What to expect when you go in your first gyno exam
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Going to the gynecologist isn’t something most women look forward to. But it’s an important part of staying healthy. To make things a little easier, here is some useful information.
Q. How should I prepare for my visit? A. Don’t use yeast medications, spermicides or douches 24 hours before your exam. If you’re sexually active, it’s best not to have sex the day before. Write your questions down so you don’t forget when you get in the office. When you arrive, ask if they will want a urine specimen. If not, urinate before you see the doctor. The examination will be more comfortable.
Q. When is the best time to schedule a gynecological exam? A. Generally it’s the week after your period. Breasts tend to be least lumpy, so any serious lumps will be easier to feel. The worst time is the week before your period. Breasts may be swollen and sore. You can have a pelvic exam during your period, but try to avoid it. The presence of blood makes Pap smears hard to read.
Q. What should the doctor know? A. Be honest. Don’t withhold health information because you’re embarrassed. Doctors are professionals. They need to have all the facts to take care of you properly. Most will tell you that they’ve seen it all. With that in mind, make sure your doctor knows:
Your family’s medical history
Your entire sexual and gynecological history
If you’re using birth control or are at risk for a sexually transmitted disease
If you’ve had unprotected or forced intercourse
If you’ve experienced any unusual bleeding
If you’ve had any discomfort or itchiness
Go ahead and ask your questions. Remember that list you wrote up before your appointment? Pull it out of your purse and refer to it so you don’t forget anything. Make sure you understand the doctor’s explanation. Ask until you understand.
Q. What can I expect during the breast exam? A. Your doctor should spend at least 30 seconds on each breast. Also, you should be doing breast exams at home to familiarize yourself with your own anatomy and to notice any changes or lumps. Lumps are often fibroids or cysts, but the more comfortable you are with examining your breasts, the more likely you are to find any growths or tumors. Not sure how to do a self-exam? It’s easy. Your doctor can show you how. Request a card or pamphlet with how-to information to refer to at home.
Q. How can you get the most thorough pelvic exam? A. The doctor will first examine the external surface of your vagina, feeling for bumps or sores. These might be an indication of an ingrown hair, a blocked gland, a herpes blister, or a genital wart. Next a speculum, a device that holds the walls of the vagina open, will be inserted. The doctor will examine your vaginal walls for sores and inflammation and your cervix for discharge, signs of infection and damage. He or she will probably take a Pap smear, a little scraping of cervical cells. It doesn’t hurt but might feel weird. Afterward, a little spotting is normal, but tell your doctor if it’s more than a few droplets of blood.
Breathe deeply. Count the dots in the tiles on the ceiling. Let your mind wander. Make small talk. Do whatever it takes to relax your muscles. Relaxation makes the whole thing more comfortable for you. As the gynecological exam progresses, most doctors will tell you what they are seeing. If not, just ask what’s happening. "Everything look normal?" is a great question.
Next is the manual exam. The doctor inserts two gloved, lubricated fingers into your vagina while pressing gently on your abdomen. This is how she or he checks out the surface of your uterus, ovaries and fallopian tubes. It usually doesn’t hurt. Try to relax. Breathe slowly and deeply.
Finally, a rectal exam. If your doctor doesn’t make this exam a regular practice, ask for it. It’s important. This step, in which one finger is in the vagina and the other is in the rectum, helps detect rectal lesions and growths (an early sign of colon cancer) and also helps find endometriosis, ovarian cysts, and any misalignment of the uterus and other pelvic organs.
Q. Anything else I should know? A. The doctor should summarize the outcome of your exam and give you a chance to ask more questions. Find out when you can expect the results of your Pap test, and have them mailed to you. (Call if you don’t get them.) Now is a good time to discuss any other health concerns you have. If the doctor seems to be in a hurry, find out if there is another time in the week when you can talk in more detail. Getting your questions answered is important.
You should not feel awkward, uncomfortable or dissatisfied with your physician/patient relationship. If that’s the case, check your health insurance plan to see if changing doctors is an option. Nothing is more important than your health.
Q. What if I get a prescription? A. If your doctor gives you a prescription, here are some questions to ask about it: What is this? What does it do? Any foods I should avoid while taking it? Are there any other drugs that interact badly with this? How long do I have to take this? Will I need to refill the prescription or make another appointment to see you? Is there a generic version that’s cheaper?