If you haven't done so before, you should see a gynecologist when you need contraception, or if you have any abnormal symptoms of course. However, some gynecologists recommend that you have a gynecological exam after your first menstrual period.

Many girls are afraid of going to a gynecologist for the first time. Fear is usually the result of ignorance. We want to explain exactly what will happen at the exam.

The gynecologist

A gynecologist is a specialist for women's diseases. You should decide first whether you would rather be treated by a man or a woman. It is always good if you can go to a doctor who has been recommended. Maybe your mother or a girl friend have a doctor they can recommend? But you can also look in the telephone book or on the Internet.

Before the exam

First the doctor will ask you about your past medical history (illnesses, operations etc.). Information about when you had your first period (menarche), the date of the last period, the length of the cycle and the amount of bleeding is important. It is therefore a good idea to keep a menstrual diary.

In order to gain a full picture your doctor will also ask whether you have already had sex and what contraceptives you are using.

What you and your doctor talk about will of course vary from person to person. It will also depend on what questions you have. If you feel unsure make a note of the questions you want to ask. Do you want to ask about contraception? . Do you want to ask questions about your period? You can talk openly about all these things and be sure that your questions will be treated confidentially. The doctor is bound by medical secrecy. This also applies to very young girls who do not want their mothers to be informed.

However, if you like you can also take your mother or a girl friend with you when you go to the gynecologist for the first time.

The Menstrual Diary

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The gynecological (pelvic) exam

The gynecological exam is performed on a special examination chair. Many young girls feel unsure of themselves and embarrassed. Such feelings are understandable but they are entirely unfounded. If you wear a loose skirt instead of long trousers when you go for the exam this can help you feel less exposed. Then you only need to pull up the skirt for the exam.

To examine the cervix the doctor will insert an instrument called a speculum into the vagina. This spreads the walls of the vagina so that the cervix can be seen. The speculum may feel a little cold. Some doctors therefore warm it slightly first. The examination is not painful – so do not tense up, just breathe quietly in and out. The doctor will inspect the vagina and the cervix. He will examine the cervix with a microscope which allows him to see any pathological changes of the mucosa. He will also take a cervical smear for examination in the laboratory. This is done by removing a scraping of cells from the surface of the cervix using a cotton swab or tiny brush.

The speculum exam may be followed by an ultrasound exam. This is done with a thin ultrasound probe which is introduced into the vagina and allows a very good assessment of the uterus and the ovaries.

The bimanual exam is another typical examination method. For this the doctor inserts one or two fingers of the right hand into the vagina, the uterus is placed on the fingers and pushed upwards. The left hand is on your lower abdomen and presses against the abdominal wall. This allows the doctor to feel the uterus or to shift the ovaries and the uterus into a position in which they can be evaluated.

The breast exam

Finally the doctor will examine your breasts for any masses or lumps. Regular examination of the breast is an important part of cancer screening. You should examine your breasts regularly yourself from now on. The best time for breast self examination is immediately after your period as the breasts are then soft and it is easier to feel any changes.

After the exam

After the examination the doctor will discuss the findings with you. If you want a contraceptive which has to be prescribed by a doctor (e.g. the pill) and there are no medical reasons not to use such a contraceptive the doctor will write you the necessary prescription.

In general the gynecologist should allow plenty of time for a patient's first visit in order to establish a trusting relationship.