What to Expect at Your First Visit to a Gynecologist

Gynecology is the branch of medicine that deals with the functions and diseases of the female reproductive system. Regular gynecological checkups can help adolescent girls and women against certain diseases and cancers, including the early detection and treatment of illnesses. 

Gynecological care is very important regardless of age, level of sexuality, or marital status. However, the time to visit a gynecologist is often a personal choice. There are adolescent girls as young as 13-14 years old who visit a gynecologist to discuss their menstrual problems. In general, females need to see a gynecologist once they become sexually active and are ready to discuss birth control and STD protection, including STD screening. There are also gynecologists who specialize in adolescent girls. You can ask your pediatrician for any recommendations. 

You may need to regularly see a gynecologist if you have any of the following conditions:

• A mass or lump in the breast
• A family history of breast cancer, particularly before reaching menopause
• Past and current sexual health problems
• Sexually transmitted disease (STD)
• Having a sex partner who has an STD
• Planning for pregnancy
• An abnormal Pap test result in the past

Other conditions that require a visit to the gynecologist include:

• Irregular menstrual cycle
• Breast irregularities
• Genital abnormalities
• Pregnancy

Seek help from a gynecologist if you experience any of the following symptoms:

• An abnormal thickening of the armpit or lump in the breast
• Unusual vaginal discharge 
• Abnormal vaginal bleeding
• Vaginal itching
• Itchy vulva
• Abnormal pelvic or vaginal pain
• Severe pain in the lower abdominal area and pelvis
• Lumps or sores in the vagina or vulva
• Painful vulva or vagina
• Unusual breast changes in shape or size or dimpling
• Sudden onset of nipple retraction
• Unusual nipple discharge or bleeding
• Pain and discomfort before menstruation

What to Expect at Your First Gynecologic Visit

Here's what you need to know at your first visit to the gynecologist:

1. Talking about your medical history

On your first visit, you will likely start out by talking to your doctor and answering questions about your personal medical history, including your family history. Your gynecologist may also ask questions regarding your sexual health, the number of sex partners you have had and whether you use contraception, including other types of protection.

Although it may feel uncomfortable talking about your sexual health, remember that it is also very important to honestly answer your doctor's questions to properly address your concerns. It is completely fine to tell your doctor that you are nervous and ask if you can let your sibling, parent, or loved one stay with you. 

You can also ask your doctor about HPV vaccination and other questions regarding irregular menstrual cycles, pain during sexual intercourse, or any concerns you may have. The information you share with your doctor can be kept confidential. 

2. Physical examination

After getting your medical history, you will be asked to take off your clothes and underwear, and put on a lightweight paper gown. Your gynecologist will perform a routine physical exam.

In certain cases, the doctor will check for unusual breast lumps, which are a common sign of breast cancer. Once women turn 21, it is highly recommended to have annual breast exams. 

3. Pelvic examination

After the breast exam, the doctor will ask you to place your feet into the stirrups for a pelvic exam. You may be embarrassed or feel a little awkward while on this position, but know that the doctor will be communicative about what they are doing, so you will understand and know where they will be touching you. Some may have small talks about their patient's life to help ease the tension. 

The doctor will perform a pelvic exam, particularly if you have signs and symptoms of an infection, an irregular menstrual cycle, and pelvic pain. Otherwise, young girls and women who are below 21 years old do not need routine pelvic exams. A pelvic exam is also unnecessary if you have never had oral and/or anal sex. Wanting to start using birth control does not also require a pelvic exam. 

• External Exam: A pelvic exam starts with a visual examination of the external genitalia to check for cuts, warts, and other genital abnormalities.

• Speculum Exam: The external exam is then followed by a speculum exam, in which the doctor inserts a device called speculum into the vagina to look inside of it and check the cervix. It is normal for you to feel slightly uncomfortable but not in pain during the exam. Inform your doctor once you feel any pain. During the exam, the doctor may also collect a fluid sample from the vagina to test for any infection. If your doctor recommends a Pap smear, cells from your cervix will be collected. Once finished, the doctor will remove the speculum.  

• Bimanual Exam: After the removal of the speculum, the doctor performs bimanual palpation, in which two fingers are used to palpate the cervix. The doctor will place their other hand on your abdomen and gently press it down. In this way, the doctor can assess the health of the ovaries, fallopian tubes, uterus, and cervix.  

Once the doctor is done with the pelvic exam, you will be asked to sit up, taking your feet out of the stirrups. The doctor will let you know about his or her initial assessment or any concerns he or she may have. You will also be informed about the tests that will be performed. 

4. Other tests

In some cases, blood extraction may be required for further testing. If the doctor's office doesn't perform blood extraction, you may need to go to a laboratory for blood collection. Getting your blood drawn for additional testing does not necessarily mean that there is something serious going on. 

If there is anything unusual with the tests, you will be contacted once the results are completed. A pregnancy test result is often readily available during your doctor's visit while it may take 3-14 days for other test results to be available. 

5. Medications

After you are done with the exams and other tests, someone will talk to you regarding medications. You can get information or ask questions if you want to start using or continue using birth control. If you have an infection, your doctor will prescribe an anti-yeast treatment or an antibiotic.