When should I have my first pelvic exam?

When should I have my first pelvic exam?

By Susan Block
MD

A good time to schedule a visit with a gynecologist (or women’s health specialist) is when you first have problems or concerns with menstrual periods, including premenstrual moods, acne around menses, vaginal discharge or any other cyclic discomfort. That appointment will involve a conversation about what is bothering you and may include a pelvic exam or may not.  Likely the doctor will ask you questions and together you will decide whether or not an exam is necessary.

Around age 13, even if you feel fine and are just wondering when you should come in for a routine exam, is a good time to schedule an appointment to discuss your female health, contraception and screening for sexually transmitted infection.  Vaccinations may be recommended if you have not already received routine immunizations. Some of the things that may be discussed include your health history, family health history, your habits with regard to diet and exercise, smoking or any drug use and sexual activities.  Some of these topics are things you may find difficult to discuss with friends and family.  In the gynecologists office we talk about those things all of the time!  Often we give you pamphlets or point to online resources for you.  The conversation is confidential and it is okay for you to remind the health care provider that you wish it to remain confidential. 

What is a pelvic exam and why might I need one?

A pelvic exam is often part of the visit with the gynecologist but it is not always included.  A pelvic exam is usually performed to obtain a pap smear or to examine the uterus, ovaries, and vagina.  The pap smear is a screening test for cancer of the cervix and is performed by inserting a small speculum into the vagina, to hold the vaginal walls open, and wiping cells off of the cervix.  It is usually first performed at age 21.  If there is an exam performed prior to age 21 it may or may not include an internal vaginal exam.  It might just be an external examination.  Often the first exam is just a conversation between you and your doctor or nurse practitioner.  Screening for sexually transmitted infection and starting contraception may also be provided without an internal exam.

If you have concerns or questions about a pelvic exam, or have questions about your health and are avoiding a visit because of a pelvic exam, don’t hesitate to speak up and let your health care provider know and please don’t let that prevent you from making an appointment to discuss your questions.

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