Facing your first gynecologist visit? Don't be scared — it's really nothing to be afraid of. While you may feel nervous about having a medical provider examine you and talk about your reproductive health, it's usually a rewarding experience. Still, whether it's your first gynecologist visit or your 20th, it's always good to have a clear idea of what to expect.
Although a lot of people see obstetrician-gynecologists (OB-GYNs) for their women's health care, certified nurse midwives, nurse practitioners, and even physician assistants are also qualified to provide gynecological care under many circumstances, including annual exams.
Here's what you should know before you head into your OB-GYN's office.
At an annual appointment, you'll most likely have a breast exam, visual exam, and pelvic exam. Before you see the doctor, a nurse or medical assistant will take your height, weight, and blood pressure. Then you'll head into the exam room, change into a gown (sometimes paper, but it may also be like a hospital gown) and wait until your provider enters the room. The exam will be performed with you sitting or lying on an exam table.
The breast exam is a short exam where the provider checks for lumps or abnormalities in your breast tissue. The visual exam includes looking at your vulva, including the labia, and inside your vagina. This involves a speculum, which is a metal or plastic device that holds the labia open so the provider can see your cervix (basically the neck of the uterus). Having the speculum inserted is often slightly uncomfortable and it may pinch or feel cold, but take deep, slow breaths and relax your pelvic muscles to make the process as smooth as possible.
You may also have a Pap smear, which is a test that checks your cervix for abnormal cells that could indicate cancer. According to the American Cancer Society, women ages 21-29 should have a Pap every three years, then every five years after age 30 up until age 65. If you're over 65 and don't have any risk factors for cervical cancer, you may stop Pap smears if that's what your doctor advises.
The provider will also do a pelvic (also called bimanual) exam, where they insert one or two fingers into your vagina while pressing with their other hand on the outside abdomen. This is done to check the size and shape of your organs, including your uterus. Occasionally, the doctor or advanced-practice clinician will also physically examine the rectum. If you have pain during this process, your provider may ask you specific questions to learn more about where the pain is and how it affects you.
You may also use your exam time to give your OB-GYN an overall picture of your health (including sexual health and activity) and ask questions about any concerns you have about your body or life. If you haven't received the Gardasil vaccine (a vaccine that prevents against human papillomavirus, or HPV, a virus that can cause some gynecological cancers and/or genital warts), your doctor may talk to you about whether you want to receive it.
If you want to talk in depth about another topic, such as painful periods or your options for birth control, it may be a good idea to make a separate appointment where you can discuss that in your doctor's office rather than in an exam room. This can give you more time and also make you feel more comfortable because you'll be in your own clothes rather than the exam gown.
If you're nervous overall or have triggers around being touched, let your provider know. They will be able to talk you through any procedures and should always stop if and when you feel uncomfortable. Some providers will be able to do other things to make you feel more in control, like having you insert the speculum yourself or not using stirrups during your exam. Others may offer you aromatherapy to help you feel calmer or ginger candies to settle your stomach.
Remember that an OB-GYN visit should never be painful or stressful. You should always feel safe and respected, even during your first gynecologist visit.
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