What I Wish I Knew Before My First Gyno Appointment
By: Molly Horan
The pelvic exam — complete with the stirrups and the speculum — isn’t anyone’s favorite thing about having a vagina. But it’s really important because it’s how your gynecologist checks the overall health of your sexual organs. The pelvic exam is also when your doctor can do a pap smear, the screening test for cervical cancer.
Your first-ever gyno appointment is actually supposed to happen way before your first pelvic exam, according to the guidelines from the American College of Obstetricians and Gynecologists (ACOG). At this visit, which is recommended at the start of puberty around age 13, you’re just supposed to have what amounts to a meet and greet with an ob-gyn (aka a women’s health specialist), during which you simply chat with the doctor about your changing body before she does an external genital exam.
The more invasive and scary-sounding pelvic exam and pap smear tests aren’t needed until you become sexually active or turn 21 (whichever comes first), explains Cheryl Iglesia MD, director of female pelvic medicine and reconstructive surgery at MedStar Washington Hospital Center.
It’s totally normal to be nervous, even scared, the first time you go in for these screening tests — but it doesn’t have to be that way. Like any doctor’s visit, you’ll feel more comfortable if you’re more prepared for what’s going to happen.
For the pelvic exam, the doctor will use a speculum (the duck-billed device illustrated above) to look at your vagina and cervix. She will insert one or two gloved fingers to feel your cervix while pressing down gently on your abdomen with her other hand. For the pap smear, she will use a swab to grab cells from your cervix that she can send to the laboratory to be checked for abnormalities.
All of the above is what any gynecologist will tell you. To help you feel even more prepared, though, we asked a few women to share with us what they wish they’d known before their first appointment. Their experiences, plus the advice we got from Dr. Iglesia, should help you feel as comfortable as possible as you sit waiting in that paper dress.
In addition to the actual exams, there will be a lot of talking between you and your doctor.
“I wish I’d known that she couldn’t tell my mother what we talked about! I went to my first gyno appointment when I was a senior in high school because I wanted to go on the pill before I went to college,” Maria, 26, says. “My mother was under the assumption that I was still a virgin, so I told my gyno that I was, thinking that she’d report back to my mother if I’d told her I’d been sexually active for over a year. Now I know about physician-patient privilege, but it would have been nice to have been more open with my original gyno as that’s the basis of a trusting relationship.”
Iglesia tells us Maria is absolutely right: Whatever you share with your doctor is between you and her, alone. Plus, being honest with your ob-gyn is crucial: “Honesty about sexual history is important so your [doctor] can assess risk for STIs, pregnancy, and any concerns about domestic violence, sexual abuse or LGBTQ concerns,” she says.
“You should actually think about whether you would prefer a male or female doctor,” Beatrice 27, says. “My first appointment was with a female doctor, but when I moved I made an appointment with a male doctor and immediately realized that it was a different experience.”
This is not to say one gender is better than the other in terms of skills; Gynecologists get the same training whether they’re men or women, Dr. Iglesia says.
But still, it’s up to you to decide what you’re comfortable with, and if you’d prefer one gender over the other, that’s okay, too.
“Before my first gyno visit at age 14, my mom told me I had to remove all of my pubic hair in order to look “presentable” for my doctor. I didn’t know how to put a razor to my lady parts (which obviously led to some nasty cuts) and the whole experience was totally traumatizing. (Thanks, Mom!)” Kriti, 23, says. “Several years later, my gyno giggled when I apologized about my grooming situation (or lack thereof). She told me that docs couldn’t care less when it comes to hair and have seen bushes of every style, near and far.”
Lesson: Your doctor is not there to judge you. And yes, she’s seen it all before.
“I was expecting the pap smear to really hurt because everyone always described it as ‘uncomfortable.’ I wish I knew that it really doesn’t hurt at all,” Molly, 32, says.
The pap test, or pap smear, involves scraping a patient’s cervix to collect cells that can be screened — so yeah, that certainly sounds like it’d be painful. But in most cases, this doesn’t hurt at all, according to the Mayo Clinic.
We’re not going to lie, though: Just because it doesn’t hurt, doesn’t mean it’s pleasant. “There is no way to describe what it feels like to get your cervix scraped,” Maggie, 27, says. “It is uncomfortable. But it will be over soon.”
The pap smear only lasts a few minutes, but this short episode of discomfort is still incredibly important. “If your test results show cells that are not normal and may become cancer, your doctor will let you know if you need to be treated. In most cases, treatment prevents cervical cancer from developing,” according to the CDC.
Almost all cases of cervical cancer are caused by human papilloma virus or HPV, a sexually transmitted infection. Getting the HPV vaccineis another important piece of protection from cervical cancer — and your first exam visit is the perfect time to ask about it. “With the vaccine, 99% of HPV-related cancers can be prevented so it’s important to get that vaccine [by] age 26,” Dr. Iglesia says.