Click here to take survey about your first pelvic exam.
Most girls will start going for gynecological care when they are
having any abnormal symptoms (such as vaginal discharge), if they have just
started having sex (or are planning to start), or even if they haven't yet
become sexually active but have reached the age of 18. Here is a step-by-step
breakdown of exactly what is going to happen during the exam.
First off, the patient should make sure that she schedules her
appointment during the middle of her menstrual cycle. If it gets too close to
menstruation, the uterus will start to shed cells, which can interfere with the
Pap smear results. If the patient feels that she may want someone to be in the
exam room with her during the exam for support, she should ask what the doctor's
policies are on this subject while making her appointment. Also during the
scheduling, the patient should make it known that it is her first visit and
exactly why she will be coming for the visit. Secondly, the patient should not
put anything into her vagina for 2 days before the appointment, as this can
cause an abnormal Pap smear. This means that the patient should not have
intercourse, douche, or put dildos, tampons, or fingers into her vagina.
It is helpful for the patient to write down any specific
questions, symptoms, or anything else she may be wondering about and take it to
the exam. If considering birth control, the patient should think about her
preferences before her visit. The patient will be asked about any current
medications, so be sure to bring the bottles for any current medications and
also any old medical records if uncertain about the details of any previous
procedures. Also, waits at the doctor's office may be long, so if nervousness is
going to be a problem, make sure to bring a good book or something else to do
that can provide a distraction.
Before the nurse takes the patient back to the examining room,
she may ask the patient for a urine sample in order to diagnose urinary tract
infections or pregnancy. Even if a sample is not requested, it is a good idea to
empty the bladder to aid in avoiding feelings of discomfort during the exam.
Once back in the exam room (which will be set up with a tray for the various
tests), the patient will have to give her medical history. She will be asked
about such issues as family history of cancer of the female reproductive organs,
past operations or hospitalizations, and any medications that the patient may be
Before doing the external pelvic exam, your doctor will probably
do a breast exam. During the pelvic exam you値l be lying on your back with your
bottom at the very end of the table and your heels resting in metal supports
called stirrups. The doctor sits at the end of the examination table so that he
or she can examine your external and some internal organs. The doctor will wear
exam gloves during all parts of the examination.
Your doctor will do an external examination of your genitals.
The bimanual exam is performed when your gynecologist inserts
two fingers into your vagina and places the other hand on top of your lower
abdomen, while feeling for any abnormalities that might have occurred since your
last pelvic exam. During this part of your examination, your doctor checks the
size, shape, and mobility of your uterus. Changes in your ovaries, such as
ovarian cysts may be detected during the bimanual exam, as well as other uterine
changes including endometriosis, fibroid tumors, or other common uterine
A speculum is a metal or plastic instrument that looks somewhat
like a duck's bill. The "bills" are inserted into the vagina and opened in order
to spread the vaginal walls and visualize the cervix. After the speculum has
been opened, a cervical brush and then a spatula will be used to rub a sample of
cells off the cervix. This may cause you to experience some spotting after the
exam, but it will not hurt. The sample of cells is spread onto a slide and this
is the Pap smear. Any samples for testing for infections will be collected. Some
doctors screen for sexually transmitted diseases routinely. However, most tests
will only be done if there is a reason. The speculum is then closed and removed
from your vagina. There will be some clicking noises during the locking and
unlocking of the speculum; these noises are routine, so there is no need to be
concerned by them.