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)

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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 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

 

Related Information:

• Choosing a Primary Health Care Provider
• Breast Health: A Guide for Teens
• Related Links

 

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