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.
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