What to Expect

A gynecologic visit focuses on the female reproductive organs and functions. Young women should have their first gynecologic visit between the ages of 13 years and 15 years. The first visit may just be a talk between you and your doctor. This will help you both to get to know each other and help you find out what to expect at future visits. It is normal to feel nervous about your first visit. It may help to talk about it with your parents or someone else you trust so you know what to expect.

Your doctor may ask a lot of questions about you and your family. Some of them may seem personal, such as questions about your menstrual period or sexual activities (including vaginal, oral, or anal sex). Your doctor needs to ask these questions to best know how to care for you and keep you healthy. Giving open and honest answers to these questions is key to your care. This is a good time to ask your doctor any questions you might have.

If you are concerned that your doctor will tell your parents what you talk about, discuss this concern with your doctor first. Your doctor will explain the kinds of information that can remain private between the two of you, and the kinds that he or she must tell your parents.

Exams

You may have certain exams at the first visit. It depends on your age, if you have had sex, or if you have any problems. This visit may include the following exams and tests:

• General physical exam
• Breast exam
• Pelvic exam
• Pap test

Symptoms That Need Care If you are having any of the following symptoms, tell your doctor:: Severe pain in the lower abdomen Bad cramps during your period Periods that are not regular or missed periods Pain around the vagina or burning, swelling, itching, or discharge Blood in your urine

General Physical Exam

During the general exam, your height, weight, and blood pressure will be checked. You also will be examined for any health problems you may have (see box).

The Breast Exam

During this exam, your doctor will check your breasts for growth and signs of any problems, such as a lump. The doctor will examine your breasts by moving his or her fingers around your breasts in a pattern.

The Pelvic Exam

Most girls do not need a pelvic exam at their first gynecologic visit. But if you have had sex or are having certain problems, a pelvic exam may be needed. For the pelvic exam, you will be asked to undress and put on a paper or cloth gown. You then will lie on an exam table. You will be asked to put your feet against footrests and slide to the end of the table.

The pelvic exam has three parts:

Looking at the vulva Looking at the vagina with a speculum Feeling the internal organs with a gloved hand

The doctor may look at your vagina with a speculum. He or she may take a sample of your cells to check for some sexually transmitted diseases (STDs). Another sample may be taken for a Pap test.

After the speculum exam, your doctor will check your internal organs. The doctor will place one or two gloved, lubricated fingers into the vagina and up to the cervix. The other hand will press on the abdomen from the outside. This exam helps the doctor check the size, position, and shape of the internal pelvic organs. It also may help the doctor find any problems. The pelvic exam may feel uncomfortable, but should not hurt.

The Pap Test

The Pap test checks for abnormal cells in the cervix that could lead to cancer. With the speculum in place, the doctor collects cells from the cervix with a small brush and a small tool called a spatula. The cells are sent to a lab to be studied.

You may not need to have a Pap test at your first gynecologic visit. A Pap test should be done within 3 years after you first have sex or by the time you turn age 21 years.

Vaccines You May Need The following vaccines are recommended for all adolescent girls: Diphtheria–tetanus–pertussis (Tdap) booster (once between ages 11 years and 18 years) Human papillomavirus vaccine (one series between ages 11 years and 12 years; one series between ages 9 years and 26 years for those who have not been vaccinated) Meningococcal vaccine (between ages 11 years and 12 years or 13 years and 18 years if not previously vaccinated) Influenza vaccine (“flu shot”) Depending on the vaccines you have already had, you also may need the following “catch-up” vaccines: Hepatitis B virus vaccine Inactivated poliovirus vaccine Measles, mumps, and rubella vaccine Varicella (chickenpox) vaccine Special vaccines may be given to girls who are at an increased risk of certain diseases or who live with people at increased risk: Hepatitis A virus vaccine Pneumococcal vaccine You can find the most current information about the vaccines recommended for your age at http://www.cdc.gov/vaccines.

Vaccinations

Vaccinations or immunizations are shots that protect against diseases caused by bacteria and viruses. Some are given on a routine basis (see box). Other vaccinations are offered to women who are at an increased risk of certain diseases. Your doctor may ask you about your medical history and suggest you receive certain vaccinations.

Special Concerns

Many young women share the same health concerns. Most of these concerns are a normal part of growing up:

• Cramps and problems with menstrual periods
• Acne
• Weight
• Sex and sexuality
• Birth control
• STDs
• Emotional ups and downs

Most young women enjoy good health. Health problems that arise for young women often are a result of high-risk behaviors, such as having unprotected sex or using alcohol or drugs. Your doctor may offer some tips on how you can help prevent these problems and stay healthy (see box).

Being Healthy Making good lifestyle choices can help you stay strong and healthy for years to come: Maintain a healthy weight by eating a well-balanced diet and exercising often. Avoid smoking, drinking alcohol, and using illegal drugs. Seek help if you have emotional ups and downs or feel depressed. Use birth control if you are having sex. Protect yourself from STDs by using a latex condom, knowing your partners and limiting their number, and avoiding risky sex practices. Keep up with routine exams, tests, and immunizations.

Finally...

Your first gynecologic visit is a great chance to take charge of a healthy lifestyle. You may be nervous at first. Knowing what to expect will help ease your fears.

Be involved in your health care. Follow up with your doctor to find out test results. Ask questions. See your doctor on a routine basis to be sure you have all the tests and vaccinations you need to stay healthy.

Glossary

Birth Control: Prevention of pregnancy.

Cervix: The lower, narrow end of the uterus, which protrudes into the vagina.

Condom: A thin sheath used to cover the penis during sex to prevent sexually transmitted diseases and pregnancy.

Menstrual Period: The discharge of blood and tissue from the uterus that occurs when an egg is not fertilized (also called menstruation).

Pap Test: A test in which cells are taken from the cervix and vagina and examined under a microscope.

Pelvic Exam: A manual examination of a woman’s reproductive organs.

Sexually Transmitted Diseases (STDs): Diseases that are spread by sexual contact.

Speculum: An instrument used to spread the walls of the vagina.

Vagina: A tube-like structure surrounded by muscles leading from the uterus to the outside of the body.

Vulva: The external female genital area.

This Patient Education Pamphlet was developed by the American College of Obstetricians and Gynecologists. Designed as an aid to patients, it sets forth current information and opinions on subjects related to women’s health. The average readability level of the series, based on the Fry formula, is grade 6–8. The Suitability Assessment of Materials (SAM) instrument rates the pamphlets as “superior.” To ensure the information is current and accurate, the pamphlets are reviewed every 18 months. The information in this pamphlet does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice may be appropriate.

Copyright © December 2008 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

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