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What to expect at your first pelvic exam (karma: 39)
By JoyNoellePremium member
On Sat Jan 28, 2006 03:17 PM
Made sticky by hylndlas (107168) on 2006-01-30 15:14:53 I really, really , really ,think this should be a sticky! Great post!!!!

Not sure what to expect at your first pelvic exam? Are you afraid? Embarrassed? Well, don't be! It's all part of being a woman, and the sooner you get used to the idea of having gynecological exams, the better, because these will be part of your life forever. I hope the following information will be useful and will help you relax as you face your first visit to the gynecologist.

There are no hard and fast rules about when a girl should start seeing a gynecologist, but these are some guidelines:

. You are sexually active, or are planning to become sexually active
. You're older than 15 or so but still haven't started menstruating
. You're experiencing lower abdominal pain, excessive bleeding, irregular periods, or unusual discharge
. You think you might be pregnant
. You're concerned that you may have been exposed to a sexually transmitted disease
. You want to get on birth control
. You've found a lump in your breast

When you're ready, you're going to have to choose a gynecologist. If your mother, sister, friend, etc., has a gynecologist that she trusts and likes, you might consider seeing the same doctor. If you're new in town and don't really know anyone to ask for personal recommendations, you can call local hospitals, Planned Parenthood clinics, the health center at your college, etc., and ask for recommendations. A lot of women are very uncomfortable with the idea of having a male physician examining their genitalia; you may be more at ease with the idea of seeing a female physician. Keep in mind that the doctor's gender shouldn't make any difference, as they've had the same training and are obligated to observe the same rules when seeing patients, but if you simply can't fathom the idea of being examined so personally by a male, choose a female. You should also keep in mind that during the exam, regardless of whether you're seeing a male or female physician, you have the right to request that a female (nurse, friend, parent, etc.) be present.

Once you've chosen the doctor and made your appointment, you'll need to prepare for the visit. Basically, there are just a few things you shouldn't do: Don't have sex, or douche, or use any type of vaginal products for at least 24 hours prior to your exam. (You really should never douche, but that's a whole different topic!)

When you arrive at the doctor's office, you'll be presented with forms to fill out; these will ask for your personal and family health histories, and may ask what brings you there (i.e., are you having a specific problem?), whether you're sexually active, etc.

A nurse will call you in and will take your vital signs (weight, height, blood pressure, pulse, temperature), and may ask you for a urine specimen. (Even if they don't ask for a urine specimen, be sure you empty your bladder prior to the pelvic exam. This will definitely make it more comfortable!) S/he will probably ask you some basic questions about your health and why you're there. At this point s/he may take you to a consultation room or office, or she may leave you in the exam room. If s/he instructs you to remove your clothes and put a gown on, but you'd prefer to meet your doctor while you're fully clothed, let her/him know. (You can ask about their procedure for new patients when you call in to make your appointment. If they're unwilling to respect your choice to see the doctor for the first time while you're wearing your clothes, find another doctor.)

Finally, the doctor will join you. Be prepared for some general chit-chat and basic "getting to know each other" conversation. If you have any questions or concerns, this is a good time to bring them up. Once you're being examined it's easy to forget things you wanted to say. It's a good idea to bring a written list of things you want to ask, so that even if nerves take over you'll still recall everything you wanted to say.

Your doctor will leave the room (if you're already in an exam room) or will escort you to an exam room, and will give you a gown to put on and a sheet to cover up with. While you're waiting for her/him to return, try to relax by doing some slow, deep breathing.

Once the exam begins you should be thoroughly checked from head to toe, even though this is a gynecological visit. The doctor should check your eyes, ears, nose, and throat, then move down to feeling the glands in your neck, listening to your heart and lungs, and checking your reflexes. S/he may take your blood pressure again, as well.

The breast exam will come next. If you're not currently performing breast self-exams, let your doctor know so that s/he can teach you the correct way to do it, as well as the best time of the month.

Last, but definitely not least, comes the pelvic exam. You'll be asked to slide your bottom all the way to the end of the exam table; this can feel quite disorienting if it's your first time, because you'll swear you're going to fall off. But you won't! Your feet will be placed in stirrups (some exam tables have leg holders instead of stirrups) and you can help by letting your legs fall open. Don't tense up or try to keep your legs together; just let them fall naturally apart. This is probably when you're going to feel most embarrassed and vulnerable, but just remember that the doctor has done this hundreds, if not thousands, of times and while it's new to you, it's not new to them. For them, it's just part of a day's work.

This is an overview of the female genitourinary system:
Image hotlink - ''

The exam will begin with the doctor visually examining your external genitalia; they're looking for abnormalities such as cysts and they're also noting the size and condition of your clitoris and your labia minora and majora. The doctor must separate the labia in order to see the vaginal introitus (opening) and the urethral opening. This is what the external female genitalia look like:
Image hotlink - ''

Your doctor may proceed by inserting a finger into your vagina in order to determine the speculum size best suited to you, and also to check to see if your hymen is intact. Or they may proceed by inserting the speculum. Either way, it's very important that you keep your abdominal and pelvic muscles relaxed now, as tensing them up will make the exam difficult for the doctor and uncomfortable or painful for you. Once again, taking slow, deep breaths can help you relax. This is what the speculum looks like:
Image hotlink - ''
If at any point during the internal exam you're experiencing pain or discomfort, let the doctor know. But keep in mind that since this is a new experience for you, it's possible that it simply feels odd and unusual, but isn't actually painful.

The speculum is inserted while it's closed; only after it's correctly positioned inside your vagina will its blades be opened; this should not hurt. The doctor will direct a very bright lamp at your vagina so that s/he can see what's going on in there; this may feel warm, but don't let it startle you. They're looking for a number of things, including the size, condition, and placement of the cervix (the opening of the uterus), any lesions/sores/cysts on the vaginal walls, and any discharge or bleeding. The last step of the speculum exam is the Pap test, in which the doctor will take scrapings from the cervix and the vagina. Again, this may feel strange, but it should not be painful. Here's a diagram of a speculum exam:
Image hotlink - ''

Once the speculum has been withdrawn, the doctor will move on to the manual portion of the exam, in which they'll insert gloved, lubricated fingers into your vagina. Depending on various factors the doctor may insert a single finger or two fingers. While their fingers are in the vagina, they'll use their other hand to press on your abdomen in order to feel your internal organs, including the ovaries and uterus. This may be a little uncomfortable but shouldn't hurt. Here's a diagram of a bimanual exam:
Image hotlink - ''

Finally should come the rectal and/or rectovaginal exam. In the former, the doctor places one finger in the rectum, while in the latter they insert their index finger into the vagina and their middle finger into the rectum. This is a very important part of the pelvic exam as it allows the doctor to check the rectum for abnormalities such as hemorrhoids, fissures, and signs of cancer, allows them to have a better feel of certain organs, and is the best way for them to check the wall between the vagina and rectum. No pelvic exam is complete without a rectal exam, so if your doctor doesn't automatically include it be sure to request it.

You'll now have another opportunity to discuss things with the doctor before they leave the room. If you're going on birth control be sure to discuss all of the options available to you, including when you should come back for a followup visit. If there's anything you forgot to ask, you can do it now.

Most Pap smears are normal, and chances are you'll receive a lab report in the mail informing you that yours was, too. In the event that any abnormalities were found, or if the results were inconclusive, you'll hear from the doctor's office and be asked to come in to be retested. Don't let this alarm you as there are many reasons a Pap test may initially appear abnormal, yet everything turns out fine when you're retested. Of course if something abnormal really is found, you and your doctor will discuss a plan of action.

Well, that's it! You've made it through your first visit to the gynecologist and you're well on your way to taking charge of your own healthcare and well being. :)

(NOTE: No two doctors perform exams in exactly the same manner, so your exam may proceed differently from what I've described. However, even if things are done in a different order, all of what I've described should be done during the course of the exam. If your doctor skips anything, don't feel strange about asking them to do it. Believe me, they will not think you're weird for asking!)

Credit for the diagrams goes to the Doc Hollywood Project.

175 Replies to What to expect at your first pelvic exam

re: What to expect at your first pelvic exam
By cesaria
On Sat Jan 28, 2006 04:31 PM
Awesome post! I'm a grown woman, and I've been going to the gyno for over 10 years, and I think the pics you posted will really help some girls who are new at this. I remember thinking "speculum? What is a speculum?" the first time I went - it would have been awesome to have this info first.
re: What to expect at your first pelvic exam
By DragonFlyPremium member
On Sun Jan 29, 2006 01:27 AM
thanks that was useful. But kinda scary lol.
re: What to expect at your first pelvic exam
By Legwarmermember has saluted, click to view salute photosPremium member
On Sun Jan 29, 2006 11:43 AM
Scary, but I adore you, honey!
re: What to expect at your first pelvic exam
By Kirsty_Pmember has saluted, click to view salute photos
On Sun Jan 29, 2006 01:51 PM
Im glad I took the time to read it, great post! I knew most of it, but im pretty sure alot of people won't. Karma+ the will to make a sticky =)
re: What to expect at your first pelvic exam
By ximmaspecial1xmember has saluted, click to view salute photos
On Sun Jan 29, 2006 02:34 PM
This is a really informative post. I have a question though. I am 20 years old and I am a virgin. And I dont just mean that I've never done the deed, I mean I have never had anyone touch me down there. And I have never gone to the gynocologist. I've been thinking for a while that I probably should go just because I've read that you're <i>supposed</i> to...? What do you think?

And wow that speculum thing really scares me. really really. :?
re: What to expect at your first pelvic exam (karma: 1)
By JoyNoellePremium member
On Sun Jan 29, 2006 06:01 PM
^ The short answer is: Yes, you should start seeing a gynecologist. I realize I'm an unusual case, but at your age I was battling a near-fatal gynecological illness that ended up forcing a hysterectomy by the time I was 22. Even though it's very unusual for someone your age to have any serious gyn problems, it's still best to start having an annual exam. A few reasons I can think of to support that idea: You will eventually become sexually active; you never know when you may have gyn problems; Pap smears are very good at detecting cancer in its early stages, before any symptoms appear; etc. It's much better to have a doctor you're already familiar, and comfortable, with than to have to find one in a hurry when something comes up unexpectedly.

Regarding the speculum that seems to be scaring's not that bad! Really. The doctor will choose a speculum that's sized appropriately for you. In other words, if you're a young teen, and a virgin, they'll use a very small one, whereas if you're a woman who's borne one or more children, they'll use a larger one. So don't worry about it being uncomfortable because it really shouldn't be. Strange, yes, but not uncomfortable or painful.
re: What to expect at your first pelvic exam
By xSupastarxmember has saluted, click to view salute photos
On Tue Jan 31, 2006 08:23 AM
Great post! ;) Really informative and stuff. I'm glad it's been made a sticky, and hope everyone reads it! But goodness, that sure looks painful :?
re: What to expect at your first pelvic exam
By dancergirl10member has saluted, click to view salute photos
On Tue Jan 31, 2006 09:34 PM
I really don't think i'd mind the vaginal exma....but I don't think i want one or more fingers up my bum, its too small an apperature.
re: What to expect at your first pelvic exam (karma: 1)
By dance_is_life_99member has saluted, click to view salute photos
On Thu Feb 02, 2006 07:01 PM
^Uh HUH! I was completely unaware that this included a rectal exam?? I mean...I'm sure it wouldn't be quite as bad for me as I've had other things up there before (even though I did NOT enjoy it)...but I didn't know that was a part of it?? I'm SO not down with that. I know I have to, but wow. Not. Down.
re: What to expect at your first pelvic exam
By missdancer
On Fri Feb 03, 2006 04:43 PM

Sorry if i seem a little dumb but i have NEVER heard of anything like this! Does everyone get it? Is it in every country?

Because im 15 live in Scotland and i've never come across this before!!!

missdancer x
re: What to expect at your first pelvic exam
By ReelDancer7
On Sat Feb 04, 2006 11:39 PM
I'm pretty sure its in every country. The exam makes sense to get it done. My mom has told my about it. Doesn't sound too bad actually. Everyone makes it to be such a big deal. I'd perfer a woman doctor though.
re: What to expect at your first pelvic exam
By KMonstermember has saluted, click to view salute photosPremium member
On Sun Feb 05, 2006 02:35 AM
Just reading that makes me sick to my stomach. I know it shouldn't, but it really does. I'll probably end up crying the first time I go because I'm no nervous. It's good to know that you can request someone to come with you. I'm sure it wouldn't be half as bad holding my mums or my best friends hand as it happens. Thanks for the information I was always curious on the topic.

re: What to expect at your first pelvic exam
By Danseusemember has saluted, click to view salute photosPremium member
On Sun Feb 05, 2006 05:30 AM
Thank you for this! I like many here didn't know about the Rectal exam or what a Speculum looks like. Very useful studd indeed.
re: What to expect at your first pelvic exam
By the_next_prima1member has saluted, click to view salute photos
On Sun Feb 05, 2006 10:05 AM
Great Post! Karma for you! Definately, a good guide for girls who have never seen a gynecologist before.

re: What to expect at your first pelvic exam
By JoyNoellePremium member
On Wed Feb 08, 2006 01:10 PM
Silly me! I somehow managed to leave out a picture I meant to include, so here it is. This is an exam table with stirrups:

Image hotlink - ''
re: What to expect at your first pelvic exam
By pirouette89
On Fri Feb 10, 2006 08:35 PM
I wouldn't mind any of this stuff if I could just get some help! I'm so sick of being an emotional basket case and being in pain half of my cycle. If I could only see a doctor, I wouldn't care about the pelvic or rectal exam. I would welcome it, if anything. I just want to know what's wrong with me and how I can fix it.
re: What to expect at your first pelvic exam
By JoyNoellePremium member
On Fri Feb 10, 2006 09:06 PM
^ Can you expand on that a little, Pirouette? What's wrong? What kind of symptoms do you have? What have you done about it? Why haven't you seen a doctor?

If you want to explain your situation in more detail, perhaps someone will have advice/suggestions for you.
re: What to expect at your first pelvic exam
By pirouette89
On Fri Feb 10, 2006 10:59 PM
I already posted a while back, but I can't seem to find it in the shuffle. Anyways, I'm concerned I might have an STD that's been lying dormant for several years (I suspect Syphilis the most), but I also think I have some sort of hormonal/chemical imbalance. I'm absolutely emotionally insane for about 10 days each cycle, and it's interfering with my life. I get depressed and can't sleep, even though things are going well for me; I become convinced that the people who are supposed to love me really don't like me at all, but then I think that I can't blame them because I hate myself too.

My mom doesn't think I really have a problem, which may be true, but I've had problems with severe PMS for a long time, and this seems to be escalating each month. I can safely say that this state is WELL beyond PMS. Plus the cramps seem to get progressively worse each month, as well as the nausea (see the current poll). I have a hard time thinking, and I can't pay attention to whatever I'm studying.

Plus I have insomnia really bad for that week and a half or so, and it keeps getting worse. I'm exhausted the next day, but then by the time I crawl into bed I just lie there crying because I think no one likes me. I'm normally not like this! I'm getting really tired of people thinking I'm emotionally unstable because of something hormonal going on in me a large chunk of the time. I don't know if going on the pill would even help that, but at least maybe if I went to the doctor I could figure out what it was.

I have no idea what that describes, but if anyone is reminded of any kind of condition, I'd be interested in knowing about it.
re: What to expect at your first pelvic exam
By MisS_sHoNa
On Sat Feb 11, 2006 12:52 AM
thank you so much!!!!! i was just about to post a 'HELP! i need to get a pap smear and dont know what to do!' post lol

shona :)
re: What to expect at your first pelvic exam
By JoyNoellePremium member
On Sat Feb 11, 2006 09:50 AM
^ You're welcome, Shona! Glad it helped.

^^ Pirouette, I just reviewed the post you'd made some time ago and it refreshed my memory on the whole issue. I guess I'm a bit confused at this point as to why you still haven't seen a doctor. :? You were given lots of great advice, such as going to Planned Parenthood or local health department clinics for free or low cost exams/tests, but apparently you haven't gone yet. You were concerned about lying to your mother, but I don't get why you'd have to. For one thing, you're at an age where it's certainly reasonable to be seeing a gynecologist, but you're also at an age where you can get yourself to a clinic without your mother's knowledge. So if you really feel the need to keep this secret from her, why not get yourself to a clinic and get it over with?

Clearly, you need to see a doctor, and I hope you'll do that soon. If you want to discuss this further, I'd like to suggest using your original thread so that we can keep this one on-topic.
re: What to expect at your first pelvic exam
By pirouette89
On Sat Feb 11, 2006 11:26 AM
Edited by pirouette89 (95651) on 2006-02-11 11:31:31
I can't drive, or I would take myself. And anyways, I had no intention of bringing everything up again until you asked...

If I do have something terrible, I don't want to go around my mom's back to find out about it. I want her on my side. And I have issues with Planned Parenthood; I don't trust them, and I don't want them looking at my body. I think I can hold out another year if my alternatives are to be sneaky and dishonest to my mom. I'm now the proud owner of a hot water bottle, and as far as the emotional stuff goes maybe if I exercise more I'll feel better.

Back on topic, does it hurt at all when they do the bi-manual? I don't like being touched that low down on my stomach, and I think it would be uncomfortable to have much pressure applied there. I didn't really get that part of the thread.
re: What to expect at your first pelvic exam
By buhbamember has saluted, click to view salute photos
On Wed Feb 15, 2006 05:21 AM
Edited by buhba (130943) on 2006-02-15 05:22:45 cannot seem to read properly
:o oh dear, helpful, but scary!
re: What to expect at your first pelvic exam
By dancerchick375
On Thu Feb 16, 2006 09:20 PM
Joy Noelle love your icon anyways nice pictures. ive never been to a genocologist and i dont think i need to but nothings wrong with a check up
re: What to expect at your first pelvic exam
By Sparkz_NzPremium member
On Wed Mar 01, 2006 01:48 AM
Hey Joy!

I just have to say, it's not the same in EVERY country, well not exactly.

I had my smear test today, nice!

We too have a speculum, or apparently, I've never had the name explained to me. My sheet that I got after the test says:

- All woman between 20 and 70 who have ever had sexual intersourse should have regular tests.

They don't take smears off women that at virgins, as HPV (the Human Pap-something virus they test for) is an STD, so no sex, no HPV.

But that's just the policy here, I'm glad though, it allowed me to delay them for a while!

Your guide looks very informative. I'm just glad we don't have those stirrup things, they look HORRIBLE, and so 70s! All I was asked to do was to lie on the table and put my feet together and my knees apart. Ahhh charming tests they are.
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