What to Expect (and What Not to Expect) at Your First Gyno Visit
By Almie Rose
No matter how old you are, the idea of going to a gynecologist for the first time can make anyone nervous.
But keep in mind, we’re talking about a doctor here, who knows what she’s (or he’s—there’s nothing wrong with getting a male doc!) doing. There’s no shame at all in making sure your body is healthy and working in its most kickass form.
So we spoke to Dr. Lauren Streicher, an associate professor of Ob/Gyn at Northwestern University Feinberg School of Medicine, about what you can expect from your first gyno visit—and what are some red flags.
You Are Within Your Right to Ask for a Consultation Before Even Getting an Exam
First of all, you should know there’s no “one-size-fits-all” approach to your sexual and reproductive health.
“There are so many different approaches to the first exam,” Streicher says. “[It’s] dependant on her age, why she’s going to the gynecologist, and who she’s seeing for her first exam. That will dictate what happens.”
For example: “There’s an enormous difference between the 17-year-old who’s coming to see me for a pre-‘I’m going off to college and my mother said I should go to the gynecologist exam’ versus the 27-year-old, who for whatever reason has never been to the gynecologist, to the 40-year-old.”
“So I think the number one thing is, is that there’s a lot of variation in what might happen with that first exam,” she says. And she wants you to know that, no matter what your age, you don’t need to hop into those stirrups right away.
As Streicher explains: “If I see someone who is 16-18 and who has not been having sex, and comes in as, ‘hey, I’m here because my mom thought it was a good idea,’ a lot of times with those young women, I don’t even examine them. I just talk to them. Because the last thing in the world I want to do is freak them out so they never come back.”
“So essentially what I’m doing is establishing a relationship,” she says.
This can mean talking about pap smears or STD screenings, and also showing them the tools they use for examinations—like the speculum—though not necessarily using it.
“It’s about gauging their comfort level,” she explains. And this is something you can ask for!
“You always have the option to just do a meet-and-greet. You don’t have to have an exam,” she explains. You can request a consultation. This can give you a great idea of what to expect.
What you may not realize is that a lot of gynecologists understand the need for comfort. As Streicher puts it, “[some women] are essentially saying, ‘Before I take off my clothes and give my vagina to you, I really need to meet you and feel comfortable.’ And I think that’s very important.”
What Not to Expect, or a Red Flag: The doctor refuses a consultation.
“It is always perfectly okay to say, ‘you know what, I’m not sure I’m going to have an exam today,” Streicher says. “[You can say] ‘I’d just really like to meet and talk to the doctor first.’ And if they say ‘no,’ that’s kind of a big red flag right there.”
Let’s say you’ve had a consultation, or are ready to go right into the exam. What can you expect?
First of all, you can expect privacy—and this means being within your right to ask your mom not to come with you to the exam room if you don’t want her there.
Streicher explains: “As far as what I would like to tell young women about their first exam is, number one, even if your mom has always accompanied you to your doctor appointments, this is different. This is your doctor, this is your time, and even if you’re not 21, you have the right to go and see a gynecologist without your parents’ permission, and without your parents accompanying you. That’s totally appropriate and expected.”
Be expected to be asked some personal questions. It’s not so the doctor can gossip about you; it’s for your own health.
“Expect to have a history taken that may be different than questions you’ve been asked before [by previous doctors],” Streicher notes. “Because as gynecologists, we’re obviously focused on things like menstrual cycle. So be prepared.”
So before you go in, you should have an exact date—or at least a good idea—of when you had your last period, if your periods are regular, and so forth, “because those are the questions you’re going to be asked.”
And yes, the gynecologist will likely ask if you’re sexually active. This is not meant to shame or trap you!
“You’re going to be asked if you’re sexually active. And if you are, don’t worry about it,” she says. “The doctor isn’t going to tell your mom. You need to be honest.”
Remember that doctor-patient confidentiality is a very real thing, and that your doctor asks these questions so they best know how to treat you and provide the best care.
You’ll be asked if you’re using or are taking some form of contraception, which “isn’t about being judgemental,” Streicher stresses. “It’s about wanting to know what we need to screen for.”
You are within your right to ask why your doctor is asking certain questions.
Even knowing you’ll be asked some private queries, you’re still allowed to ask the doctor why they’re asking.
“It’s perfectly okay to say, ‘I’m wondering why you’re asking me that particular question. How is that relevant?’” Streicher says. “That’s valid!”
For example, your doctor may ask you if you smoke cigarettes. They’re asking because, as Streicher explains, “if we’re going to talk about contraception, that’s going to be good information to have—if you’re going on the pill, for example.”
(Birth control pills have been shown to increase health risks if the user smokes cigarettes. Planned Parenthood states: “We know that smokers over age 35 will have an increased risk of stroke and heart attack if they use the pill”—though that doesn’t mean you’re free and clear if you’re below 35, either.)
What Not to Expect, or a Red Flag: Your doctor won’t tell you why they’re asking you a particular question.
As Streicher tells us, “[i]f you don’t know why you’re being asked a question, you can ask.”
It’s also important to be truthful with your answers so the doctor can determine how best to examine and treat you.
“And if you don’t want to answer a question, rather than lie, it’s always okay to say, ‘I prefer not to answer that question.’ You always have that right.”
Expect to be asked about your sex life and sex practices.
Streicher offers an example: “Do you have sex with men, sex with women? We ask everybody that because we don’t know. And there’s a lot of women who identify as gender-preference fluid, so we really try to identify where are you on this.” Because knowledge, as always, is power.
And if your doctor hasn’t asked you a specific question you were hoping for, don’t leave without asking him or her yourself—and don’t be embarrassed! Even if your question is something like, “my boyfriend says I taste funny, is that normal?”
Your concerns are important, and there’s no need to be ashamed! These doctors have heard it all—from questions about odor and taste to how a patient’s labia looks. They’re doctors.
What Not to Expect, or a Red Flag: Your doctor shames you for your sex life.
That should not happen. While a doctor has to ask personal questions, they definitely do not have to—and should not—judge you.
The physical exam itself may feel uncomfortable.
You’ll likely be asked to have the front of the gown open, as many gynecologists will also do a quick breast exam, to check for signs of cancer. Then the doctor will do an external exam to check your vulva (to make sure there are no “rashes or discolorations or concerns.”)
If you are getting a pap smear, which you won’t get until you’re the age of 21, that’s likely when you’ll be first introduced to a speculum—the device shaped kind of like a duck bill, used to open up your vaginal walls.
“We’re looking for abnormal discharge and making sure the cervix is clean and healthy,” Streicher explains.
Then, after the speculum is removed, “we generally put one or two fingers inside the vagina with the other hand pressed down gently on the abdomen in order to feel the contour of the uterus and the ovaries,” she says.
What Not to Expect, or a Red Flag: the exam is downright painful.
The physical exam shouldn’t hurt. “It should not be painful,” Streicher notes.
“It [feels] weird—but it should never be painful.”
It’s normal to clench up when you’re on the table for your pelvic exam, feet in stirrups, as the speculum enters your body. If you’re tense, this can make the exam feel a little uncomfortable.
“I’m not blaming [a patient],” Streicher makes clear, “[but] if someone is very afraid they are going to tighten up. There are people whose knees are literally one inch apart and every muscle in their body is clenched, and even if I could do an exam, I can guarantee it would be uncomfortable for them.”
Your doctor realizes this. As Streicher notes, “[y]ou can’t just say to someone, ‘relax,’ because they won’t. Having said that, if the speculum is pinching, or if you feel something sharp, it may need to be re-adjusted, or you may need a different size.”
Her advice? “Speak up. Say it’s pinching!”
Ultimately, you need to be your own biggest advocate because the doctor can’t read your mind. That’s why it helps to be familiar with your own body—and that can mean taking a real close look at your vagina.
“Get the long-handled mirror out and take a look!” Streicher suggests. Why? “So if you do have any questions or concerns, you can ask.”
Almie Rose is a writer from Los Angeles, California. She has written for The Establishment, HelloGiggles, Thought Catalog, and others. Her book is titled “I Forgot To Be Famous” and is available now. Her favorite thing to do is eat, sleep, and repeat.