Your first gynaecological visit may be a nerve-racking idea to contemplate, but it should not be a nerve-racking experience. A good gynecologist is aware that you're probably uncomfortable with the idea of your first pelvic exam, and the doctor and other staff will do everything they can to put you at ease.
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Before Your Visit
Ask your family doctor or primary care provider, or a woman friend that you trust, to recommend a gynecologist who is relaxed and easy to talk to. Schedule the appointment for a day when you will not be having your period, and tell the receptionist that it will be your first visit. Do not douche, use any vaginal deodorant or other preparation, or have vaginal sex for 24 hours before your appointment. Write down any questions you may want to ask--it can be easy to forget them.
You will be asked to provide a complete medical history. Questions that you will be asked will include how frequent, regular, light or heavy your periods are, whether you have ever had sex or been pregnant, and whether or not you experience any unusual symptoms in your pelvic or genital region such as itching, pain or spotting between periods. You will be asked what you do, or intend to do, about birth control and sexually transmitted disease (STD) prevention.
It's important to be honest in this conversation. Your gynecologist is legally required to keep everything you say confidential, and can only provide effective care if you give accurate information.
General and Breast Examination
Your weight, height and blood pressure will be checked, and you'll be asked to provide a urine sample. It's a good idea to empty your bladder completely, as this will make the pelvic examination more comfortable.
You will be asked to remove all of your clothing and get into an examining gown, and the doctor will gently and thoroughly feel your breasts, including the nipples and lymph nodes in the underarm area, to check for lumps, swelling or any other irregularities. Ask the doctor to teach you how to do a breast self-examination, so that you'll be able to do a quick check yourself each month after your menstrual period. This is a critical procedure that every woman needs to perform on herself to catch lumps that might turn out to be cancerous.
The entire pelvic examination takes less than five minutes and is completely painless unless you are extremely tense or have an underlying medical problem. You will be asked to lie down at the end of the examining table and place your feet in "stirrups" that will support your feet. Your knees will be raised and spread apart in this position, and your lower body covered by a drape. The doctor will check the external part of your genitals--the folds and lips of your vulva and surrounding areas--for lumps, rashes or other irregularities.
The doctor will insert a speculum, which is a sterile metal or plastic instrument shaped like a duck's bill, to spread the walls of your vagina. A good gynecologist will show you the speculum, explain how it works, make sure it isn't uncomfortably cold, and use KY jelly for maximum comfort; feel free to request these services if they're not suggested.
Relax your legs and abdominal muscles as much as you can and breathe deeply. While the speculum is inserted, the doctor will use a swab to collect sample cells from your cervix for a Pap test, which allows early diagnosis of cervical cancer, and another swab to collect a sample to test for STDs. You may notice a slight scraping feeling, but this should not be painful.
Finally, the doctor will insert one or two gloved, lubricated fingers into your vagina and apply gentle pressure to your abdomen with her other hand to check your ovaries and uterus, and may also examine you rectally. The examination is brief and painless.
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