Here's how to get the most out of your next gyno visit
Going to the gynecologist is one of the most important aspects of maintaining your sexual and reproductive health, but unfortunately, it can also be one of the most stressful. From sharing intimate details about your sex life, to letting a stranger get up close and personal, we know it can be uncomfortable. But it doesn’t have to be! Whether you see a doctor, nurse, clinician, or midwife, your healthcare provider should offer a safe, judgment-free space (and if they don’t, find one who does). Being honest about your health and sexual history, as well as asking lots of questions, are essential to receiving the best care possible.
Here are some tips to make sure you feel comfortable and prepared for your next gyno exam.
The basics
A gynecological exam, also called a pelvic exam, physical, or well-woman visit, is an essential yearly check-in appointment with a healthcare provider for anyone who has a vulva, breasts, or a uterus. According to the American College of Obstetricians and Gynecologists, more than half of all women consider their gynecologists to be their primary care providers, which means that for the majority of women, this visit may be their only contact with a physician all year. During this visit, your provider usually discusses not only your sexual and reproductive health, such as periods, birth control, and STIs, but also your overall physical and mental health. The physical component of the exam usually includes an abdominal exam, a lung exam, a breast exam, and sometimes a pelvic exam, depending on whether you need certain tests.
How to prepare
Bring everything you would to a typical doctor’s visit: insurance card, ID, payment. You will most likely be asked about your personal medical history, including any new allergies or medical issues, your family medical history (mother, siblings, aunts, grandparents), any medications and supplements you are currently taking, and the first and last days of your most recent period. If you think you might forget any of these, write them down in advance. You can also prepare a list of questions and concerns you have. Think about what you want from the exam, whether that is a specific diagnosis or just information.
You should not use douches in general, but especially avoid them before your visit, as they can negatively affect exams like a pap test by washing away the cells that your provider needs to examine. Also avoid yeast medications and spermicides during the 24 hours before your appointment.
Most providers agree that the best time for an exam is during the middle of your cycle, a week or two after your period. Your breasts will not be as swollen, making exams and mammograms easier and more comfortable, and a pap test more effective. If you are seeing your provider for a vaginal discharge problem, menstrual blood could interfere with tests. However, if you are experiencing irregular or heavy bleeding, your provider may prefer to see you while you are on your period.
What to expect
What happens during your visit depends on your age and medical and sexual history. At your very first exam, which is recommended at the start of puberty (around age 13), your provider will just talk with you and perform an external genital exam. Pelvic exams and pap tests are not necessary until you become sexually active or turn 21 (whichever comes first). If you are under 18, you may receive some shots, like the HPV vaccine.
Before the physical exam, your provider typically asks about birth control, your sexual history, your pregnancy history (which includes miscarriages, abortions, and births), and whether you practice safe sex. Make sure your provider knows if you have had unprotected or forced intercourse or if you have experienced any unusual bleeding, pain, discharge, or itchiness. STI screenings may not be a standard part of your annual visit and not every provider tests for the same infections, so let them know if you would like a test and ask which infections they screen for. HPV tests are not automatically included in pap tests, so make sure to ask if you want one. Your provider will also ask you about your overall health. These questions may cover your medical history, family history, eating habits, physical activity, alcohol and drug use, mental health, and relationships.
For the physical component of the exam, your provider usually measures your height and weight, checks your blood pressure, takes your temperature, and examines your abdomen, lungs, and breasts. During a breast exam, your provider will manually inspect your breasts and underarms for any lumps or abnormalities. If you need STI tests, your provider may take a urine sample, a cheek swab, or a blood sample. A pelvic exam is not always necessary, but if you need one, it usually includes both an external and internal exam. For the external exam, your provider will examine your vulva and the opening of your vagina to check for bumps or sores, signs of cysts, abnormal discharge, warts, or irritation.
The internal exam
The first part of the internal exam is performed with a speculum, a metal or plastic instrument that holds the walls of the vagina open. This might feel uncomfortable or awkward, but it should not hurt. If it does, let your provider know and they may be able to adjust the size or position of the speculum. Your provider will examine your vaginal walls for sores and inflammation, and your cervix for discharge, signs of infection, and damage. If your provider is performing a pap test, they will use a tiny swab, spatula, or brush to collect cells from your cervix while the speculum is inside you. This sample will be sent to a lab to be tested for cancerous cells. If your provider is testing you for STIs such as chlamydia or gonorrhea, they will use a swab to take a sample of the discharge from your cervix. Again, these swabs might feel a little weird, but it should not be painful. Light spotting afterward is normal, but let your provider know if there are more than a few drops of blood.
The second part of the internal exam is manual — your provider will insert one or two gloved and lubricated fingers into your vagina while gently pressing on your lower abdomen with their other hand. They are checking the size, shape, and position of your uterus; for tenderness or pain; and for enlarged ovaries, fallopian tubes, ovarian cysts, or tumors.
Finally, you may receive a rectal exam. Some providers do not regularly perform rectal exams, so make sure to request one. During this exam, your provider will insert a gloved and lubricated finger into your rectum to check the muscles between your vagina and anus, and for tumors behind your uterus, on the lower wall of your vagina, or in your rectum. This exam helps them detect rectal lesions and growths (an early sign of colon cancer), endometriosis, ovarian cysts, and any misalignment of the uterus and other pelvic organs. Some providers put another finger in your vagina while they do this to examine the tissue in between more thoroughly.
How to feel more comfortable
It is 100% understandable and okay to feel uncomfortable about or even triggered by gyno exams. Just remember that your provider’s job is to make sure you feel safe and informed, and you should not tolerate anything less. If you feel embarrassed asking intimate questions or being naked in front of your provider, just remember that they have heard and seen it all before and that everything you discuss is confidential. Being honest about your health and lifestyle is important to receive the proper tests and diagnosis. No one knows your body better than you do, and if you do not tell your provider what is going on with your body, they cannot offer you the best help.
If you are nervous about the exam, don’t be afraid to ask what is being done and why every step of the way. It’s okay to ask what a pelvic exam entails and what it will feel like, or why they are taking a blood sample. If your provider prescribes you a new medication, you should ask about side effects, potential drug interactions, or cheaper generic versions. Worried about forgetting important information? Take notes or ask to record your discussion. Tell your provider if there is specific language you would like them to use or avoid. For trans or nonbinary folks, that means specifying your pronouns and which words you use to refer to your genitalia. If you find certain words triggering, like “relax” or “this won’t hurt,” let your provider know. Before your exam, tell your provider what would make you most comfortable, whether that means chatting for distraction, or listening to music and zoning out.
You might feel more comfortable bringing a friend or family member to your exam, either as support or as an advocate who can make sure all your questions are answered and take notes. Most providers allow at least one guest, but make sure to ask if you can bring someone before your appointment. Remember, this visit is about you and your comfort and health, and your provider’s job is to help make it as easy as possible.