Just For Teens

Adapted from an article on www.teenwire.com, with additions by Tara Fisher

Are you sexually active?
Then you need a complete gynecological exam once a year.

Are you 18?
Then you need a complete gynecological exam once a year.

• Why do I need an exam?
• Making the appointment and preparing for the paperwork
• This is my first exam. I'm nervous!
• What if I prefer to be seen by a woman clinician?
• We need to talk!
• The breast and pelvic exams
• After the exam
• It's Worth It!

The gynecological exam is important for all women who are sexually active or 18 and older in order to keep their reproductive systems healthy.

Even if you are sexually active only with other women, you still need the exam!

There are certain cancers, including cervical and breast cancer, that can be detected during the exam and treated early. And you can still get many sexually transmitted infections.

Because you are a female, you will need to have at least one exam a year. The earlier you get started, the more pro-active you can be about your reproductive health. It is important to note that it does not matter your age, marital status, sexual identity, or decision to have children or not.

The gynecological exams throughout your life are an important factor in your overall health as a woman.

• To make an appointment at Planned Parenthood of the Rochester/Syracuse Region, call our toll-free help line at 1-866-600-6886. If you live outside our region, call 1-800-230-PLAN, or find the health center nearest you on the web.
• Unless you are going specifically for menstrual problems, do not schedule your exams when you have your period.
• If it is your first visit to Planned Parenthood, arrive early so you can fill out the paperwork before your scheduled time.
• Make a list of written questions you want to ask the clinician before or after the exam
• If you are going on your own, without insurance, ask about the clinics payment policy so you are not caught off guard when you leave. Planned Parenthood has sliding scale fees. If you are coming without a parent or guardian, we count only your personal income in determining how much you will need to pay. If you work, you need to bring a pay stub to verify your income. Your visit to Planned Parenthood is completely confidential.
• Make a note of the first day of your last menstrual period. Be prepared to discuss your health history and your personal sexual history.

Most women get nervous when they go in for their first gynecological exam. For some people, just talking about the subject can be embarrassing. But it's an important part of staying healthy, and with a skilled doctor or nurse practitioner, the physical exam will be quick, painless, and respectful.

It gets easier as you learn to relax your mind and your body. And while the exam may never feel great, it should not hurt, and you can always ask to take a break.

Many gynecological clinics allow you to choose a female clinician, if that is your preference. At Planned Parenthood of the Rochester/Syracuse Region, we can easily accommodate your wishes.

The first part of the appointment will be a talk with your doctor or clinician. They'll want to know about your medical history and your sexual activity. Questions they will ask include:

• Are you sexually active?
• What type of birth control are you using?
• Do you use condoms to protect yourself from sexually transmitted infections?
• Are your menstrual periods regular, light, heavy, painful?
• Do you have any abdominal pain or problems urinating?
• Is it possible that you are pregnant?

Think of your clinician as your teammate. You both must work together to insure your reproductive health. Be honest about your sex life and your sexual practices. Make sure to tell the clinician if this is your first exam so that she or he can explain more in detail what is going to happen.

In some ways, this conversation is the most important part of the visit. Each year things change - your body, your lifestyle, and your attitudes. Your health care provider is an excellent source of information for you. If you have concerns about your body, sexuality, birth control, sexually transmitted infections, or anything else, take this opportunity to ask.

At Planned Parenthood health clinics, these conversations are always confidential. Always ask about confidentiality before any medical appointment.

The physical exam usually involves a check of your body from head to toe. Most of it will be just like you're used to - peering in your mouth or listening to your heart and lungs. Next, the clinician will perform a breast exam. She or he will touch each breast, including the nipple, looking for lumps or other evidence of breast cancer. If the person doing the exam is a man, you can ask to have a woman in the room if it would make you feel more comfortable. Ask about how to do a breast self exam so you can check yourself for lumps or changes each month. (If you ever feel anything that concerns you during a self-examination, call your clinic right away for an immediate appointment.)

The most awkward part of the exam is the pelvic exam. This starts simply with a quick check of your genitals. The clinician is looking for infections, such as warts or herpes. The touch should be respectful, and you can ask them to let you know when they are ready to touch you.

If you find yourself getting nervous, a couple of techniques can help: Some women find that it helps to make small talk - talk about the weather, a pair of new shoes, whatever it takes to keep your mind occupied. Other women like to close their eyes and focus on the sound of their breath. In and out, in and out - it's like meditation and will relax your body as well as your mind, which can make the entire exam easier.

Internal Exam

The next part of the pelvic exam is usually the speculum exam. (If you're a virgin, you usually won't need to have this done. And if you do, it won't affect your virginity.)

The sides of your vagina touch each other, so in order for the clinician to see your cervix and the walls of your vagina, she or he will gently open your vagina using a tool called a speculum. The speculum can be made of metal or plastic. If the speculum is metal, you can ask the clinician to warm it under warm water. You can also ask to see the speculum and learn how it works.

Remember, this part of the exam might feel uncomfortable, but it should never hurt - speak up if it does! With the speculum inside your vagina, the clinician will check your vagina and your cervix. They're looking for discharge or other signs of infection. They will also collect a few cells from your cervix for a test called a Pap test To do this, the clinician will collect the cells first with a soft brush and then with a curved (but not sharp) piece of wood, like a tongue depressor.

You may feel crampy and uncomfortable for a moment when the brush touches your cervix, but it will take just a few seconds. The cells will be checked at a laboratory for evidence of cancer. This part of the exam is very important because your clinician can not only see if you have cervical cancer now, but also, sometimes, whether you need to be treated to prevent you from getting cancer in the future.

The last part of the exam is called the "bimanual" exam. The clinician will insert two fingers into your vagina and place one hand on your belly. By gently moving their hands together, they will be able to feel to your uterus and ovaries. Again, the main reason for this is to make sure you don't have an infection or cancer. This part of the exam may be uncomfortable, but like the other procedures, it shouldn't hurt.

This is a good time to further consult with your clinician about concerns or questions you have about the exam, further appointments, birth control, sexually transmitted infections, and your results. The clinician will go over as much as she or he knows at the time, and will tell you when to expect the other results, depending on what tests you had done.

Other considerations:

• If you came in for a pregnancy test, the results should be done before you leave.
• Make sure your file has your current phone number and address on it.
• If you do not want the clinic leaving a message at your residence, make sure to leave word on how and when to reach you.
• This is the perfect time to talk to someone confidentially about any concerns you have; go ahead and ask!

Every woman who is sexually active or over age 18 should have a gynecological exam every year. During the exam, the clinician can find problems that you don't even know you have, and when they're treated early, most problems can be cured completely. Although you may find the exams unpleasant at first, if you can stay relaxed it should not hurt.

Make sure you know your clinic's phone number, so if you ever have a problem or a question, you have a trusted professional to give you the answers you need.

To make an appointment at Planned Parenthood of the Rochester/Syracuse Region, call our toll-free help line at 1-866-600-6886.

If you live outside our region, call 1-800-230-PLAN, or find the health center nearest you on the web.