Heather Responds

Hi there! I read your posting in the Women’s Health/Going to the Gynecologist message area and wanted to reply. I was scared to death before I went for my first exam too. But I was scared more because I had no idea what was going to happen. Since no one actually posted and told you exactly what to expect, I will do so. The detailed description I will give you isn’t meant to scare you or gross you out, but is a detailed description of what you will actually experience. Since you are old enough to be having an exam and since you are mature enough to ask what will happen and want to know, I wanted to answer your question honestly and in detail so you will be prepared for your first exam. Knowing ahead of time what to expect and what you will experience should help you to relax and ease your fears.

I know it isn’t easy to talk to your mom about this type of stuff, but you should try. She maybe easier to talk to than you think and she may be able to give you some good advice and answer your questions. Since she made the appointment for you, she obviously cares about you.

You asked for a description of what will happen during the exam and since I have had three exams now, I feel pretty confident to explain it to you. I am now 17 and had my first exam at 14 and like you, I am also a virgin. What I will describe is a “usual” type of exam. There may be slight differences between doctors and how they each do the exam, but it is mostly the same. Some people like men doctors and some like women doctors. That is your choice. I chose a woman because I felt I would be more comfortable. Make sure that you are comfortable with the dr., it will make a difference. The gyn exam won’t be painful, but it is slightly uncomfortable. If it is painful, tell the dr. to stop what he/she is doing and tell him/her that it is painful. The dr. should listen to you. The routine gyn exam check up should never be painful.

The dr. should meet with you first when you are dressed and go over any questions you may have. My doctor met with me in her office before the exam to ask me several questions. This is called taking a history. She (I will use she, but it could be he) will ask you several questions about: why you are there, if you are having any problems, your family medical history, your menstrual history, your most recent period, if you are sexually active or have had any sexually transmitted diseases, are using birth control, etc. Be sure to tell her that this is your FIRST exam and you are nervous. She should tell you what will happen before she starts the exam and also tell you what she is doing at each step of the exam.

Then, after you have answered all of the Dr.’s questions and she has answered any that you have, you will be asked to go into the exam room and completely undress in private. You will be given some type of exam gown or sheet to cover yourself with. My doctor has me put on a cloth gown that closes in the back. It looks like a short night gown. Then the dr. will come in and begin the exam. She will listen to your heart, take your blood pressure and look at your eyes, ears, nose and throat, same as any regular dr.

Then she will do the breast exam. You will lower the top of your gown to expose your breasts and lay on your back on the exam table. The dr. will look at your breast and use her finger tips to feel around your breast to check for lumps and cancer. She will also look at and feel your areola (the dark area around the nipple) and also look at and gently squeeze your nipple. Then she will repeat this on your other breast. This takes about one or two minutes then you slip back into the gown. Make sure she explains to you and shows you how to do your own monthly breast self exam. It is important to do as part of your own health care and could save your life.

The next part is the pelvic exam. You will lay on your back on the exam table and the dr. will have you put your feet in foot rests, called stirrups. The stirrups are extended from the end of the table. Then you will slide down so that your buttocks are at the very end of the exam table. With your feet placed in the stirrups, your legs will be slightly separated and your knees will be bent upward. The dr. will put on a pair of thin rubber exam gloves and sit on a low stool at the end of the exam table between your legs, facing you and your genital area. She will ask you to let your knees relax to each side so that your legs are fully spread apart and your genital area is completely exposed. She will turn on and adjust a small lamp so she can easily see. She will first touch your thigh and then begin the exam, explaining each step as she does it. If she doesn’t explain, ask her to, as it makes the exam easier.

She will examine your external genitals by sight and touch. She will look at and feel your outer and inner labia (lips). As she does this you will feel her spread apart your labia and feel her fingers examine the labia. As she does this, she is also looking at the area between the labia where your vaginal opening, urethral opening(pee hole) and clitoris are located.

Then she will do an internal exam using an instrument called a speculum. Ask her to show you the speculum before your exam. The speculum, which has rounded edges and is shaped like a ducks bill, will be either metal or plastic and comes in several sizes. Since this is your first exam, and you are a virgin, she will use the smallest size. The speculum is used to hold open the vaginal walls so that the dr. can see inside you and take a Pap smear. The dr. will first warm and moisten the speculum by running it under warm water, but it still feels a little cold when inserted. She will spread apart your labia with her fingers and insert the speculum into your vagina. Once the speculum has been inserted, she will open it slightly so she can look at the inside of your vagina and the opening of your uterus(womb), called the cervix. With the speculum inserted you will feel “stretched open”. This is slightly uncomfortable but does not hurt. She will take a long Q-Tip type of swab or a swab with a little brush on the end and gently scrape some cells from your cervix and vagina. She will put these cells on a glass slide to look at under a microscope later. This is called a Pap test or Pap smear and can detect cancer in the cervix. The “scraping of cells” sounds painful, but it is not. I could barely even feel it as she took the sample. The test results are usually ready in about a week and the dr. should call you with the results.

She will slide the speculum out of your vagina and then do the last part of the exam. She will stand up at the end of the table facing you and put some lubricating jelly (K-Y Jelly) on her fingers of one hand. The jelly makes her fingers slick so that she can insert them easily. She will insert two of her fingers into your vagina and place her other hand on your belly, between your navel and pubic hair. She will feel inside your vagina with the two fingers and at the same time press on your belly with the other hand. She is checking the size and shape of your uterus, ovaries and fallopian tubes to make sure they are healthy. When she inserts her fingers, the jelly will feel a little cold at first and then you will feel her moving her fingers inside of you. She will then remove her fingers from your vagina and insert one finger into your anus and rectum and re-insert one finger into your vagina. She will examine your uterus and ovaries again as well as feel the area inside of you between your vagina and rectum and also feel inside your anus and rectum to check for cancer. She will then remove her fingers from you and take off her gloves and have you slide back on the table and help you take your feet out of the stirrups and sit up on the exam table. Then it’s over and the dr. will give you a couple tissues to wipe yourself with, as there is usually some excess lubricating jelly. The dr. will leave the exam room and you can get dressed. The dr. may talk with after your exam and discuss any findings with you and answer any questions you may have.

The pelvic exam sounds like it takes a long time, but from the time you put your feet in the stirrups till the time you take them out is maybe 3 or 4 minutes at the most. It is much quicker than the time it probably took you to read this description of the exam. I hope this helps you and makes you feel more comfortable knowing in detail what will happen during your exam. Like I said, I had a very nice dr. who explained what was going on through out the exam. From the detailed description I gave you it may sound like a horrible thing to go through, but it really isn’t so bad. I now realize that I worried much more about it than I needed to. I also now understand that it is important for your health to have this exam every year and not to put it off because you are scared or embarrassed. Yes, it is a little embarrassing to have someone looking at you and touching you in a personal area, but remember that all women go through this and is a normal part of your health care. Also remember that they are Dr.’s and do this all the time as part of their job. They are not looking at you to judge you or form an opinion about you, just to make sure that you are healthy. If you have any other questions or questions about the exam that I wasn’t clear about, please e-mail me at H77008. Take care and good luck with your first exam! Let me know how it goes.

Heather

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