My First Visit to the Gynecologist

The regular gynecologic exam is a key part of your health care. Routine gynecologic exams are important to a woman's total health and well-being. From the start of menstruation (menarche) through the end of the time when menstrual periods end (menopause) and beyond, any number of problems can occur that involve the reproductive organs. The healthy condition of these organs is essential to sexual satisfaction, normal fertility, uncomplicated pregnancy and childbirth, and the health of any future infants.

By performing exams on a routine basis, your doctor can detect problems and treat them before they become worse. This is especially important with cancer of the cervix, which can be detected in an early stage with a simple, quick test, called a Pap test, that can be done in your doctor's office. Your ob-gyn can also give you preventive care-guidelines and advice to help you stay healthy-in areas such as nutrition and sexually transmitted diseases.

When your reproductive organs are healthy, there is less risk of problems during pregnancy and childbirth. It is ideal for obstetric care to begin when a woman first decides to have a baby-before she becomes pregnant. A woman and her doctor need to know about her overall health so they can plan in advance for a healthy pregnancy and a healthy baby.

When Should You Have an Exam?

You should have your first gynecologic exam by age 18 or earlier if:

• You are or may soon become sexually active
• You have menstrual problems, such as unusual pain or abnormal bleeding
• You have a vaginal discharge that has a foul odor or is causing irritation
• You are planning to become pregnant
• You have not had a menstrual period but have developed breasts and pubic hair

How often your visits should be depends on the care plan that you and your doctor prepare. In most cases, you should see your doctor once a year. Of course, if you have a health problem, notice any changes in your body, or become ill, you should contact your doctor right away.

What Is the Exam?
A routine exam lets the doctor evaluate you as a total person. It also provides clues in finding the causes of problems such as abnormal uterine bleeding or vaginal discharge, urinary or bowel problems, pain in the abdomen or lower back, infertility, or sexual problems. The exam consists of a personal and family health history, a physical exam, lab tests, and education and counseling.

Health History
One of the first things your doctor does on your first visit is ask you for a personal and a family health history . Your personal history tells the doctor specifically about you. The family health history gives him or her a general view of your family's health. It also provides information on diseases that may be inherited (passed on) from your parents to you or from you to your future children. It is important to give answers that are honest and as complete as possible during the health history. Don't let fear or embarrassment keep you from giving your doctor important information about your health. Keep in mind that these discussions between you and your doctor are strictly confidential.

Physical Examination
The physical exam by your ob-gyn usually involves your entire body, including your reproductive organs. It usually begins with a check of your weight, nutritional status, and blood pressure. An examination of the chest and abdomen may also be performed. Your blood pressure should be checked on a regular basis. A person can have high blood pressure and still feel fine and have no symptoms. High blood pressure overworks the heart and circulatory system and, if not treated, can lead to kidney damage or stroke. During the exam, your doctor checks your breasts for signs of cysts or lumps. This is done in addition to the monthly breast self- examination you should be doing on your own.

Pap Test
During the internal exam, your doctor may perform a Pap test. In this test, a few cells are taken from the cervix and vagina with a cotton swab or applicator. This is not painful. The cells will be examined in a lab for early signs of abnormal cells. Such abnormal cells could signal cancer in an early stage. Although abnormal calls are sometimes found on the cervix, as long as 10 years may pass before cancer develops. A Pap test can detect cancer when it is in an early stage, before it invades deeper tissues. At this early stage, there is a greater chance that the cancer can be treated with success.

A Pap test done on a regular basis is a key part of your overall reproductive health care. You should have your first Pap test by age 18 or when you begin having sex. Most doctors feel that women should have a gynecologic exam, including a Pap test, every year. If any of your tests shows abnormal results, your doctor may advise you to have a Pap test more often than once a year. Other lab tests, along with the Pap test, are also part of a periodic gynecologic exam. These may include several tests of both blood and urine. Special tests, such as X-rays, tests for infections, or mammograms (X-rays of the breasts), may also be needed.

Your Doctor's Advice
After taking your history and doing a physical exam, your doctor will discuss results with you and answer any questions you may have. If the lab tests that have been ordered show anything unusual, you will be informed later.

Your doctor and the office staff can discuss with you such topics as:

• Cancer signals
• Breast self-exams
• Drug use
• Diet
• Concerns about menopause
• Exercise
• Sexuality
• Types of birth control
• Having a baby
• Counseling about any disorders that can be inherited
• Infertility

You probably will have specific questions about these matters. Feel free to ask your doctor any questions you have.

Source: Patient education material from the American College of Obstetrics and Gynecology was used as a source of information to develop the content for this topic.

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