If you haven’t heard yet, a gynecologist is a doctor who is strictly dedicated to taking care of the breast, pelvic and vaginal area. Yes, there are doctors out there who specialize in specific areas of the body and a Gynecologist is one of them. Some Gynecologists deliver babies and take care of pregnant women and these doctors are called Obstetricians. In many cases, you might get a doctor with the title OB-GYN and this just means that the doctor is qualified to do both.
Gynecologists and primary doctors recommend that teenagers have their first reproductive health conversation with a physician between the ages of 13 and 15. This first visit might just be a talk between you and your doctor so that you can get to know them and become more comfortable speaking with them. It is also a good time to ask questions about menstruation (your period), birth control, and sexually transmitted infections, as well as an opportunity to discuss your medical history (and sexual history, if necessary). If a female has had sex (oral, vaginal or anal) or is 21 years old, doctors strongly recommended a GYN exam every year. So, what is a GYN exam exactly? I will explain each of these parts in detail as we go along but basically it includes a chat with your doctor, a pelvic exam, a Pap test, a bimanual exam, and a breast exam.
It’s okay to be nervous about your visit. In fact it’s really normal. Most people find it hard to talk about sex and might be embarrassed about being examined in their personal space. In fact you may have heard your share of “horror” stories about going to the GYN. But don’t worry; going to the GYN is not a terrible or scary thing. Part of what can be frightening is not knowing what to expect. Here I will let you know all the tricks to making it more comfortable and less intimidating. So let’s get started.
The first part of your exam is, you guessed it, talking. Your GYN will start off by asking you questions about your medical history. They will also ask you about menstruation, your sexual history and answer any questions you have about your vaginal area. It’s really important to BE HONEST with your doctor no matter how personal the questions may be or how silly you think your question might sound. The more they know the more they can help you and make sure you’re healthy. Trust me, I know it may seem a little far-fetched, but gynecologists have heard it all and their real concern is your health. If a patient has had sex or is thinking about it, this is a great time to talk about different birth control and safer sex options for teens. Everyone is different so a GYN can be a big help in deciding which method makes the most sense for that person. Also, it’s important to know that this talk is confidential, but if you’re concerned this is a good time to ask your doctor about any questions you have about privacy.
The second part of the GYN exam is the physical part. Note: if a patient wants STI testing she needs to let her doctor know before the physical portion of the exam. Many doctors will not do this unless a patient asks. The doctor or nurse will give you a hospital gown to put on and will step out of the room for a few minutes while you change out of your clothes into the gown. Then the doctor will knock before they come into the exam room and start the exam. They might start out by listening to your heartbeat or checking your blood pressure. It might feel embarrassing to be wearing only a hospital gown in front of a doctor. Just take a deep breath and before you know it, it will be over. Here are some other tips that might help you relax during the rest of the physical exam.
The clinician will ask you to lie down on the exam table so they can do a routine breast examination by touching the breast and the nipples, making sure that everything is normal. If your GYN is a man, then there will be a female medical assistant in the room with you during your examination. The next part of the physical exam is the pelvic exam—this is where the doctor first takes a look at the genital area. In order to examine the genital area, the doctor will ask the patient to scoot down towards the bottom of the exam table. The GYN exam table has special foot rests called stirrups that the feet rest in while the knees spread open. The doctor will also use a small bright light in order to see the area more clearly. The purpose of looking at the genitals is to check for bumps, sores, swelling, funny colors, or unusual discharge. This part of the exam is where the doctor will first touch your genital area. NOTE: This should be a respectful touch. You have the right to let the doctor know when you are ready to let them touch you.
Here comes the most important part of the GYN exam, the inner examination or speculum exam. Since the sides of the vagina touch each other in order for the doctor to see the cervix he/she will gently open the vagina with something called a speculum. The speculum can be metal or plastic, although most doctors use plastic. Even before the speculum exam begins you can ask to see the speculum and learn how it works. NOTE: This part of the exam might feel uncomfortable but it should never cause pain. The more relaxed you are the more relaxed your vaginal muscles will be. Make sure to use those tips I mentioned so that this can be as comfortable as possible.
When the speculum is inside the vagina, the GYN will check the vagina and the cervix. What they're looking for is discharge or signs of infection; they will also collect a few cells from your cervix for a test called a Pap test (also known as a Pap smear). To do this, the clinician will collect the cells first with a brush and then a spatula. Some women will feel a slight pressure, but most women don’t feel anything when the brush touches their cervix. The sample of the cells will be sent to a laboratory to check for anything abnormal. If a patient requested STI testing this is the time where the GYN will take a swab (which is a lot like a Q-Tip) and gather more cells from the cervix for testing. The GYN will also collect a urine sample and a blood sample to test for other STIs. You can follow up with you GYN with any questions and to get any test results in a week or two after the appointment.
The last part of the exam is called the bimanual exam. The clinician will insert two fingers into the vagina and place one hand on the lower part of the abdomen. By moving their hands together, the GYN will be able to feel the uterus and ovaries. The pressure might feel uncomfortable but like mentioned before it shouldn’t hurt.
Visiting the GYN can be an uncomfortable experience but, think of it as a visit to the dentist or the foot doctor, it will be awkward at first but with time these visits will become easier as you get to know your doctor and feel comfortable around them.
GYN visits are done yearly so plan a time during the year where you can make time for your GYN.