Gynecologist for the first time

Dear Just Wondering,

First of all, three cheers for prioritizing your sexual and reproductive health! And, some good news: you don’t have to wait to have sex for the first time to make a visit with a gynecologist or a women’s health care specialist. Current recommendations for screenings and exams are based on your age, not your sexual history. In fact, visiting with a gyno before you’re sexually active can help prevent unintended pregnancy and sexually transmitted infections (STIs). But, there are a number of other benefits to seeing a provider, too. Keep reading to learn more about women’s health recommendations, what to expect at your first visit, and what you stand to gain from meeting with a gynecologist.

Currently, the American College of Obstetricians and Gynecologists (ACOG) recommends that annual visits to a gynecologist start for patients as early as 13 to 15 years old, but can start any time before you turn 21. This type of visit is used to establish and foster a relationship between the patient and provider. A number of issues are commonly discussed during these visits including normal body development, body image, healthy weight, immunizations (such as the human papillomavirus (HPV) vaccine), birth control, and sexually transmitted infection (STI) prevention. Pelvic exams aren’t typically a part of these visits; if they are, they’re often limited to examination of the external genitalia (including the vulva and perineum).

By the age of 21 and regardless of sexual history, pelvic exams and cervical cancer screenings become routine components of a gynecological visit. Pelvic exams are typically recommended on an annual basis, but you and your provider will determine a frequency that’s appropriate for you. For example, you may not have a pelvic exam if you’re not experiencing any symptoms or have complaints. However, a number of factors may indicate the need for one including (but not limited to): particular patterns in your medical history, irregular menstrual periods, pelvic pain, infertility, and vaginal discharge. The frequency of cervical cancer screenings (also called a Pap test or Pap smear) also varies depending on your age. They typically occur once every three to five years in conjunction with a pelvic exam.

What might you expect from a pelvic exam and cervical cancer screening? Routine pelvic examinations include both an external and an internal exam. The provider will examine your vulva (inner and outer lips), clitoris, and vaginal opening. After that, they will look inside your vagina using a speculum, which may be the most unfamiliar part of the exam. A speculum is an instrument used to hold your vaginal walls apart. It may be a bit uncomfortable — even though this may seem impossible, try to relax; it does tend to get easier over time.

The provider will then examine your vaginal walls for lesions, inflammation, or unusual discharge, and will also check your cervix for the same. They will collect a sample of cells from your cervix using a swab as part of the Pap test. Some women feel a slight cramping when the cells are being gathered. The collected cervical cells are then sent to a lab to check for abnormal cell growth and to screen for cervical cancer. Abnormal cell growth is often caused by HPV. If the results of the Pap test are inconclusive or abnormal, a follow up test for HPV itself may be done. It’s also good to note that the Pap test does not test for pregnancy, STIs, vaginal infections, or other types of gynecological problems. Additional tests and exams may be requested for those issues separately — and all of them may be addressed in your visit.

Just wondering, no matter if you meet with a gynecologist before or after having sex for the first time, the experience will likely help you learn more about your body and yourself. If you're still wondering about women's health visits and have more questions, you could have a chat with a health educator to get more information before your first visit. When you do meet with your provider, feel free to let them know that it’s your first appointment of this kind and don’t be afraid to ask them to explain each procedure or exam. As you continue to build a relationship with your gynecologist by communicating any health concerns and making regular visits, you’ll be better able to inform decisions about your sexual and reproductive health now and in the future.

Best of luck as you take charge of your health!