WHEN SHOULD A WOMAN LOOK FOR HER FIRST GYNECOLOGIST?
I am only fifteen years old. I have never had a pelvic examination but I have always wondered what the doctor does. I have never taken my clothes off in front of a man before. I don't know if I could do it, even for a doctor. I don't like it in gym when I have to undress with my classmates.
The problem is my mother. She wants me to see a doctor for a vaginal examination. She says that since I've had my period for three years, it's time. Is she right? I've never had any problems and I've never had sexual intercourse.
I don't think I could live through it. I embarrass easily and I would die if a doctor saw me naked.
S.R.
Corpus Christi, Texas
With today's good nutrition, it's not uncommon for a woman to reach menarche at age ten. Girls find themselves living with monthly cramps and worrying about contraception before they've even started to wear pantyhose.
When a woman's periods become regularone or two years after her first signs of spottingit may be time for her first gynecological checkup. A young woman may have monthly pain, heavy bleeding, frequent bleeding. There may be any number of unforeseen conditions that could easily be treated with a visit to a gynecologist. First, a young woman may want to talk with her mother or a favorite teacher about what she is going through, but a doctor is probably going to be the best person to help her.
Of course, a menstrual problem is not the only reason why a young woman may want to embark on her first visit to a gynecologist. The high rate of teenage pregnancies shows that today's young women are making decisions about sexual relations very soon after their menstrual cycles begin. If a teenage girl is thinking about having sex with her boyfriend, her thoughts alone should send her to a gynecologist. She should try to talk to a doctor about birth control and the consequences of intimacy before she becomes physically involved. No young woman should become her boyfriend's lover if she feels he is pushing her into sex before she's ready. But if you're a sensible woman who has established a deep friendship with one young man whom you feel is special and important, then a doctor's visit may be the wisest move you could make.
A mother who suggests that her daughter visit a doctor during her mid-teens, while she is still a virgin, is understandably concerned and protective. With so many teenagers becoming pregnant, having abortions, she wants you to have the proper counseling and an early examination as part of your health education. Armed with information, you'll be able to avoid an unwanted pregnancy and plan an unburdened life.
Mother's Gynecologist?
If a young woman has a close, give-and-take relationship with her mother, she may be happy to go to her mother's gynecologist. Some young women might be embarrassed to tell their mothers that they're thinking about sex, and they would rather visit a Planned Parenthood office or a high schoolor college clinic, where they may find or be referred to doctors. Certain teenage girls might request women doctors.
The doctor a girl visits for the first time should not reveal any of her secrets. Even if he is your mother's doctor, he should be ethical. He should not break the understood vow of silence the two of you share. If you don't trust him, don't go to him. Your doctor must be compatible, understanding, and responsive to your needs.
Your mother should not be in the examining or consultation rooms if you don't want her there. However, if you're nervous and want your mother in the examining room, the doctor should permit her presence. Afterward, she should not be included in your private consultation unless you'll feel more comfortable with her sitting in the chair next to you.
What to Expect During an Examination
A woman's first gynecological experience can enhance her sexuality if it's an easy, gentle meeting. If a doctor does not follow the procedure as it's described below, you could ask him for a more complete examination. If he is reluctant to comply, you might feel more confident with another doctor. Here's what to expect:
Either in his office or in the examining room when you're fully gowned, the doctor will ask you for your personal history. If you have never had sexual relations, don't be too shy to tell him. Whether you're in the office or the examining room, you'll both be sitting and having a face-to-face conversation.
After your chat, you'll be asked to urinate so that your bladder is empty and the doctor can have a better chance to examine your organs. Also, you're providing urine to be tested for sugar and protein content which might indicate upcoming diabetes and kidney problems. You'll change into a gown and wait in an examining room where a nurse will probably take your blood pressure before the doctor enters. You'll be wearing an open gown, but you should never be completely nude.
The first thing the doctor will do is to feel your neck to be sure that there are no abnormal lymph nodes and that the thyroid gland is not enlarged. Then he will check your breasts one at a time for lumps and examine your abdomen. If he notices any excessive hair growth, he should explain the possibility of excessive male hormones to you. The doctor should communicate with you throughout the examination so that you can monitor your body when you're by yourself. Then it's time for the internal.
You will be lying on your back on the examining table with your knees bent and your legs apart. The doctor will sit on a chair facing your legs. He will shine a light on your genital area and examine your outer vulva. Then, with a small instrument called a speculum he will look inside the vagina and check the cervix, the mouth of the womb. The speculum comes in various sizes and the doctor should choose the version that's right for you. A woman who knows she has a narrow vaginal opening may suggest that he use a small speculum. If a woman is a virgin, he may entirely disregard the instrument and examine her with a swab. If a doctor does use a speculum, it should be warm, and there's nothing wrong with a woman asking her doctor to take the chill off the instrument with a heating pad or hot water.
During the speculum examination a doctor can only see a woman's vagina and cervix, he cannot peer into her uterus and study her ovaries. A physician can outline the size and the shape of the uterus and the ovaries, however, by gently pressing on the organs with both hands. The finger of one hand is placed inside the vagina to steady the organs. The other hand is rested outside the abdomen and by moving the hand in a circular motion, the doctor can tell if there are any abnormalities. All this should be done with great sensitivity and at no time should a woman feel any severe pain, although there might be some discomfort.
The entire internal should be done slowly and gently, without embarrassment to the doctor or to the woman. (Remember, you are gowned, and not totally naked.) A woman should feel free to ask her doctor to explain what he is doing as he is doing it. There should be no mystery for you to ponder after you leave a gynecologist's office.
Is It Illegal for a Doctor to Examine a Woman Under Eighteen?
Not any more. A doctor is now permitted to see a woman who is a minor if she comes to him for a VD check. Thus, many physicians are able to justify the teenage girls among their patients by explaining that they were originally concerned about VD. A young woman who wants to see a gynecologist without an accompanying adult should keep in mind that doctors in private practice can be very expensive. It might be more practical for an independent young woman to visit a hospital clinic, a Planned Parenthood clinic, or a clinic recommended by a local women's health collective. A woman on a tight budget can benefit by mining the health resources in her area.
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Women's Health