It doesn't have to be intimidating or uncomfortable.
By Kristin Canning, Reposted from Self.com
If you have a vagina, there will come a time when you have to see a gynecologist—it’s an essential part of maintaining your health. But that first gyno exam can seem totally foreign—and even scary. The thought of discussing sensitive health topics and letting a total stranger examine your vagina might make you want to skip the appointment altogether. But here’s the thing: Seeing an OB/GYN doesn’t have to be intimidating or uncomfortable; in fact, it can even be pretty damn empowering. Below, you’ll find exactly what you can expect from your first OB/GYN appointment—including how to best prep for it, how to stay calm when you’re feeling uneasy, and how to leave feeling confident about your sexual and reproductive health.
1. First things first: Know why you set up an appointment.
The American College of Obstetricians and Gynecologists (ACOG) recommends girls have their first ob/gyn appointment between the ages of 13 and 15, with a yearly wellness visit after that. You might have specific things to bring up with your doctor during your first appointment, like period issues, birth control options, and testing for sexually transmitted infections. It’s smart to be clear about why you’re seeing the ob/gyn, Lauren Streicher, M.D., associate professor of obstetrics and gynecologist at Northwestern University and author of Sex Rx: Hormones, Health, and Your Best Sex Ever, tells SELF. That way, you can make sure to discuss everything on your mind and be a better advocate for yourself. “For a new patient, most doctors will schedule 20 to 30 minutes,” says Dr. Streicher. “If you prepare before you get there, you can maximize your time and get your questions answered.” Plus, preparing can help you combat pre-exam nerves.
2. If you’re under 21, you probably won’t need a pelvic exam or Pap test.
Regardless of your age, a medical professional will do a general physical exam to check your height, weight, and blood pressure before an ob/gyn checks you out. Your doctor typically won’t perform a pelvic exam to check out your reproductive organs during your first ob/gyn visit. The exception is if you’re sexually active, want STI testing, or have other health concerns like abnormal bleeding or very painful periods. If you’re 21 or older, however, a pelvic exam is recommended, along with a Pap test. During a Pap test, your doctor will swab your cervix (the lower portion of your uterus that connects to your vagina) to collect a sample of cervical cells to check for abnormalities that could indicate cervical cancer (which is rare and often treatable, so try not to stress!). Your ob/gyn may also perform a breast exam. Even though young women have a low breast-cancer risk, your doctor will likely use this as an opportunity to show you how to examine your breasts and identify any changes, says Dr. Streicher.
3. Still, it’s best to know what happens during a pelvic exam, just in case.
A typical pelvic exam consists of three parts, according to the ACOG. The first is an external genital exam to look at your vulva, which includes everything you can see on the outside of your body, like your labia, clitoris, and the opening of your vagina. If your doctor offers you a mirror so you can see what’s up down there—or if you want to request one—don’t be shy! An ob/gyn visit is the perfect time to make sure you know the name, location, and purpose of all the parts of your vulva.
Your doctor will also perform a vaginal and cervical exam with a speculum, which is a device they’ll insert into your vagina and expand to get a better view of your vaginal walls and cervix. While the speculum is inserted, your doctor will use a soft brush or a flat scraping device to take samples for your Pap test and to test for certain STIs.
Real talk: This part can be kind of weird. “Most people are uncomfortable with the speculum,” Mary Jane Minkin, M.D., professor of obstetrics and gynecology at Yale School of Medicine and creator of MadameOvary.com, tells SELF. Pro tip: Speculums come in different sizes, so if you’re worried about it hurting, you can let your doctor know and ask them to try something smaller. “And if you feel pinching or pain, you can say something,” says Dr. Streicher. The good part is that a speculum only needs to be in your vagina for around a minute for a doctor to perform a thorough exam, William Schweizer, M.D., clinical associate professor of obstetrics and gynecology at New York University Langone Health, tells SELF.
Once that’s done, your doctor will conduct a bimanual exam to study your reproductive organs. With a hand on your lower abdomen, they’ll insert one or two of their gloved, lubricated fingers into your vagina and feel around to make sure your uterus and ovaries are healthy. This is another part that can make people anxious, but it also only takes around a minute, Dr. Schweizer says.
4. Even without a pelvic exam, you can still get birth control.
Most doctors don’t require a pelvic exam to prescribe birth control—they’re able to make an informed decision based on your medical history and personal habits. If you’re curious about birth control options, they’ll start by asking questions about your behavior and preferences to help figure out what’s best for you. For example, contraceptive pills might not be a great option if you know you’re super forgetful, Dr. Minkin says, so your doctor may recommend a “set it and forget it” method like an IUD or an implant that can last anywhere from 3 to 10 years, depending on the type. For some methods, you can usually walk out of the office with a prescription that day.
5. Don’t worry about how you look.
Though you might feel exposed during your first gyno exam, remember that your doctor isn’t judging any aspect of your body, whether it’s your pubic hair or the length of your labia. Their purpose is to evaluate you medically, full stop. “We really don’t care, we’ve seen it all, and honestly, we barely notice,” says Dr. Streicher. If you’re able to, you can shower and rinse your labia with water before an appointment (no douching or perfume, though, because that can boost your risk of irritation or infection). If you can’t do this, it’s so not a big deal.
You also don’t need to worry about being on your period unless you’re specifically going to have your doctor examine your discharge, adds Dr. Streicher. Having your period may also affect the results of your Pap test or any STI testing, so you should give your doctor’s office a call to see if it still makes sense to come in or if you should postpone your appointment.
6. Be prepared to talk about your menstrual cycle—and your sex life.
You’ll need to know the first day of your last period, so make sure you’re keeping track of that in the month leading up to your exam. You should also mention any pain, cramps, heavy bleeding, irregularity, or mood changes you get with your period. Your ob/gyn can prescribe birth control to help with period symptoms or look for signs of conditions like endometriosis, a condition that can cause pain, heavy periods, and trouble getting pregnant.
Your doctor will also ask about your sexual activity. Don’t be afraid to be open and honest here—your ob/gyn will keep everything confidential and won’t judge you. “It’s their job to support you. You have to answer honestly because STI screening will be based on that,” says Dr. Schweizer. Keep in mind that your oral sex and anal sex history count here, too, as both can lead to STIs. If you’re worried you might be pregnant because you’re sexually active and you’ve missed a period, be honest about that, too, and ask your doctor for a pregnancy test.
7. Know your personal and family medical history.
Your doctor will ask you about any medical conditions you have, medications you’re on, and past surgeries. That stuff can be hard to remember, especially when you’re nervous, so it can help to write everything down beforehand, says Dr. Streicher. That includes any relevant dates.
They’ll also want to know your family’s medical history. “It’s especially helpful to know about your mom’s health history and any family history of blood clots, as that can inform what birth control methods are best for you,” says Dr. Minkin. Contraception that contains estrogen, like the combined hormonal birth control pill, may put users at a higher risk of blood clots, according to the Mayo Clinic. The risk is still really small overall, but there are options that pose less of a risk if you have a personal or family history of blood clots, like the arm implant, an IUD, and progestin-only pills.
Also, if you haven’t gotten your vaccine for human papillomavirus (HPV), now’s the time to ask about that. The vaccine protects against cancers caused by an HPV infection, including cancers of the cervix, vagina, and vulva, as well as cancers of the anus, back of the throat, and penis.
8. Know you have control over the appointment.
That starts from before you even arrive. You may find you’re more at ease talking to and being examined by either a male or female ob/gyn. It’s OK to research different medical practitioners in your area and choose based on who you think you’d feel most comfortable with. (Of course, you might be limited due to your insurance or one of your parent’s preferences, but it’s perfectly fine to do your best to choose who you’re going to see.)
Then, if you are anxious when you arrive or at any time in your appointment, tell your doctor, says Dr. Schweizer. “Let them know it’s your first time and you’re nervous. You can ask to have a nurse come hold your hand, or you can even bring in headphones and music if that helps.” If your doctor’s OK with it, you can also bring someone into the room with you—like a close friend or parent—if you need a little extra support, says Dr. Minkin.
You can even keep an eye on what the doctor is doing to ease your anxiety: “Sometimes it helps to see what the doctor is doing, so I offer to hold up a mirror if patients want to see what’s going on. And if you want to be told what I’m doing, step-by-step, I will,” says Dr. Schweizer. “It’s the doctor’s job to make you feel comfortable.”
9. Be prepared for a follow-up call.
If you got any tests done during your appointment, your doctor’s office may call to inform you of the results or ask you to come in to review results or be retested. If you have STI testing, the results may be ready in a day to two weeks, says Dr. Minkin, and Pap test results typically come in one to two weeks. Some offices won’t call you if your tests don’t show anything unusual, though, so be sure to clarify what you can expect before you leave your appointment. You can also sign off to have someone else, like a parent or close relative, get your test results if you’re super nervous.
10. Consider scheduling your next appointment before you leave.
Current guidelines only call for a pelvic exam every three years, though your doctor may suggest you get them more frequently, depending on your medical history or any health issues. But most women will go for a yearly wellness visit to renew their birth control prescription, have their well-woman visit, get STI testing, or check in on any other sexual health concerns they have. It’s especially important to get regular STI testing if you have new sex partners or if you’re having unprotected sex, says Dr. Minkin. Sometimes it’s difficult to get an appointment on an ob/gyn’s calendar, so it can be helpful to schedule your next appointment before you head out.
[Notes. This article is about the standard recommendation in the United States. Reposting as a reference but recommendation might differ in different countries.]