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First Gynecological Exam

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: What happens during a girl's first visit to a gynecologist?

A: Excellent question! Teens and parents alike often ask pediatricians about this. The gynecologic exam is an important part of health care for all women. Its purpose is to evaluate the size and shape of the uterus (womb) and ovaries, to do a Pap smear to detect early signs of cervical cancer, and to screen for sexually transmitted diseases.

The doctor will start the examination with you resting on your back on an exam table. You'll have you put your feet into footrests at the end of the table, to help you stay comfortable with your legs apart during the exam. The doctor will start by looking at the outside of your genital area and then use a gloved hand to look at the vaginal opening between the labia (folds of tissue around the vagina).

The next step is the speculum exam. A speculum is a plastic or metal object that helps the doctor look inside the vagina. The speculum has two flat blades about the size of a tongue depressor, which are inserted a few inches into the vaginal canal until the doctor can see the cervix (opening of the uterus). Most women say that this feels uncomfortable but not painful, and that it causes a sensation of pressure. The doctor will usually take cell samples for three tests from your cervix; two are with cotton swabs to look for sexually transmitted diseases, and the third is with a brush and a flat blade for the Pap smear. Once these have been taken, the speculum is taken out of the vagina.

The last part is a manual exam with the doctor's hands. The doctor will put a lubricating jelly on her gloved hand and will insert one or two fingers into your vagina. With the other hand, she will push on the lower part of your abdomen (belly). This helps the doctor feel the size of your uterus and ovaries.

The entire exam takes only a few minutes. The doctor explains what she is doing throughout the exam, and you should ask questions at any point. Afterwards, it is normal to have a small amount of blood spotting over the next day or so. Don't forget to check the results of the tests for sexually transmitted diseases and the Pap smear, which take a few days to come back.

Hank Bernstein
Children's Hospital

More on: Expert Advice

Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.


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