I've had a crazy amount of emails relating to this post. Mostly from teens and young women. Mostly asking about gynecological exams. Breast exams. But the hot topic, has been PAP Smears and Pelvic Exams. So I thought I'd post about this.
It's honestly, nothing to be afraid of. When you get your yearly physical, you generally will have these done. You can go to your PCP, for these things. Or you can request to see a gynecologist. If you are not comfortable with a male doctor, you will be sent to a female doctor...or midwife. So you might have your annual physical with one doctor...and your pelvic exam with another.
Basically, if you're under 18...your parent/guardian will be in the room. They will ask you a handful of questions. About your basic health. And ask if you have any questions. You will be asked to undress. Basically, you will just be wearing a paper gown and socks.
They will ask you to get on top of the exam table. And your doctor will give you a full body exam. They will look for any moles, discoloring, or any other abnormality on your skin. They will have you lay back. And will give you a breast exam. Your doctor should talk you through this. And if you've never had one done, they will teach you how to give yourself an exam. Remember monthly self exams are so important!
Honestly, this is super important. All of it. From them checking your skin...to the breast exam. Nothing should be painful. The doctor should try and make you feel as comfortable as possible. Nothing should feel inappropriate.
Next, they'll ask you to scoot to the bottom of the exam table. They probably gave you a paper drape. You may have been wearing it as a blanket. At the end of the table, the doctor will probably have their stool or chair. You might see a table, with supplies on it. And perhaps a light.
This is were it can vary for ladies. If you are not sexually active (still a virgin) you will just have a pelvic exam. In so many terms, if you are not putting anything in your vagina, you will not have a PAP Smear. No sex, no tampons, no nothing...you just have a basic exam.
What happens? You slide your bottom all the way to the end of the table. You are lying down. And they will ask you to put your feet in stirrups. Let your knees completely relax, and fall to the sides. The most important part of this exam, to not feel pain, it to relax. This should not be painful.
The doctor will exam the exterior of your vagina. They are looking for anything that doesn't appear normal. This can be anything from the skin, to odor, the way you react to touch. Think of it like, when a doctor is examining your back for moles. Or something like that. They are just looking to make sure everything looks OK.
During this part of the exam, your doctor is looking at your vulva and the opening of your vagina. They are looking for warts, cysts, smells, signs of infection, abnormal discharge, or abnormal coloring.
They might palpate, or feel from the outside, your abdomen. To see if everything on the inside feels OK. If they don't find anything wrong, your exam is over. They'll probably remind you to do a monthly self breast exam. And you are done. If you are not sexually active, they may talk to you a little about safe sex practices.
Now if anything is going into your vagina. For sexual reasons or tampon use, you will have a PAP Smear. You will have had the same exam as above. But now, they are going to take a look inside. You may have noticed a few things on their side table of supplies. A large Q-tip looking thing. It will be used to take a discharge sample from your cervix...to test for STDs. There is also probably a spatula looking item, that will be used to collect cells from your cervix (PAP Smear) to test for cancer or precancerous cells.
So when they begin this part of the exam, they will probably be talking to you. Literally telling you what they are going to do, right before they do it. Again it should not hurt. Or feel sexual in any way. They'll take a speculum, metal or plastic looking "duck's beak." And insert it into your vagina closed. When it is open the doctor will use it to separate the walls of your vagina. It should not hurt. If at any time, you feel pain, tell you doctor. Remember to stay relaxed. Your legs, muscles in your stomach and vagina should be as relaxed as possible.
The first thing they will probably do, is your PAP Smear. Then your swab for STDs. You might notice a little mirror. They use that to get a better look inside. Next you will have a manual exam. The doctor will put a gloved and lubricated finger or 2, into your vagina. They will gently press on your abdomen, to check your uterus, ovaries, fallopian tubes, any cysts, or tumors. They are also checking for tenderness or signs of an infection.
Lastly, they are going to check your rectum. This is so important. I know, it can be uncomfortable. But it is important to check for cancer. So the doctor will put a gloved finger into your rectum. They are checking the tissue between your anus and your vagina. Sometimes, a doctor will have one finger in your vagina and one in your rectum. It helps to check the tissue between very thoroughly. You might feel like you have to poop. But you won't. Don't worry.
For the basic pelvic exam, your doctor may also check the outside of your rectum. It's important. Don't panic. Really, it is the only way to check for cancer.
Your entire exam should just take a few minutes. They will probably spend more time talking to you, than examing you. Your doctor should talk you through the entire thing. Start to end. Telling you what they will be doing. What they feel. And what they find. It should not be painful or sexual. Just try and stay relaxed.
How often do you need a pelvic exam? That depends. If you have normal health, every 2 years usually. If you have had one, and then become sexually active, you should return to your doctor before the 2 years. And then you will probably be reset to every 2 years, at that point.
You might also talk to your doctor, at this time, about birth control. If you are looking at have any type of IUD placed. This is the time. Speak up.
If you have some issues, it can be more frequent. Things like abnormal PAP Smear results, family history of certain types of cancer, history of STDs, or a sexual partner with STDs, a history of sexual health problems, or reoccurring yeast infections, or pain in the general area...generally have to be tested more frequently.
When do you begin them? Most people say 21. I was told 16. But I did have some family history of things. But definitely when you become sexually active. So if you're having sex before 21...don't wait until you're 21. These exams become a routine way, to care for your body. The same way we have annual physicals. Don't be afraid.
Also, don't be afraid that your doctor is looking "down there." They do it all day long. They're really not going to remember much...about your vagina. Don't worry, they won't be chatting with all the nursing staff when you leave. I worked L&D for an extended period. And I don't really remember much about all those vaginas. Don't flip out, if you don't think you are normal there. You probably are.
If you want to ask me some more questions, if I didn't answer something, or you want to chat...send me a message at LilMorningGloryChats (at) gmail (dot) com.
XOXO,
Desiree
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