as accurate as possible. Save the sex for another night and focus on your personal health the night before.
DON’T use yeast medications, spermicides, or douches 24 hours in advance.
To begin, douching is something that women should never do. Dr. Gottfried emphasizes, “DO NOT EVER douche. Your vagina is like a self-cleaning oven. When you douche, you might send all those vaginal bacteria up into your uterus and out your tubes into your belly, which is not good!” Not only will it negatively affect the routine tests, but it just isn’t good for your body.
Yeast medications and spermicides, on the other hand, are okay to use. However, they should be avoided during the 24 hours before your appointment. Dr. Gottfried explains, “If your vagina is full of yeast medication or spermicide, how are we supposed to get a good sample of your delicate cervix cells?” Any foreign substances just make your doctor’s job more difficult and can lower the effectiveness of the various routine exams.
When the time comes to schedule your next gynecology appointment, keep these dos and don’ts in mind. Make this the most effective, efficient, and healthful annual check-up yet. Make sure you show up prepared, informed, and willing to ask questions. You now have the knowledge to be a pro when it comes to seeing your gynecologist and to make every minute of your appointment count
Your First Appointment With The Gynecologist
Many women feel nervous or uncertain before their visit to the gynecologist. It means accepting that your body has changed and that you’ve taken the step from girlhood into womanhood. Before going to your first appointment, here are some things you can expect and how you can prepare.
When should you start your gynecologic checkups?
Your first appointment will likely occur between 13 and 15 years old. Some women wait to start their gynecological examinations until they have sexual intercourse for the first time, or until they have a symptom or problem such as an abnormal vaginal discharge, vaginal burning, strong menstrual cramps or irregular periods. There’s no need to wait. The sooner you start regular exams the better.
What will happen at your first gynecological appointment?
It’s normal to feel nervous, but there is really nothing to worry about. Your first appointment is usually very simple, and your doctor will spend time getting to know you. The doctor will ask about you and your family’s medical history and your sexual health. Many women may feel uncomfortable discussing such personal issues, but being honest is important because it will allow the doctor to give you any help you might need.
What are gynecologic exams?
There are four types of examinations that you may have during your visit. Each type depends on the length of your first appointment, your age, your sexual history and whether or not you have any particular symptoms.
If you are going to have any tests, the doctor will explain them first so you don’t have to be anxious. The doctor will instruct you to go to the bathroom or a changing room to undress in private and put on a gown. It’s normal to feel uncomfortable about being naked, but the gown will cover you, and the doctor will only uncover the areas needed for the examination. Also, remember that all women are tested in the same way.
The four kinds of examinations are:
- General physical examination: As with any medical examination, your weight, height and blood pressure will be measured.
- Breast examination: Your doctor will check your breasts with his or her fingers to detect whether there are any lumps or abnormal discharge.
- Pap smear: The Pap is the scraping off of a few cells that cover your cervix. The doctor uses a special brush and then sends the sample to the laboratory to check for the presence of abnormal cells.
- Pelvic examination: This test is not performed on all women unless they’ve had sex or have certain symptoms in their vagina or abdomen. To do the test, your gynecologist will ask you to lie on the exam table with your feet in special stirrups and your legs open so he or she is able examine your vagina. Using gloves, the gynecologist will check your vulva (the outside of your vagina) to rule out signs of infection. Then he or she will open your vagina with a speculum (a metal or plastic instrument) to shine a light inside and take samples of a few cells that will allow her to tell if you have any STDs (sexually transmitted diseases). If necessary, he or she will also take a Pap smear at the same time. Finally, the doctor will insert one or two fingers of one hand into the vagina while pressing on your abdomen in order to feel your cervix, ovaries and womb. This is to assess their size, see if there are cysts present, etc. It can be a bit uncomfortable, but if you’re relaxed the examination is usually not painful.
How should you prepare for your first appointment?
- First, choose a doctor with whom you feel comfortable.
- Ask for the appointment on a day when you know you will not be having your period.
- Before going to the doctor’s office, think about what you’d like to ask about your sexual and reproductive health. There are no stupid questions. Ask about anything you’re unclear of. If it helps, write down a list of the things that concern you: your vaginal health, contraception, unusual pain in your breasts, questions about your menstrual period, etc.
The first appointment can produce the most anxiety, but the next ones will be much easier. The good news is that if you’re uncomfortable with the doctor you chose, you can always choose another one. It’s important that you find a gynecologist you trust. You should see your gynecologist on an annual basis to maintain good vaginal health.
There comes a time in every person with a vagina’s life that they must start seeing an ob-gyn. I went for my first gynecologist visit after I got my first period, and she just acted like the blood coming out of my vagina was normal, so I did too. When I got to college, I had a few friends claim to be “best friends” with their gyno. Complete honesty without shame? Sign me up. Talking to your gyno about things like vaginal discharge might seem odd if you’re not used to talking about that stuff, but your ob-gyn’s job is to make you feel comfortable about the uncomfortable. Got a question about a new smell? Ask it.
Before you make your first appointment, we found out exactly what you should know before your first gyno visit by talking to Sherry Ross, M.D., ob-gyn and women’s health expert at Providence Saint John’s Health Center in Santa Monica, California, and Antonio Pizarro, M.D., a board-certified gynecologist in Shreveport, Louisiana.
Below are 10 more things every person should know before going to the gyno.
1. You don’t need a reason to schedule your first appointment.
“It’s recommended girls 13–15 years old see their gynecologist to start and build a relationship to discuss sexually transmitted infection screening, prevention, and other health care advice,” says Dr. Ross. “If you missed this window, now is the time to make yourself an appointment. You want to develop an open and honest relationship where you feel comfortable to ask questions that may make you squirm in your seat or blush.”
2. Being nervous is normal…but you don’t need to be!
According to Dr. Pizarro, it’s all going to be okay. “It is normal to be nervous about going to the doctor, especially to address an issue as private and personal as reproductive health. Patients should not let this overwhelm them. There will be a female chaperone if a pelvic exam is needed, even if the clinician is a woman.” He continues, “Pelvic examination can cause patients to experience pressure, but it should not cause pain. You are in control of your health care, so if at any time during a visit to a doctor you are not comfortable, you should ask for the encounter to end.”
3. You don’t need to wax or shave before your appointment.
“Some women consider grooming their vaginas as part of their weekly or monthly beauty prep along with their mani-pedi and brow wax. It’s not necessary to shave or wax your vagina before getting a gynecologic exam,” Dr. Ross ensures. “Vaginal grooming is your personal choice. The main consideration on how to prepare for an exam is to simply be clean, so showering or using a vaginal hygiene wipe prior to your visit is suggested.”
4. You can bring someone with you, or you can have them wait outside. It’s up to you.
“It may help, if the patient chooses, to have one friend or family member present during the visit,” suggests Dr. Pizarro. “Some patients prefer for that person to stay for the examination, if one is indicated. I never ask a patient’s companion to leave, unless the patient requests that. Patients should feel in control and as comfortable as possible.”
5. Be prepared for honesty.
“Patients should prepare to be open and direct about their health, habits, sexual history, fears, and concerns,” says Dr. Pizarro. “Productive and effective health care only takes place when clear lines of communication and trust are established. The visit is private, and the topics discussed in the visit are protected by privacy laws.”
6. If you have your period, it’s a good idea to reschedule.
“Having your period and getting a gynecologic exam is not a good idea,” warns Dr. Ross. “If you have a pap smear during your period, blood can make the results inaccurate. Hormonal changes during your period can make a breast exam really uncomfortable and vaginal bleeding makes a pelvic exam messy. It’s best to reschedule your gynecologic exam if Aunt Flo pays you a visit.”
7. Drink some water before you show up — you’re going to pee in a cup.
“You will need to pee in a cup during your gynecologic exam. When you pee in a cup the gynecologist is able to perform a ‘dipstick’ test of your urine,” Dr. Ross says. “This simple office test can check to see if you have anything you may be unaware of happening in your body. Finding bacteria can suggest a bladder infection or finding sugar (glucose) may suggest you have diabetes.”
8. You don’t need to give a blood sample.
“The good news is if you are having a routine gynecologic exam, meaning you are not having any health problems, it is unlikely you will need to have your blood drawn,” says Dr. Ross. “If you are having irregular periods or want a complete sexually transmitted infection screening, a blood sample is likely.”
9. If you’re under 21, you don’t need a pelvic exam yet.
“Pap testing and routine pelvic exam are not indicated before age 21. So, unless a patient younger than 21 is having a specific problem, there may be no reason to see a gynecologist,” says Dr. Pizarro. “Problems that her pediatrician cannot address may require referral to a gynecologist, and Pap testing should probably not be part of that. After age 21, routine exams and Pap testing are indicated.”
10. You can get the birth control pill without having an internal exam.
“It is not necessary to undergo a vaginal examination to start hormonal contraception. A directed abdominal-pelvic exam can be considered — it does not require a genital exam and it will provide a great deal of important information,” says Dr. Pizarro. “The timing of when to start hormonal contraception depends: If periods are normal, then start soon after next normal period without a pregnancy test; but a negative pregnancy test will allow for contraception to start right away.”
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Related: 11 Things Every Girl Should Know About Sex and Sexual Assault in College
Check out Teen Vogue’s December/January issue cover star, Fernanda Ly.
I’ve never been to the gynecologist. What can I expect at my first visit?
The first time you see a new gyno, you’ll often meet in his or her office to talk. Your doc is going to want the scoop on your life before beginning the exam. ” should expect to be ready to be truthful about a lot of issues, including sexual activity, the number of partners she’s had, whether they were male or female, the age she first got her period, and when she became sexually active,” says Shari Brasner, M.D., an assistant clinical professor of obstetrics, gynecology, and reproductive science at Mount Sinai School of Medicine in New York City, and a partner in a private practice. The gyno will want to know your family history and things that have affected your health and that of your parents and siblings. Think you may need to be tested for an STD? Bring that up now. Your gyno will discuss the Pap smear, appropriate testing for sexually transmitted infections like gonorrhea, chlamydia, and trichomoniasis, as well as whether you need blood work to test for HIV, hepatitis C, or syphilis.
Then you will move into the exam room, where you will undress completely and put on a robe. Your gyno will do a head-to-toe exam, including possibly checking your neck for thyroid abnormalities, a breast exam, and then the pelvic exam. During the pelvic exam, your doc will use one or two fingers inside the vagina and one hand on top of the belly, in the pubic region, to feel the internal organs. He or she may also use a speculum to hold the walls of your vagina apart to see the cervix and take specimens using swabs.
Total time? Approximately 20 minutes. Since that’s such a short amount of time, it’s wise to come prepared with a list of specific questions you want to ask. It’s very important not to leave the office without disclosing something important that could influence what kinds of tests the doc should perform. “I don’t want to finish my specimen collection and then find out that the patient suspects her boyfriend is cheating on her,” Brasner says.
What kinds of things should I talk to my gyno about?
Sexually transmitted diseases and infections
These days, your gyno is going to talk to you about sexually transmitted infections even if you’re in a long-term, stable, monogamous relationship. That’s because so many of these infections are viruses that can be dormant or latent for many years. Plus an STIs like HPV can lead to cervical cancer if left untreated.
Aches and pains or concerns
Ask your doc about anything that’s of concern whenever you want, but be sure to tell her when something has happened a repeated number of times, Brasner says. Although there may be no need for an expensive workup, it’s important that the problem is addressed and monitored so both you and your doc can get a better idea of what’s going on down there. If you have an acute pain or urgent question, don’t hesitate to call. Many times the office will be able to screen over the phone the need for an immediate visit. For example, says Brasner, if someone has symptoms of a urinary tract infection, she shouldn’t wait an extra day. Speak with a doctor to see if a visit is necessary or if it’s something that can be handled on your own or over the phone.
Gynecologists sometimes take on the role of an overall women’s health expert, and some ladies see their gyno and no one else. “I talk to my patients about their sleep habits or exercise habits, because even though I may not be an expert in those fields, I have a network of colleagues I can refer my patients to,” says Brasner. Plus, more than any other kind of doctor, a gynecologist also deals the most with urinary problems. If you have a urinary issue, or suspect you have a urinary tract infection, call your gyno first.
How much info is too much to disclose about my sexual partners?
It is critical to discuss your sexual partners. “I need to know the health of the relationship, if you have suspicions of infidelity, if you have been unfaithful, and how many partners you have, and I need honest answers in terms of safe sex versus unsafe sex,” says Brasner. Your gyno appointment is not the time to feel embarrassed and withhold information. Remember, there’s nothing you can say that your doc hasn’t heard before. A gynecologist isn’t there to pass judgment, and you have to be willing to talk about things.
How will I know if my exam results are normal?
First, ask for feedback during any phase of the exam. “When I’m doing an exam, I may forget to let my patient know that her breast exam is completely normal. It’s absolutely fine for her to ask if everything feels right,” Brasner says. Also, clarify how the results from your exam will be communicated. Every office has its own policy. Sometimes you will be given a code to check online in a couple weeks, and sometimes you will be told that you’ll get a call from the office only if something showed up abnormal on your Pap or other tests.
Is there anything I shouldn’t ask or tell my gyno?
Don’t ask your gyno about your best friend’s health issues. Although you may be concerned about your pal, the time you have with your doctor is all about you, so you want to make the most of your time. Yes, your gyno will want to know if you have a lot of stress at work, but she can’t sit with you to discuss your awful boss. If you have other things you want to discuss that are not typical for a checkup, ask if it is appropriate to set up another appointment.
Do I have to get completely naked for the exam?
Actually, no. You can leave your socks on, Brasner says. It’s the one item of clothing you can feel free to wear in the chair, especially if your feet get cold. Other than that, it’s everything off. Your doc is most likely going to do a breast exam, so be sure to take your bra off too and avoid an awkward moment. And stop worrying about how you look, says Brasner. You don’t need to shave your legs or worry about making sure your lady parts are waxed. The gyno is down there for more important reasons.
How often do I need a pelvic exam and a Pap test?
Today’s doctors know more than ever about HPV and its link to an abnormal Pap smear. They’ve learned that young women do not have the same HPV risk that older women do, so the guidelines have relaxed in terms of the age of your first visit. However, since many ladies see only a gynecologist, it’s still important to have checkups. “I try to keep in mind that a lot of my patients don’t see other doctors and aren’t going to have any other face-to-face contact with a health-care professional if they don’t come to see me,” says Brasner.
There is a difference between how often you need a Pap smear and how often you need to visit the gyno. For younger women, Brasner recommends having a Pap every three years but going for a checkup every year to get the interaction or feedback from her about anything new, vagina-related or not.
Do I really have to go to a gynecologist for my problem? Can’t I just self-diagnose?
Self-diagnosis on the Internet is a double-edged sword, says Brasner. The Web has a wealth of information, but without the proper filters and or education to sort through symptoms, it may be difficult to separate fact from fiction. “The Internet will walk a patient down the path of the worst-case scenario, so the patient will assume she has an awful problem when it is really a mild issue,” says Brasner.
But if you’re going to use over-the-counter products without consulting your gyno, Brasner has a few tips. Anything that’s heavily cosmetic—such as lotions, potions, and perfumed sprays—is no good. If you have an itch, buy an OTC product that is free of parabens and alcohol. If you really don’t know what to buy, call your gyno, who will be able to recommend the right OTC products.
Is it normal to have a sonogram at the gyno if I’m not pregnant?
Sonograms are used for nonpregnant women only if something in their medical history or physical indicates an abnormality. If you have no history of cysts or health issues, consult your insurance company before agreeing to a sonogram from your doc. They can be quite expensive and can sometimes produce false positives, requiring the need for further testing, says Brasner.
I just moved to a new area. What should I look for in a doctor, and how can I find a good one?
Ask around. Your peers are a great resource to start with, because most of the time, they have similar needs as you. For example, your coworkers may have similar insurance policies and will know how to find a local gyno who is on your plan.
The big debate: Would you feel more comfortable with a male or female gyno? Back in the day, patients didn’t have much of an option because most gynos were men. Plenty of women still see male doctors, and every doctor is required to have a nurse in the room during the exam, so you should feel safe with either sex.
Do some research. Find out if your new doc is board certified and if he or she is affiliated with a hospital. This may not seem important to you now, but it’s good to know. If you ever need to be hospitalized or if you are planning on having a baby, you’ll want to be familiar with the hospital where your gyno works. Determine how many doctors are in the practice and if your preferred gyno is there part time or full time. And inquire about office hours, what days the practice is open, and if special appointment times (such as early morning or evening) are available.