Your First Gynecologist Exam

2016-05-09

If you’ve never been to a gynecologist, you may be nervous about what happens during an ob-gyn exam. Put yourself at ease and use it as an opportunity to learn more about your body and your health.

By Madeline Vann, MPH | Medically reviewed by Lindsey Marcellin, MD, MPH

A gynecologist is a doctor who specializes in women’s reproductive health issues. When you first try to find a gynecologist, you may see that some are called obstetrician-gynecologists or ob-gyns. This refers to the training they have undergone to treat women from adolescence through pregnancy and delivery.

If you haven’t been to an ob-gyn before, you may wonder why you should find a gynecologist and what to expect when you get there.

Reasons why you should have a gynecologist exam include:

• To learn about birth control options
• To learn about screening for and preventing sexually transmitted diseases
• For an annual pelvic exam
• Screening for reproductive cancers, such as a Pap smear, starting at age 21 and then every two years (some women may need to have it more frequently, based on their doctor’s recommendations, while others may only need it every three years)
• To find out about human papillomavirus (HPV) vaccination
• For care for yourself and your baby during pregnancy

When to See a Gynecologist

Guidelines about when to have a gynecologist exam include:

• When you are 21 or earlier if you become sexually active
• If you have unusual bleeding or irregular periods
• If you stop having periods for three months or more
• If you suspect or know you are pregnant
• If you have been trying to get pregnant without success
• If you have pelvic pain
• When you are between 40 and 50 to get your first mammogram referral
• After menopause for bone density screening referrals

How to Prepare for a Gynecological Visit

Take these steps to make sure you get the most out of your gynecologist exam:

• Do not douche, have vaginal intercourse, or use a vaginal cream or suppository for 24 to 48 hours before your visit.
• Write down anything that has been worrying you, such as irregular periods or unusual discharge or discomfort — and bring pen and paper to write down the answers.
• Bring a list of all medications, vitamins, and herbal supplements that you are taking.
• Be able to share your family health history, especially reproductive health problems in family members.

What to Expect at Your First Gynecologist Exam

Here is what you can expect at your ob-gyn appointment:

• Health history. A nurse will ask you questions about your personal health history and your family health history. She may also ask about health behaviors such as drinking alcohol, smoking, using illegal drugs, and sexual history. Some of the questions may feel very personal to you, but remember that everything that you share is private between you and your doctor unless you give written permission for it to be discussed with someone else.
• Vital signs. The nurse will weigh you and check your blood pressure.
• Pre-exam. You will be given a gown that opens in the front to wear and a sheet to cover your legs. You will need to remove all clothes including undergarments.
• Discussion. Your ob-gyn will talk to you briefly about your concerns and will explain the gynecologist exam to you. This is a good time to bring up any questions you have.
• Breast exam. Your ob-gyn will use her fingers to feel each breast and nipple in a pattern. This is to find unusual lumps or changes in tissue and skin.
• Pelvic exam. You will lie on the exam table with your knees bent and your feet resting in stirrups to keep your legs apart. Your ob-gyn will sit at the end of the table for the exam. “A pelvic exam includes inspection of the vulva, insertion of a speculum to allow inspection of the vagina and cervix, the bimanual exam with two fingers in the vagina and another hand on top of the abdomen to examine the uterus, fallopian tubes, and ovaries,” explains ob-gyn Concepcion Diaz-Arrastia, MD, director of gynecological oncology and associate professor at Baylor College of Medicine. The speculum is an instrument that slides smoothly into your vagina to stretch it slightly so your doctor can take samples from your cervix. The pelvic exam should not be painful, but there may be some discomfort or pressure, and the speculum may feel cold at first.
• Pap smear. During the pelvic exam, your doctor may take cells from your cervix for a Pap smear, which tests for precancerous changes of cervical cells. This is not painful.
• STD testing. If you request it or your doctor recommends it, she can also take samples from your vagina to be tested for sexually transmitted diseases (STDs). Some STDs have to be found using a blood test.
• Discussion. Your doctor will let you know if she sees anything unusual and may recommend additional testing based on this exam, such as a mammogram, bone density test, or blood work. This is another opportunity for you to ask more questions, including any about her findings or suggestions. The results of the Pap smear and STD tests will not be available for a week or more, but at this point your doctor can give you a prescription for birth control or any medication that you need.

You may be nervous about having your first gynecologist exam, but think of your ob-gyn is your partner in sexual health. She should become the practitioner you feel most comfortable talking with about some of your most private health issues.

Learn more in the Everyday Health Sexual Health Center.