QuestionI know that you're not a gynecologist, but a few weeks ago my mom said she might let me take birth control. She also told me you had to get a pap smear. I have asked my friends and checked on blog sites and they have all said that their doctors didn't require it; only that it was recommended. My doctor helped my mom give birth to me many years ago, so we know each other pretty well(lol), but I don't know if he'll still make me have one regardless of what other people have said. I am also not sexually active so there's really no reason for a doctor to check for anything wrong, but I'm still worried.
Thanks
AnswerDear Denielle,
All females who are even considering obtaining birth control are considering the possibility of having some kind of sexual contact. So, that is why a Pap smear is recommended for anyone before obtaining birth control - to get a baseline BEFORE sexual contact begins. The American College of Obstetricians and Gynecologists (ACOG) recommends that Pap smear testing begin within three years of sexual intercourse, or by age 21. However, in my opinion, those are absolute MINIMUM standards and all women should have a GYN exam before or within one year of sexual intercourse, or by the age of 18. So many STDs and some cervical cancers could be prevented if this was done!
As for the exam... the best time to schedule it is the middle of your cycle - about 1-2 weeks after your period ends. Refrain from sexual intercourse for at least 24 hours before the exam. Make sure to be hygienic (showered and clean) BUT never douche. Douching increases the chances for vaginal infections. The vagina is a self-cleaning area - no need for douching. With it being your first visit, your doctor may order a urinalysis so you might want to have a slightly full bladder when you go BUT make sure to empty your bladder before the exam. It helps to make it a more comfortable pelvic exam for you. Blood tests may be ordered too. It just depends on how well this doctor knows you and your medical history.
Be prepared to fill out the typical medical history questionnaire and know when the first day of your LMP was. The nurse will then usually get your height/weight, blood pressure, pulse, etc,.. and ask you additional questions regarding current medications and any concerns you may have. She'll then give you a short gown (usually paper# which you put on after taking ALL clothing off with the opening to the front so the doctor can easily open for the breast exam, and a sheet to place over your lap. Once you've changed to the lovely little gown, you'll sit down at the stirrup end of the exam table so that when the doctor comes in it will be easy to simply lie back for breast exam and then skooch down a bit a put feet in stirrups for pelvic exam and Pap smear.
Now, you wait for doctor to come in. Try to relax because if you are tense, the exam is more uncomfortable. If you are relaxed and talking to doctor or whatever through the exam - it really flies by and all of a sudden it is done. Depending on the doctor, the nurse will accompany him in. I think this is standard practice anymore unless you have seen the doc for eons and there is a trust relationship established on both sides. If it isn't done and you prefer to have a female in the room, you have that right. You can ask the nurse about it when she is doing her interview at the beginning if you have that concern.
For the actual doctor's exam, he may start with some general assessments like heart/lung sounds, but the breast exam will come first. Do not be surprised if it is pretty thorough, but it should not take more than about 30 seconds per breast. He will probably incorporate an abdominal assessment in after the breast exam also. Now is when you'll need to get your feet in those nice, cold stirrups. #by the way, you can keep your socks on!# He will sit on a stool between those stirrups and here is where you really do need to concentrate on relaxing. If you have never had this exam before, it will not seem natural to you to have this doctor looking between your legs with the fluorescent lights glaring in the room and the world walking by on the other side of the door. But here's the thing - about 30 of these are done every single day in this very room you are in! It truly is ridiculous how many vajayjays he has to look at on a weekly basis. It is like us looking at a computer screen - it's just no big deal to them unless they happen to see something requiring medical attention.
First, he'll put his gloved fingers in to separate things a bit and feel around for any abnormalities #some wait and feel around at the end of exam#. He will then put in an instrument called a speculum. Most use metal but many have come to realize they can decrease the discomfort if they keep them in warm saline or sterile water. Before they did this, they were quite cold and that was uncomfortable initially. They open the speculum up to see the cervix. This spreads the walls of the vagina apart and you can feel that a little but not a great amount. Again, the more relaxed you stay, the less you feel because your muscles won't be all tensed up. He then takes a swab #like a long Q-Tip) and swabs the cervix for cells which will be checked for any sign of cancer or abnormality. When he does this, it can sometimes make you feel a little crampy inside. After the swab, he will remove the speculum. Now may be the part where some of your friends felt the most uncomfortable. He will place one hand inside you and one hand on your abdomen to feel the size, shape, and mobility of your uterus and make sure he can feel no obvious uterine or even ovarian abnormalities. This is called the bimanual exam. Some doctors will then do the colorectal exam. This is when he would insert his finger into the anus to check the rectum. This can be a life-saving exam in the prevention of colorectal cancers. However, some GYNs do this only at age 40 and over, while others will do it on everyone, and still others will do it younger than 40 with a family history of this type of cancer. It truly is over in less than 15-20 seconds and as long as you are not tensing up, it is not that bad. However, if you are tensed and squeezing those muscles, it absolutely will be more uncomfortable.
That's about it. The whole thing probably takes less than 15 minutes for the doctor's part - even if he takes his time with you.
I hope this has helped you and answered your question. I wish you well.
Brenda
