What to Expect

Young women should have their first gyn visit between the ages of 13 and 15 years. The first visit may just be a talk between you and your doctor. This will help you to get to know each other and to find out what to expect at future visits.

It is normal to feel nervous about your first visit. It may help to talk about it with your parents or someone else you trust so you know what to expect.

Your doctor may ask a lot of questions about you and your family. Some of them may seem personal, such as questions about your menstrual period or sexual activities (including vaginal, oral, or anal sex). Your doctor needs to ask these questions to best know how to care for you and keep you healthy. Giving open and honest answers to these questions is key to your care. This is a good time to ask your doctor any questions you might have. If you are concerned about confidentiality, you and your doctor should talk about it before you answer any questions.

Exams

You may have certain exams at the first visit. It depends on your age, if you have had sex, or if you have any problems. This visit may include:

• General physical exam
• Breast exam
• Pelvic exam
• Pap test
• Vaccinations

If you choose, a nurse or family member may join you for any part of the exam.

Symptoms That Need Care If you are having any of the following symptoms, see a doctor: Severe pain in the lower abdomen Bad cramps during your period Periods that are not regular or missed periods Pain around the vagina or burning, swelling, itching, or discharge Blood in your urine

General Physical Exam

During the general exam, your height, weight, and blood pressure will be checked. You also will be examined for any health problems you may have (see box).

The Breast Exam

During this exam, your doctor may check your breasts for growth and signs of any problems, such as a lump. The doctor will examine your breasts by moving his or her fingers around your breasts in a pattern. You also may be shown how to examine your breasts at home.

The Pelvic Exam

Many times your first gyn visit will not include a pelvic exam. But if you have had sex or are having certain problems, a pelvic exam may be needed. For the pelvic exam, you will be asked to undress and put on a paper or cloth gown. Then you will lie on an exam table. You will be asked to put your feet against foot rests and slide to the end of the table.

The pelvic exam has three parts:

Looking at the vulva Feeling the internal organs with a gloved hand Looking at the vagina with a speculum

For the pelvic exam, the doctor will place one or two gloved, lubricated fingers into the vagina and up to the cervix. The other hand will press on the abdomen from the outside. The doctor also may insert a finger into the rectum. This helps the doctor check the size, position, and shape of the internal pelvic organs. It also may help the doctor detect any abnormalities. If you would rather not have the rectal exam, you can tell your doctor. The pelvic exam may feel uncomfortable, but should not hurt.

The doctor will look at your vagina with a speculum. He or she may take a sample of your cells to check for some sexually transmitted diseases (STDs). Another sample may be taken for a Pap test.

The Pap Test

Girls who have had sex may need a Pap test. It is done to check for abnormal cells in the cervix that could lead to cancer. For this test, the doctor inserts a small brush, or a cotton-tipped swab through the vagina into the cervix. Cells are removed from the cervix and then studied under a microscope.

Vaccinations

What Vaccines You May Need The following vaccines are given to all girls aged 13–18 years on a routine basis: Tetanus–diphtheria booster (once between ages 11 years and 16 years) Hepatitis B virus vaccine (one series for those who have not been vaccinated) Meningococcal vaccine (once between ages 11 years and 12 years; once at about age 15 years for those who have not been vaccinated) In addition to routine vaccines, special vaccines may be given to girls who are at an increased risk for certain diseases. Some of these vaccines include: Influenza Hepatitis A virus Pneumococcal Measles–mumps–rubella Varicella (chickenpox)

Vaccinations or immunizations are shots that protect against diseases caused by bacteria and viruses. Some are given on a routine basis (see box). Other vaccinations are offered to the women who are at an increased risk for certain diseases. Your doctor may ask you about your medical history and suggest you receive certain vaccinations.

Special Concerns

Many young women share the same health concerns. These include:

• Cramps and problems with menstrual periods
• Acne
• Weight
• Sex and sexuality
• Birth control
• STDs
• Emotional ups and downs

Most young women enjoy good health. Health problems that arise for young women often are a result of high-risk behaviors, such as having unprotected sex or using drugs. Your doctor may offer some tips on how you can help prevent these problems and stay healthy (see box).

Being Healthy To be strong and healthy for years to come: Maintain a healthy weight by eating a well-balanced diet and exercising often. Avoid smoking, drinking alcohol, and using illegal drugs. Seek help if you have emotional ups and downs or feel depressed. Use birth control if you are having sex and do not want to have a baby. Protect yourself from STDs by using a latex condom, knowing your partners and limiting their number, and avoiding risky sex practices, especially anal sex. Keep up with routine exams, tests, and immunizations.

Finally...

Your first gyn visit is a great chance to take charge of a healthy lifestyle. You may be nervous at first. Knowing what to expect will help ease your fears.

Be involved in your health care. Follow up with your doctor to find out test results. Ask questions. See your doctor on a routine basis to be sure you have all the tests and vaccinations you need to stay healthy.

Glossary

Birth Control: Prevention of pregnancy.

Cervix: The lower, narrow end of the uterus, which protrudes into the vagina.

Condom: A thin sheath used to cover the penis during sex to prevent sexually transmitted diseases and pregnancy.

Menstrual Period: The discharge of blood and tissue from the uterus that occurs when an egg is not fertilized (also called menstruation).

Obstetrician–gynecologist (ob-gyn): A physician with special skills, training, and education in women's health.

Pap Test: A test in which cells are taken from the cervix and vagina and examined under a microscope.

Pelvic Exam: A manual examination of a woman's reproductive organs.

Sexually Transmitted Diseases (STDs): Diseases that are spread by sexual contact.

Speculum: An instrument used to spread the walls of the vagina.

Vagina: A tube-like structure surrounded by muscles leading from the uterus to the outside of the body.

Vulva: The lips of external female genital area.

This Patient Education Pamphlet was developed under the direction of the Committee on Patient Education of the American College of Obstetricians and Gynecologists. Designed as an aid to patients, it sets forth current information and opinions on subjects related to women's health. The average readability level of the series, based on the Fry formula, is grade 6–8. The Suitability Assessment of Materials (SAM) instrument rates the pamphlets as "superior." To ensure the information is current and accurate, the pamphlets are reviewed every 18 months. The information in this pamphlet does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice may be appropriate.

Copyright © June 2006 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

ISSN 1074-8601

Requests for authorization to make photocopies should be directed to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923.

To reorder Patient Education Pamphlets in packs of 50, please call 800-762-2264 or order online at sales.acog.org.

The American College of Obstetricians and Gynecologists
409 12th Street, SW
PO Box 96920
Washington, DC 20090-6920

12345/09876