Dear Alice,

I am frightened to go to the doctor for the evaluation to get birth control pills. I was wondering if you knew what the doctor does to find out if you can start on the pill, and how he knows what kind to put you on?

Scared and Confused

Dear Scared and Confused,

It's natural to feel frightened when experiencing something new, especially when it involves something as personal as getting the birth control, or as private as a gyn exam. It's great that you're seeking info to ease your concerns by learning what's involved in the process.

Your health care provider will probably begin by discussing your medical history with you. As with any general physical examination, s/he will check your blood pressure, listen to your heart and lungs with a stethoscope, and check your weight. In addition, s/he will do a gynecological examination, which will include a breast exam, abdominal exam, pelvic exam, and Pap smear. After getting your medical history and examining you, the two of you can discuss whether birth control pills are a good option. These examinations and discussions are helpful because some women have risk factors that would make other forms of contraception better choices for them.

If you decide that the pill is the right choice, your provider may want to begin with a formulation that contains the least amount of hormone needed to prevent pregnancy. There are many different brands and formulations of birth control pills, so your provider can adjust your prescription accordingly depending on any side effects that you may or may not experience from taking it after a few months.

If after your exam you and your provider determine that the pill is not right for you, you can discuss alternative forms of contraception, such as the ring, the patch, the shot, an IUD, Implanon, or barrier methods such as condoms and diaphragms. You ultimately will decide what method will best fulfill your pregnancy protection needs, and your current lifestyle. Some questions to ask yourself to help make your decision include:

  • How well will it fit into my current lifestyle? Will I find it convenient to take or use on a routine basis?
  • How effective is it in preventing pregnancy?
  • How safe is it? What are the side effects?
  • How much will it cost?
  • Will it help prevent sexually transmitted infections (STIs)?

Here are a few ideas that may help you gather the courage to have an exam:

  • Make a list of all the fears you can imagine and assess how realistic they may be. (Hint: Yes, you may feel a little discomfort during an exam, but no, your provider doesn't care whether or how you groom your pubic hair.) 
  • Talk with friends, especially those who have had a gyn exam, about their fears and their experiences.
  • Tell the provider of your fears or concerns — your list may help. Your provider can explain any procedure in detail and discuss why different components of the exam are key for your health.
  • Approach the exam as a learning experience. Sexual and reproductive health can be pretty interesting, so ask lots of questions. If you can focus on learning new information, you may be able to pay less attention to the actual examination.

For more information about the pill and other forms of contraception, check out the Contraception section of the Go Ask Alice! Sexual and Reproductive Health archive. You can also visit Planned Parenthood to learn more about what happens during a gyn exam. 

Congratulations, you're about to take a great step in your own health care. Best of luck as you prepare for your visit,


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