Whether you want to see a male or female health care professional is up to you. Some women say that they prefer being examined by a female doctor or nurse because it puts them more at ease and they feel like they can talk more openly about women's health problems and sexuality issues. Other women feel comfortable being examined by a male doctor or nurse. If the doctor or nurse is male, he will usually have a female assistant in the room with him during all parts of the exam.
During the physical part of the gynecologic exam, you'll be asked to lie on your back on the table. You'll have the paper sheet or gown covering you, and the doctor will only uncover the parts of your body being examined.
The doctor will give you a breast exam by lightly pressing on different parts of your breasts. After finishing, he or she may show you how to examine your own breasts. This helps you become familiar with how your breasts feel so you know which lumps are normal and which may be the result of a change.
During the pelvic part of the exam, the doctor or nurse practitioner will ask you to move down so your behind is at the end of the table. You'll bend your knees and rest your feet in two stirrups, which are metal triangular loops that stick out from the end of the table. These might look a little scary, but they're just there to rest your feet in and keep you more comfortable. The doctor will ask you to relax your knees out to the sides as far as they will go. It might feel a little funny to be lying with your legs opened like this, but everyone feels that way at first.
The doctor will put on gloves and examine the outside of your vagina to make sure that there are no sores or swelling and that everything looks OK on the outside.
Next, the doctor will want to look at the inside of your vagina and will do so with the help of a speculum (pronounced: speh-kyuh-lum). A speculum is a thin piece of plastic or metal with a hinged piece on one end that allows it to open and close. The doctor or nurse will warm the speculum with water (some offices keep the speculum warmed in a drawer with a heating pad). The doctor or nurse will then slide the speculum into your vagina. Usually the doctor will tell you when he or she is about to place the speculum inside you so it doesn't come as a surprise.
Once the speculum is in the vagina, it can be opened to allow the doctor to see inside. Putting in and opening the speculum should not be painful, although some women say that it can cause a bit of pressure and discomfort. Naturally, if this is your first exam, you might feel a little tense. Because the vagina is surrounded by muscles that can contract or relax, the exam can be more comfortable if you try to stay calm and relax the muscles in that area.
If you feel like you're tensing up the muscles in your vagina, try breathing deeply or doing some breathing exercises to help you stay relaxed. Sometimes humming your favorite song or making small talk can distract you and allow you to feel more relaxed.
After the speculum is in place, the doctor will shine a light inside the vagina to look for anything unusual, like redness, swelling, discharge, or sores. He or she may then do a Pap smear, which involves touching the cervix to pick up cells from that area.
The cervix is the opening to the uterus, and it's located at the very top of the vagina. The Pap smear should not hurt, but it might be uncomfortable, especially if this is your first pelvic exam. The good news is this part of the exam is over quickly.
The cells that have been collected are sent to a laboratory where they are studied for any abnormal cells, which might indicate infection or warning signs of cervical cancer. (Like breast cancer, cervical cancer is very unusual in teen girls.)
If you have had sex, the doctor or nurse practitioner may test for STDs. He or she will swab the inside of the cervix with what looks like a cotton swab. The speculum is then slid out of the vagina. As with the Pap smear, the sample is sent out to a laboratory where it is tested for various STDs.
Talk to your doctor or a nurse about how you want to be contacted with results, and what they should do if they are unable to reach you. Again, doctors and nurses will do their best to maintain confidentiality, but they need to be able to reach you.
Because the ovaries and uterus are so far inside a girl's body that they can't be seen at all, even with the speculum, the doctor will need to feel them to be sure they're healthy. While your feet are still in the stirrups, and after the speculum is removed from the vagina, the doctor will put lubricant on two fingers (while still wearing the gloves) and slide them inside your vagina. Using the other hand, he or she will press on the outside of your lower abdomen (the area between your vagina and your stomach). With two hands, one on the outside and one on the inside, the doctor can make sure that the ovaries and uterus are the right size and free of cysts or other growths.
During this part of the exam, you may feel a little pressure or discomfort. Again, it's important to relax your muscles and take slow, deep breaths if you feel nervous.
At this point, the physical part of the exam is usually over. Your own doctor may do the exam in a different order, but it will probably include all these steps.