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When should you start going to the gynecologist? No one ever told us in high school about it. The first time you go, what will happen? Is it like a normal check up?

“The American College of Obstetricians and Gynecologists recommends that teenage girls start seeing a gynecologist between the ages of 13 and 15,” (girlshealth.gov). It’s also recommended that you get a pelvic exam by the time you are 21 years old—regardless of whether or not you’ve only has same sex partners (sexetc.org).

SIDE NOTE: If you don’t go when you’re 13-15, then you should go if any of the following apply (or have applied) to you:

You’re sexually active! Meaning you’ve had vaginal, oral, or anal sex. Or any kind of intimate sexual contact.

Sexual contact: “Any type of touching during sexual activity between two people, including sexual intercourse, oral sex, and skin-to-skin contact in the genital area (around the vagina, penis, scrotum, anus, and thigh). Sexually transmitted infections (STIs) such as genital herpes, HPV (warts), and syphilis can be passed by having sexual contact with areas that are not covered by a condom.”

You haven’t gotten your period in three or more months.

You have stomach pain, fever, and fluid coming from your vagina that is yellow, gray, or green with a strong smell — all of which are possible signs of a serious condition called pelvic inflammatory disease (PID) that needs immediate treatment.

You’re having problems with your period, like a lot of pain, bleeding heavily, or bleeding for longer than usual, or it has stopped coming regularly.

You have not gotten your period by the age of 15 or within three years of when your breasts started to grow.

You’ve had your period for two years and it’s still not regular or comes more than once a month.

You are having sex and missed your period.

(All the above info came from girlshealth.gov. And yeah, sexetc.org is way better, but I couldn’t find this info laid out as eloquently there.)

Basically you start going in high school. Some girls go before then because they want to get on birth control, which has many benefits that don’t include preventing pregnancy (see this post for a little bit more on that).

If you’re sexually active, then you need to start going. They’ll check to make sure everything is working right and healthy. They’ll check for STDs/STIs, they’ll ask if you’d like to be tested for STDs/STIs, they’ll look for lumps in your breasts, make sure your uterus and ovaries are good…

And I’ve always had gyno’s ask about my mental health. It’s actually really nice. They do a lot in one visit.

What to expect!

[The following is from my own personal experience. If you want a more logistical take on this, check out this article from sexetc.org.]

The first time you go, (after you’ve filled out all your forms and they’ve taken your height/weight/blood pressure etc.), a gyno will take you into their office and chat with you about why you’re there.

They’ll ask if you want birth control, or if you like the birth control you’re on. They’ll ask about family history, about your sexual history (if you’re sexually active/if you plan to become sexually active). They might ask if you think you have an STD/STI, or if your partner does. They might ask if your partner has been tested before, or how long you’ve been with your partner. They might ask a series of questions about your partner to make sure you’re not being abused. They’ll make sure you’re up to date on your shots, and if you’d like to get the HPV vaccination (SAY YES!). They’ll ask if you have any questions. If you’ve never had sex, then they might explain about hymens and how that could affect the exam.

Then, if they haven’t already, they’ll probably make you pee in a cup to test it for routine things. Then they’ll take you into an exam room and tell you to remove all of your clothing. They’ll give you a vest-thingy made of thick tissue-paper to cover your chest/torso, and a thick tissue-paper blanket-thingy to cover you below the waist. They’ll tell you that when you’re done, to have a seat on the examination table. They’ll leave. You’ll follow directions and panic the whole time that someone is going to walk into the room before you’re covered/on the exam table. LOL. I do it every time.

Your gynecologist will come back into the room accompanied by a female nurse. “A female nurse will be present in the room during the exam regardless of the sex of the health care provider who is performing your exam,” (sexetc.org). A good gyno will talk to you before they begin, find something to discuss/make sure you’re comfortable.

And yes this is the part where I start to ramble and ask is she’s seen any interesting genital-area tattoos lately and where exactly they were located. (Best response I ever got was a licking tongue tattoo on the inner thigh that was captioned: “lick it” LOL.)

Then they’ll ask you to lay back and put your feet in these metal stirrup things. She’ll likely ask you to scoot down because they’ll want your genital area as close to the end of the table as possible, and you’ll likely be as far away from the end of the table as humanly possible because you’re uncomfortable.

Once you’re in the right spot, they’ll move the tissue-paper blanket up past your knees so they, the gyno, can see your vulva and the opening of your vagina. If they see something odd they will ask you about it and might look around in your labia to make sure everything is okay. Then they’ll begin the pelvic exam.

Pause here. The following may not happen at your visit. I first went when I was 18, and I got a full pelvic exam and pap smear. But depending on age, or if you are/aren’t sexually active, they may not do this next part.

Your gynecologist will insert an instrument called a speculum into your vagina. (If you’re lucky, the practice you go to has a warming drawer so the speculum isn’t cold.) They’ll slather it with enough lubrication that you won’t have any pain when they insert it.

Pause here. If you have an intact hymen in one of the less commonly shaped ones, you might have pain. But rest assured, your gyno will have/should have already noticed this and talked to you about it. They will likely help you work through any pain you may have, and may help you stretch your hymen skin right then and there in the office. But (as I learned the other day) not all hymen skin is the same. Some people (who I really feel for) have thicker hymen skin that does not go away, or stretch out similarly to most people’s vaginas.

THEREFORE there is a chance that your gyno might ask you to go home and stretch it on your own (because it might take more time everyone is different). Then you’ll just make a follow up appointment. But that’s rare. And by the time you get to high school, if you have one of the several types of hymen that cover a significant amount of your vaginal opening—then you’re aware of it and have hopefully already been to a gyno about it.

If not, don’t worry. Your first gyno visit is a perfect opportunity to have this conversation with your gynecologist. And if you have hymen skin that covers too much of your vaginal opening, or it’s painful, or it’s impinging on your quality of life—you can have it removed. It’s called a hymenectomy. And it happens (see this hilarious article for one woman’s story). You can usually have it done in office with anesthesia or you can schedule an appointment and be completely sedated.

So! The speculum goes into your vagina. Your gyno will open it (this can feel like a lot of pressure it’s not terrible though). They they’ll look at the inside of your vagina, your cervix, and your uterus to make sure everything is good.

If you need a pap smear, then they’ll take (what is essentially) a long, thin, flexible plastic stick with a fizzy end (which I believe is called a cytobrush), and/or a spatula (that looks similar in that its long, thin and reasonably flexible) and scrape each on different parts of your cervix to get cell samples.

This is the most uncomfortable part. I’m not sure which one happens first. But that first one they scrape usually feels like nothing. To me at least. But the second one they scrape with always makes me feel like I’ve run my nails down a chalkboard. Something about feeling a part of yourself you’re not used to actively feeling—that’s in the this weird middle place in your body—grosses me out. But it lasts a fraction of a second. And then it’s over.

Your gyno will hand those to scraping devices to the nurse, and the nurse will drop them into various cups of liquid to test them for various things. The doctor will remove the speculum and then stand. She’ll insert two fingers into your vagina and feel around for any lumps or abnormalities. At one point they’ll push up with those fingers while at the same time she will use her other hand to press down on your abdomen. They’ll do this on both sides (left and right) to check your uterus and ovaries.

Then I’m pretty sure that’s in on vagina stuff…

Then they’ll remove their hands and gloves. The gynecologist will cover your legs and let you put your feet down. They’ll push around the paper vest over your stomach and chest to continue checking your stomach for lumps and stuff. Then they’ll open the front of the paper vest thing and give you a breast exam. That’s basically them using their fingertips to gently press against your breasts. They’ll touch your whole breast too, even the nipple. Then the gyno will move out to your armpits to check for lumps. They’ll cover you back up when they’re done and tell you to sit up. You might chat for a few more minutes, then they’ll leave with the nurse. The gyno might ask you to meet them in their office before you leave to chat, or they might have the nurse give you your exit papers then.

They’ll leave the room. You’ll wait until the door is safely shit before jumping up and practically running for your bra and underwear. You’ll probably have to wipe the lube the doctor used on the speculum off your genitals. They usually leave a box of tissues out for you.

And that’s it.

You’ll get your prescription (if you have any), you’ll pay your copay, and you’ll walk out the front door still able to feel a stranger’s hands on your breasts and in your vagina… but it’s better than having cancer.

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