10. The Pap smear
Once you have had the manual examination which will only take a few minutes, the gynecologist will take out the speculum. The speculum is a metallic duck-billed shaped instrument that can open its beak at the mouth of your uterus.
Before inserting it, the gynecologist will check the angle of your cervix with a finger to help angle the insertion of the speculum. Then you will feel the sensation of the instrument sliding into your vagina. It will most likely feel cold, but it should be lubricated, so it should slip in with no problems. You will then hear the sound of the speculum being screwed open, and you will feel a stretching sensation as it opens up around the mouth of your uterus.
Once the speculum is correctly in place, the doctor will have a good look, maybe even shining a torch at the mouth of your uterus. Now you are ready for the pap test. They will open a surgical packet containing swabs on a long stick. Some doctors will clean the cervix until it is free of mucus and then take a swab. Others will scrape some cells onto the swab and put it into a special solution to be sent to the laboratory for analysis.
This scraping around inside your vagina might be a bit uncomfortable. It won’t be pleasant, but it won’t hurt, and it will be over soon. There is really no way to describe the sensation, but pap tests are part of being a woman and having female reproductive organs, and they will always be a part of your life.
11. Birth control
The good news is that all the uncomfortable exams are over unless you have decided on a form of birth control that needs to be inserted like an IUD. An IUD is an Intrauterine device that will need to be inserted into your uterus, after the Pap test when you still have the speculum in place.
This can be a painful operation and often the gyno will ask you to do it when you have your period, as the mouth of the uterus is softer and slightly more open. The advantage of the IUD is that once it is inserted, you don’t have to worry about it for two years. If you have a steady partner and are not using condoms to avoid STDs, this can be a good choice.
Now is the moment to be honest with your gynecologist. If you are already sexually active or if you are planning to be soon you need to discuss birth control. You need to be able to leave their offices with what you need in hand.
Remember a doctor has a physician-patient privilege, and they will keep everything you tell them confidential. Nothing that you say will be going back to your mother or anyone else. You can make the foundations of a trusting relationship in this first appointment. Being honest with your gyno will be crucial for your health. They will need to know your sexual history to asses concerns about STDs, pregnancy, and even any concerns about domestic violence, sexual abuse or LGBTQ issues.
12. How you look is not important!
Remember you don’t have to dress up to go to your gyno, nor do you have to shave or do anything about your vaginal hair. Your doctor isn’t going to judge you for your physical structure, your being shaved, or neat or groomed in any way.
Your gyno has seen everything, and they don’t care about what your vagina looks like. They are there to ensure your health and not to judge you. They have seen it all before. What they are going to be looking for is any abnormality in your reproductive organs.
Your gynecologist will look at issues related to pregnancy, menstruation, and menopause. You can discuss family planning with them. This includes contraception, pregnancy and the termination of a pregnancy. They will also look for any problems with the tissues around the pelvic organs and any problems of the reproductive tract. They will look for the presence of cysts or abnormalities.
They will also help you with all and any type of issue with your sexuality. They will be able to advise you about any sexual dysfunctions. They can help answer your questions about same-sex sexuality. With all they have to worry about, they will not be looking at how neat your vaginal hair if, or if you are smelling of roses.
13. The exam is for you
Your gynecologist should go out of their way to make you feel comfortable during your appointment and physical exam. After all, you are there to look after yourself. If you feel in any way uncomfortable, you can always opt out of the physical exam and have it at a later stage.
You should also decide whether you feel more comfortable with a female gynecologist or a male. Both male and female gynecologists undergo the same training. In most countries, it is a further four years of specialization after a medical degree. Having a male or a female gynecologist is a different experience, and you should think about what you would prefer.
You also need to know when you feel ready to have a physical examination. You can start seeing a gynecologist within two years of starting your periods, but you don’t need a physical examination until you are sexually active or have reached 21.
Once you have started having sex, then it is a good idea to have regular check-ups and plan your contraception. You can choose when you want to have your first appointment, and you can choose who you want to have examine you.
14. Follow up call
If you have an appointment at a private clinic, then you can expect the clinic to give you a follow-up call. Your gynecologist will also want to see the results of your pap test before it is handed over to you. You might have to go to the clinic to collect the results of the Pap test, and this will be given to you in a sealed envelope.
Your doctor might want you to pop into their office to look at it together. They might have time to explain to results to you, or they might want you to schedule a follow-up visit. In this case, they will check up on any treatment they might have given you. If you have been given the birth control pill, they will want to check your blood pressure and weight and your general health, to check that your body is functioning smoothly under the new hormonal regime of the pill.
If you have had your blood and urine tested, the gyno will want to see the results along with the results of the Pap test. If the Pap test is normal, then you will only need to take that again in three years’ time. If there is anything that is not one hundred percent normal the doctor will want to have another look at it.
They should also give you antibiotics or the correct treatment for any kinds of STDs you might have. If the gynecologist gives you a prescription for anything then you can ask what it is for and what it does. Make sure you know how long you need to take it for and if it has any side effects.
15. Schedule your next appointment
Although you might have felt nervous on your first visit, now that you know what to expect you will be able to take the next appointments in your stride. You may as well get used to them because, from the time you start seeing one, you should have a gynecologist checkup at least every two years and a pap smear every three.
If you are sexually active and at risk of STDs then you should see your gynecologist at least every year. You should also be looking after your general physical health so that your weight to body mass index falls into healthy parameters and your lifestyle is healthy.
This includes eating a healthy diet, doing some exercise and not smoking. If you make good lifestyle choices, you will be able to stay healthy over time. If you keep yourself free of STDs by using a condom, you will also ensure your future reproductive health.
You will need to see the gynecologist if you have frequent lower back pain, pelvic pain, abnormal bleeding, itching, pain, swellings or lumps in and around your vulva and any changes in your breast or armpits.
16. What you take home, information, treatments
After you have finished your first appointment with a gynecologist, you should know and understand a lot more about your own body and your reproductive health. Your gynecologist should have shown you how to do a breast exam on yourself and explained various contraception methods. They should also have suggested the possibility of having some specific vaccines for young women like the Human papillomavirus vaccine, or the Hepatitis A vaccine.
You need to evaluate whether these vaccines are necessary and will be good protection for you. The choice to have them is yours, and you should be informed about any side effects before you decide to have them done.
You should also have been given exhaustive information about the different types of birth control that are available to you. You should have decided together what form is best for you. If you have decided on birth control that requires a prescription, then you should leave the doctor’s office with the prescription on hand.
If you need to have a blood or urine test, or a further specialist checkup, then you should have all the prescriptions and referrals in hand when you leave. If you need to follow a treatment scheme you should know what it is, what it does and how long you will need to do it for. You should also know when you need to go back and over what kind of time period. You should know when to keep up with routine exams, tests, and immunizations.