What To Expect When You See The Gynecologist For The First Time

You're about to see a gynecologist for the first time, and you're feeling, well, a little weird.

"It's actually common to feel nervous," said Dr. Aparna Sridhar, an OB-GYN at UCLA.

So, if that's you, Sridhar has a message: "We're not that scary."

Gynecologists like Sridhar are committed to helping you feel relaxed enough to take control of your reproductive health. And since things often feel less scary when you know what to expect, let's walk through all the steps.

WHEN SHOULD I GO?

If you're like me, you guessed wrong. I figured it was 18. But the American College of Gynecologist and Obstetricians actually recommends the first visit between the ages of 13 and 15.

OB-GYN and author Dr. Sherry Ross said the majority of her first-time clients are older than that, but added, "that transition from a pediatrician to a gynecologist will often depend on your upbringing, on your mom's philosophies."

Some parents worry that taking their daughter to the gynecologist is giving tacit permission for them to have sex, because OBs can write prescriptions for birth control.

"But there's so many other issues," Ross said. "It's about building the foundation of a relationship."

Who knows more about a young woman's early menses, pain or other concerns about reproductive health than a doctor who specializes in the area?

Dr. Aparna Sridhar, an OB-GYN at UCLA, lays out the paper sheet commonly used during an exam.

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"I usually reassure them that the body changes are going to happen, and it's very normal," Sridhar said.

Unless a teen has a medical concern, this visit is more about conversation, education, preventive medicine and establishing good, healthy habits. There can be a physical examination, but an internal exam is not often necessary at this age.

IT'S NEVER TOO LATE

If you're over the age of 15, you haven't missed the boat. There are many reasons why women go later in life. If you haven't been seen, get in when you can. Don't worry if you're an older newbie, the doctor likely won't be surprised.

When you're out of your teens, the main difference in your first appointment is the doctor may need to do a few more exams, including a cervical exam. A pap smear (a screening for cervical cancer) gets added at age 21. At 30, an HPV test (HPV is a common sexually transmitted virus that can cause cervical cancer) is added to the mix.

BEFORE THE CLOTHES COME OFF

Knowing a stranger is going to see your most intimate body parts can definitely be unnerving. But you may not need to automatically dress in a paper sheet and put your feet in stirrups. That's for later.

Depending on your age and your symptoms, you may be able to stay dressed for the first appointment, which "may just be a quick talk between me and the patient," Sridhar said.

Even when it is necessary to check out what's happening down below, the appointment will start with a conversation.

Sridhar asks new patients about menstrual cycles, sexual activity and whether they have any allergies or past surgeries.

Ross says her first interaction with her patients is a conversation while they're still dressed.

Even after you go from street clothes to hospital attire, the lines of communication should stay open.

"It's important to empower yourself with questions before you go to the doctor," Ross said.

Ross and Sridhar both explain to their patients what they're about to do before they start an examination.

EXAM TIME: WHAT'S GOING TO HAPPEN?

Once you and your doctor are acquainted, she'll leave you alone to strip down and put on a paper gown (or a cotton one, if you're lucky).

The doctor will return to check your thyroid and your breasts for lumps, bumps or irregularities.

For the pap smear or HPV testing, the doctor first puts on gloves and inserts a speculum into the vagina. It can be plastic or metal. Ask for lube, and know that specula come in a number of different sizes.

Once the speculum is in place, a tiny broom picks up cells from the cervix to be tested to make sure all is normal. The presence of abnormal cells does not mean you have cervical cancer. You may need additional tests, though.

Doctors use their gloved hand for the cervical exam. One or two fingers go into the vagina to feel the size and position of the uterus and ovaries.

WHAT'S OKAY AND WHAT'S NOT

It's okay to try out a few doctors before keeping one. You have a right to choose a doctor you feel comfortable with.

"It's awkward enough to have someone examine your body that you just met," said Ross.

Pain is not okay.

"Pap smears are uncomfortable, but not painful if done right," said Sridhar.

Sridhar does what she can to make the exam as comfortable as it can be, but if a patient is too nervous to have a full pelvic examination, she's willing to skip it.

"You don't have to accomplish everything in one visit," she said.

A professional gynecologist wants you to be comfortable enough to do these important if odd-feeling tests regularly to monitor your health. The pros understand.

WHAT TO DO IF SOMETHING GOES WRONG

With recent news of predatory doctors, like USA Gymnastics physician Larry Nassar and dozens of allegations against former USC gynecologist George Tyndall, it's important to know that patients have rights.

"If a woman feels unsafe or uncomfortable during an exam, she should be encouraged to verbalize these concerns right away," Dr. Sigal Klipstein, the past chair of the American College of Obstetricians and Gynecologists, wrote in an email.

If you want a chaperone, you have a right to one, regardless of whether your doctor is a man or a woman. And you don't have to get started until the chaperone is in the room. That's the ethical standard.

And if something feels wrong during the appointment, you don't have to just sit there.

"If there's something that doesn't feel right physically or emotionally, from a look, a glance, a touch, you can say, 'You know what? I'm not comfortable,' and you can end the exam," said Ross.

Experts recommend that you document what happened. And you can report abuse.

If something goes wrong, there are places to go for help:

• You can talk to your chaperone about your concerns.
• The National Sexual Assault Telephone Hotline: 1-800-656-HOPE (4673)
• SAFE LA, the city's domestic violence awareness initiative
• The police. The LAPD has a list of hotline numbers.
• Your health insurance provider. Your doctor probably works for someone else. Most companies have a helpline for complaints.
• The Medical Board of California

Are you a woman who wishes "the talk" had covered a few more things? LADYist is here to fill the gaps in your sex education. It's sex ed for grown women. Tell us what you want to know.

Correction: A previous version of this story mispelled Dr. Aparna Sridhar's name. LAist regrets the error.

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