Your mom just made an appointment for your first gynecologic exam and you're
feeling:
- Totally panicked. You start praying for an avalanche, four flat tires on
the car, that the gynecologist will get a broken arm, anything to
avoid that appointment.
- Pretty calm. You don't really mind going to the doctor that much, and if
your friends can handle it, so can you. But how will the doctor look
at the inside of your vagina, exactly?
- Confused. You don't feel sick at all, and you just had some vaccinations
for school and a physical for sports. Why waste time going to a doctor when
you're OK?
These are just some of the feelings that girls may have before their first
gynecologic (or "gyn") exam, and it's not surprising. You might be asking
yourself "Why me? Why now?" The answer is that you're older and have gone
through puberty, so
you need to have a physical exam appropriate for a young woman. That's where
breast and pelvic exams come in.
Why You Need These Kinds of Exams
There are a
number of reasons why yearly breast and pelvic exams are important for girls,
including:
- as a routine check. You'll want to be sure you're developing
normally. Many doctors recommend that a girl get her first gynecologic exam by
the time she turns 18 (sooner if a girl has become sexually active or if there
is a concern about her reproductive system health).
- to prevent pregnancy or infection. After becoming sexually active,
a girl should have a pelvic exam as soon as possible to discuss methods of birth
control and preventing sexually transmitted diseases (STDs).
- to deal with a problem. There may be a number of concerns that lead
to a pelvic exam. For example, if you have menstrual bleeding
problems, missed periods, pain, signs of infection, and worries
about development, it's a good idea to see a doctor.
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
the doctor you know and feel comfortable with for your first pelvic exam. There
are also a number of different kinds of doctors and nurses who have special
training in women's reproductive health:
- Gynecologists are doctors who have been specially trained in
women's health issues. Gynecologists are the doctors who most frequently
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 girls have
about their reproductive systems and can advise girls on birth control and STD
prevention.
- Nurse practitioners have had advanced training that allows them to
give gynecological exams and pay special attention to women's reproductive
health.
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.
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 otherwise). If for some reason you can't involve
your parents, you can take advantage of health clinics like Planned Parenthood.
These clinics have fully trained staffs who can often care for you at a lower
cost and respect any need for confidentiality.
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 Pelvic
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 girls, 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. It's important to answer everything truthfully - nothing you
write will be something the doctor or nurse hasn't seen before or that they will
share with anyone else. You might also be asked to write down 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.
The Breast Exam
After a few minutes, the doctor
or nurse practitioner 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. He or she may start
by going over anything you wrote down on your forms, or you may talk about these
things later. 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.
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 or nurse practitioner will only uncover the parts of your body that
he or she is examining.
The doctor or nurse practitioner 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 doctor or nurse practitioner will then examine your abdomen by pressing
on your belly to feel for any problems with your spleen, liver, and kidneys.
You'll sit up and the doctor or nurse practitioner will use a stethoscope to
listen to your heart and lungs. He or she may also look into your ears, eyes,
and nose.