Your First
Pelvic Exam:
A Guide for Teens
You may be worried about your first pelvic exam. It's very normal
to be anxious about something when you don't know what to expect.
Hopefully after reading this information, you will be reassured
that it is simple, isn't painful and takes only about 5 minutes.
It is also normal to feel embarrassed or uneasy about your first
exam. However, if you know what to expect, it may help you relax.
Your health care provider understands how you feel and will be sensitive
and gentle, and answer any questions you have.
What is a pelvic or gynecological exam?
A pelvic exam is a way for your health care provider to examine
your female organs and check for any gynecological problems.
When should I have my first pelvic exam?
There are no definite rules as to when you should have your first
pelvic exam. Most health care providers agree that you should have
your first exam in the first few years after you become sexually
active or when you turn 21, whichever comes first. There are other
important reasons to have a pelvic exam. These may include:
- Unexplained pain in your lower belly or around the pelvic area,
where your vagina is;
- Vaginal discharge or wetness on your underwear that causes itching
, burns or smells bad;
- No menstrual periods by age 15 or 16;
- Vaginal bleeding that lasts more than 10 days;
- Missed periods; especially if you are having sex;
- Menstrual cramps so bad that you miss school
Remember, it doesn’t matter how old you are or if you are
sexually active, if you have any of the above symptoms, you should
make an appointment with your health care provider or gynecologist.
Will I need a pelvic exam if I'm a virgin?
Even if you are a virgin (you've never had vaginal intercourse),
you may need a pelvic exam if you are having any of these problems.
Having a pelvic exam doesn't change anything, just as using tampons
doesn't change your hymen (the skin that partly covers the opening
to your vagina)
.
What should I do before the exam?
- When you make your appointment, be sure to let the secretary
or nurse know that this is your first pelvic exam. The nurse can
answer your questions and help explain what to expect so you won't
be worried.
- Do NOT have sex, use vaginal creams or douche for 24 hours before
the exam.
What kinds of questions will my health care provider
ask me?
Your health care provider will ask you questions about:
- Your general health, allergies and medications you are taking;
- Your menstrual period, such as how old you were when you first
got it, how long it lasts, how often it comes, how much you bleed
, the first day that your last period started, if you have cramps;
and at what age your breasts started to develop.
- Whether you have ever had sex or have been sexually abused.
- If you have vaginal itchiness or an unusual discharge (drainage)
or odor from your vagina.
Getting Ready
- If you find it comforting, your mom, friend or sister can stay
with you. The nurse or a medical assistant will too.
- After you have given your medical history, been weighed and
had your blood pressure checked, you will be asked to put on a
gown.
- You will need to remove your clothes including your underwear
and bra. A breast exam is often done
as a routine part of this check-up.
What happens during the exam?
- Your health care provider will explain the steps to the exam
and ask you to lie down on the exam table. You will be given a
sheet to put over your stomach and legs.
- You will then be asked to move down to the end of the table
and place your feet in stirrups (these are holders for your feet).
- With your knees bent, you will be asked to let your knees fall
to each side allowing your legs to spread apart.
This is usually the part when most adolescent and adult women feel
embarrassed. This feeling is normal too. Just remember that although
this is your first exam, this is routine for health care providers
and their only concern is for your health.
There are 3 parts to this exam. Sometimes not all parts of the
pelvic exam are necessary. Ask your health care provider which part(s)
will be done for your examination.
The Female Reproductive System
The External Exam
- Your health care provider will first look at the area outside
of your vagina, (clitoris, labia, vaginal opening, and rectum).
The Speculum Exam
- The speculum is an instrument made of metal or plastic. Your
health care provider will place the speculum into your vagina.
After it is inserted, it will be gently opened so that your health
care provider can see your vagina and your cervix (the opening
to your uterus). If you like, you can ask your health care provider
for a mirror so that you can see what your cervix looks like.
- After checking your vagina and cervix, your health care provider
may take a thin plastic stick and a special tiny brush or a small
"broom" and gently wipe away some of the cells from your cervix.
This is a Pap test, which detects early changes of the cervix
before they become cancer. Most girls have normal Pap tests.
- If you are having vaginal discharge, your health care provider
will take another sample to check for yeast and other causes of
discharge.
- If you are having sex, your health care provider will take another
sample from the cervix to check for sexually transmitted diseases.
When all of these samples have been taken, your health care provider
will close the speculum and gently take it out.
The Bimanual Exam
- The last part of the pelvic exam is done to check your female
organs (your tubes, ovaries and uterus or womb). Your health care
provider will insert one or two gloved fingers into your vagina.
With the other hand, your doctor will gently apply pressure to
the lower part of your belly. You may feel slight discomfort or
pressure when he or she presses in certain places, but it shouldn't
hurt. If you do feel pain, it is important to tell your health
care provider.
- Sometimes your provider will do a rectal exam. This involves
inserting one finger into your anus (the opening where bowel movements
leave your body) This is usually done at the end of the bimanual
exam. Like other parts of the exam, if you relax and take slow
deep breaths, it should not be uncomfortable.
What happens after the exam is over?
When the exam is over, your health care provider will answer any
questions you have and tell you when to make your next appointment.
He or she will also talk to you about any medications you may need
and tell you when and how you will get the results of the exam.
By
having a pelvic exam and Pap test and checking in with your
health care provider when you have unexplained discharge and/or
pain, you are taking care of your reproductive health! |
Written by the Center for Young Women's Health Staff
Updated 10/13/2005
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