Your First Gynecologist Visit
My mom wants me to see a gynecologist. That scares me. What does the gynecologist do to a virgin like me during physical examination? My friends says they will devirginize me. They say it hurts. Why should I go to see a gynecologist? I did not do anything wrong. I do not have a boyfriend. I am not seeing anybody. I have not done anything at all.... please help.
You're right, you haven't done a thing wrong. Having a gynecological exam isn't a punishment: gynecological exams are checkups for our reproductive system, just like the yearly checkups you may get for your whole body from a family doctor or clinic.
In a person's teens or twenties, either after having at least somewhat regular periods, after becoming sexually active, or because of some sort of reproductive health concern, question or issue, we may begin the habit of having a yearly exam or even just a consult with a gynecologist or a general healthcare provider who can provide gynecological healthcare. It's smart to check in with a reproductive/sexual healthcare provider every year or two as part of our overall preventative healthcare. Your mother most likely isn't punishing you, she's probably trying to help care for your health, especially if you've expressed something to her that might be an issue for you, like severe pain with your period, for example.
Do you need to go when you're very young and you haven't been at all sexually active yet (in other words, had any kind of genital sex)? No. It's not a need yet, especially if you're not having any issues when it comes to your period or any kind of pelvic or vulvar pain or discomfort.
In fact, if you do go now, not having been sexually active at all, and if you have no issues you need investigated -- like severe menstrual cramps or an absent period -- it's likely your first visit won't involve an actual exam at all, but will be more like the general physical you get at your yearly checkup from your family doctor. You may even just have a consultation, where you and the doctor just talk.
An OB/GYN -- or a family doctor or general health clinic providing those services -- should base what they do to your individual needs, and we feel like as soon as you can get started is a good time to go because it helps get you in that good habit early. As well, often we notice that the longer people wait to go, the more fear and anxiety they build up about an exam needlessly. Since a majority of our readers at Scarleteen are in their mid-to-late teens or early twenties, and many have been sexually active, we generally recommend our readers get yearly sexual and reproductive healthcare, which often includes gynecological exams.
There's no need to be scared about your first gynecological visit, though, no matter what it entails.
Be sure either you or your mother express to the doctor that it is your first visit, and feel free to communicate to the staff that you're nervous. Many people do feel nervous before a first exam: doctors know that and will want to make sure you're emotionally comfortable. Ask that the doctor tell you what (s)he is doing and why as (s)he does it. It is up to you to let the doctor know what you need to be comfortable. If you want your mother in the room with you, or want her to leave, let both of them know. If your doctor is male and that makes you uncomfortable, you can ask to have a nurse in the room. Be sure and communicate with your doctor, and if for any reason (s)he seems rushed or uncooperative with your needs, cancel the appointment and find another doctor.
My mother (a hospital administrator and infectious disease whiz) also suggests writing down all the questions you may have about your health, your cycles, and any issues that make you nervous ahead of time, and bringing that list with you for the doctor to address. Smart lady, my Mom.
If you're getting an exam, here's how the whole thing goes.
Be sure to relax, and use the bathroom first to empty your bladder or bowels. Having to go to the bathroom during an exam is not a fun experience.
Your doctor will begin with:
- Some questions about your medical history you and your mother will answer together (or, if you've asked to go the whole visit alone, which you'll answer yourself).
- A basic physical exam, just like at a "regular" doctors, including an examination of your eyes and ears, heart and lungs, blood pressure, and weight.
- A basic abdominal exam, where (s)he massages your stomach and hip area, and will ask if any spots are tender or painful.
- (S)he may also take some blood samples from your arm to check your hormone levels (which in the case of abnormal periods, may be out of whack). You may also get a standard blood and urine screen for STIs, particularly if you have been sexually active. If you have been sexually active, you should be sure to ask for those tests expressly: some doctors only do them when patients ask for them.
- Before or after this point, you'll be given a gown to get into if you're going to get a bimanual and/or speculum exam. Most likely, before the pelvic exam, the doctor will do a breast exam, during which (s)he will feel your breasts and chest area in massaging movements to check for any lumps or irregularities.
If you're not 21, and are not having any possible reproductive issues you want him or her to look into, your exam may end with that abdominal exam and blood work. If you're 21 or older, if you do have complaints or issues with your period or any part of your menstrual cycle, if you've been having any sort of reproductive issues -- like pelvic, vulvar, vaginal or rectal pain or discomfort, unexplained vaginal bleeding or spotting, or any unusual discharges, etc. -- then the rest of your exam will likely continue as follows.
Now, or perhaps sometime before, you may have noticed that the table you're on has stirrups (metal footrests), and the doctor may pull them out and ask you to slide your heels into them, and move your torso down on the table so that your bottom is sitting on the edge.
To see what your doctor sees, check out our map of your genitals. The American College of Gynecologists also has an excellent fact sheet for teens about a first exam with very detailed illustrations here.
Your doctor will first just look at the appearance of your vulva -- your external genitals -- looking for any lumps or bumps, swelling, funny colors, or unusual discharge. (S)he may put a gloved finger on your vagina to see if your glands put out any pus or mucus when touched.
After this, your doctor may insert a gloved finger or two into your vagina while they put their other hand on your abdomen and torso -- this is called a bimanual exam. (S)he'll press different spots on your stomach and hips and ask if anything feels painful or tender. Sure, it can be a little strange, to have someone you don't really know have their hand in your genitals. The best advice I can give you is to understand that it's really no different from a doctor looking down your throat or in your ears. The only difference is that in our culture, we have put different importance on the genitals, and have different feelings of privacy. Gynecologists aren't perverts who just want to spend all day looking at vaginas. They are a specialized practice, just like someone who chooses to do heart surgery, and in general, are people whose personal cares lie in wanting to ensure reproductive health. There is no reason to feel it is dirty -- it isn't. You're taking care of yourself, and so is the doctor.
You may or may not get a speculum exam: The current protocol for Pap smears is to begin them at age 21, or the person is sexually active, or there's pain or suspected infections that need to be looked into.
A speculum is a sanitary plastic or metal clamp device that comes in several different sizes which is used to hold open the vagina so that the doctor can examine the vaginal walls and cervix. If you are not used to this, or to what it feels like to have something placed into your vagina, this may hurt a little bit, but the doctor will gauge a size of speculum that is right for you so that it is not too uncomfortable. Most people describe the feeling of a speculum exam less often as painful and more often as just a bit awkward. You may feel some pressure in your bladder (it may feel suddenly like you have to urinate, even if you don't) when the speculum is in, and if you do, let your doctor know, and (s)he will make adjustments so that you are more comfortable.
If you receive a pap smear while you are there -- this is a test to look for cervical cell changes, and to help screen for cervical cancer -- (s)he will use a long q-tip of sorts to swab the cervix for tests. This swabbing doesn't hurt, it just feels a little weird, as you may not be used to ever feeling something on your cervix.
The ACOG is currently advising that pap smears, specifically, begin at age 21. Whether or not you get a pap smear often depends on the specific doctor's practice -- and when you want to start them yourself -- but as of right now, the most general guidelines of most medical associations and practices are roughly in agreement: those who are 21 or over (including those not yet sexually active), are usually encouraged to begin pap smears and have them yearly to every few years. How often paps are suggested will depend on your country's current standards and on your unique body and life.
If a pap smear doesn't show anything problematic, while bimanual exams and STI testing may need to be done more often, you may only actually need a pap smear once every three years.
If you do get a cervical exam/pap smear and are curious, you can also ask your doctor to get a mirror and show you what your cervix looks like when the speculum is in. It's actually pretty cool to get a look at. If you're a big do-it-yourselfer, some gynecologists will even show you how to do a self-exam with a speculum if you ask them. You can take a look at some information on that from my other workplace here.
After removing the speculum, the next thing (s)he may do is a rectal exam, where (s)he will put one finger in your anus, and another in your vagina. This is so (s)he can see how your uterus is aligned with the other parts of your reproductive organs. In general, this is the part of the exam most people find the most uncomfortable, especially if neither you nor anyone else has inserted a finger in your anus before. If the doctor knows it is your first exam, like any other part of the exam, you can feel confident (s)he will be gentle and careful -- and may not even do that part of the exam at all -- and do her/his best to cause you the least discomfort possible.
And that's it! That's it in just a couple of minutes, no less: the whole of that genital exam only lasts that long. It's nothing close to a long procedure. After the exam is when your doctor may ask you if you have any questions, so that's a good time to bring anything you've been wondering or worried about to the table, like genital appearance issues, questions about your period, questions about sexual activity risks, what have you. One of the best parts of beginning a relationship with a gynecologist or other doctor able to provide those services is that it gives you a great go-to person for any questions you may ever have about sexual or reproductive health!
As far as your virginity is concerned, read our piece on virginity. Chances are, if you've been physically active, used tampons, or are in your later teens, your corona (hymen) is probably already at least somewhat worn away: to some degree, it does that all on its own over time. But defining virginity by the state of your hymen isn't sound, since plenty of people who have never had any kind of sex at all do not have fully intact hymens.
Virginity is not a medical or physical condition, it is something emotional and culturally defined, and most people define it as being about sexual partnership, not healthcare services or the state of our genitals. A doctor (or other person, for that matter) cannot tell who has and who has not had vaginal intercourse by the width or tightness of your vagina, or by the state of your hymen. A gynecologist cannot "devirginize" you, but that certainly is a concern you can bring up before you have an exam.
Again, a visit to the gynecologist isn't a punishment; it is an important part of keeping yourself healthy as someone with a reproductive system and genitals, and your gynecologist can turn out to be a great source of honest, accurate sexual information for you for years to come. So, take a deep breath, and realize that keeping your sexual health in tune should be something empowering for you, not something dreadful.