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cover Part of growing up is learning to take care of your body. This means making good choices for your health, avoiding things that can hurt you, and seeing a health care provider—including an obstetrician–gynecologist (ob–gyn)—for routine health care. If you have never visited an ob-gyn before, you may have questions about what will happen at your first visit.

This pamphlet explains
  • what to expect at your first gynecologic visit
  • exams that may be done
  • special concerns that may be discussed
What to Expect

Women have special health care needs. Ob-gyns are doctors who specialize in women’s health. Girls should have their first gynecologic visit between the ages of 13 years and 15 years. The first visit may be just a talk between you and your doctor. You also may have certain exams.

External Female Genitals The outside of the female genital area is called the vulva. The outer lips of the vulva are called the labia majora. The inner lips are called the labia minora. The clitoris is at the top of the inner lips. For most women, the clitoris is a center of sexual pleasure. The vagina is the passageway that leads to the uterus. The urethra leads to the bladder. Urine passes from the bladder through the urethra to the outside of the body.
The first visit is a good way for you and your doctor to get to know each other. You can find out what to expect at future visits and get information about how to stay healthy. You can ask questions about your body, growing up, and sex.

It is normal to feel nervous about your first visit. It may help if you talk about it with your parents or someone else you trust. You may want to let your doctor know you are nervous. He or she can help put you at ease.

Your doctor may ask a lot of questions about you and your family. Some of them may seem personal, such as questions about your menstrual period or sexual activities (including vaginal, oral, or anal sex). Your doctor needs to ask these questions to best know how to care for you. Giving honest answers to these questions is key to your care. If you are concerned about confidentiality, you and your doctor should talk about it before you answer any questions. Much of the information you share can be kept confidential.

Exams

You may have certain exams at the first visit. If you choose, a nurse or family member may join you for any part of the exam. Most often, these exams are performed:

  • General physical exam
  • External genital exam
Pelvic Exam You usually do not need to have a pelvic exam at the first visit unless you are having problems, such as abnormal bleeding or pain. If you are sexually active, you may have tests for certain sexually transmitted diseases (STDs). Most of the tests that teens need can be done by the doctor with a urine sample. You also may have certain vaccinations.

General Physical Exam

During the general exam, your height, weight, and blood pressure will be checked. You also will be examined for any health problems you may have.

External Genital Exam

In this exam, the doctor looks at the vulva. He or she may give you a mirror so that you can look at the vulva as well. This exam is a good way to learn about your body and the names for each part.

Pap Test The Pelvic Exam and Pap Test

Even though you probably will not have a pelvic exam, you should know what one is. Another test that you will have later (at age 21 years) is a Pap test. This test checks for abnormal changes in the cervix that could lead to cancer.

The pelvic exam has three parts:

  1. Looking at the vulva
  2. Looking at the vagina and cervix with a speculum
  3. Checking the internal organs with a gloved hand
The doctor will use a speculum to look at your vagina and cervix. When you have a Pap test, a sample of cells is taken from your cervix with a small brush.

Vaccines You May Need

The following vaccines are given to all young women aged 11–18 years on a routine basis:

  • Tetanus—diphtheria—pertussis (Tdap) booster (once between ages 11 years and 18 years for those who have never had a dose of tetanus–diphtheria [Td] booster; those who have had a Td booster should get a dose of Tdap 5 years after they received Td)
  • Hepatitis B virus vaccine (one series for those who have not been vaccinated)
  • Meningococcal vaccine (once between ages 11 years and 12 years; once at about age 15 years for those who have not been vaccinated)
  • Varicella (chickenpox) vaccine (once between ages 11 years and 12 years for those who have not had chickenpox or have not been vaccinated)
  • Measles—mumps—rubella vaccine (once between ages 11 years and 12 years for those who did not receive the two-shot vaccine during childhood)
  • Human papillomavirus vaccine (one series between ages 11 years and 12 years; one series between ages 13 years and 26 years for those who have not been vaccinated; it also can be given to girls aged 9 years or 10 years)
In addition to routine vaccines, special vaccines may be given to young women who are at an increased risk for certain diseases. Listed are some of these vaccines:
  • Influenza vaccine
  • Hepatitis A virus vaccine
  • Pneumococcal vaccine

To check your internal organs, the doctor will place one or two gloved, lubricated fingers into the vagina and up to the cervix. The other hand will press on the abdomen from the outside.

Vaccinations

Vaccinations or immunizations are shots that protect against diseases caused by bacteria and viruses. Some are given on a routine basis (see box, “Vaccines You May Need,” on the next page). Other vaccinations are offered to women who are at an increased risk for certain diseases. Your doctor may ask you about your medical history and suggest you receive certain vaccinations.

Special Concerns

Many young women share the same health concerns. Most of these concerns are a normal part of growing up:
  • Cramps and problems with menstrual periods
  • Acne
  • Weight
  • Sex and sexuality
  • Birth control
  • STDs
  • Alcohol, drugs, and smoking
  • Emotional ups and downs
Talking with your doctor about these issues is a key step to staying healthy.

Three girls
Being Healthy

Making good lifestyle choices can help you to be strong and healthy for years to come:

  • Maintain a healthy weight by eating a well-balanced diet and exercising often.
  • Avoid smoking, drinking alcohol, and using illegal drugs.
  • Seek help if you have emotional ups and downs or feel depressed.
  • Use birth control if you are having sex and do not want to have a baby.
  • Protect yourself from STDs by using a latex condom. Know your partners and limit their number.
  • Keep up with routine exams, tests, and immunizations.
Most young women enjoy good health. Health problems that arise for young women often are a result of high-risk behaviors, such as having unprotected sex or using drugs. Your doctor may offer some tips on how you can help prevent these problems and stay healthy (see box, “Being Healthy,” on the next page).

Finally...

Your first gynecologic visit is a great chance to take charge of your health. Be involved in your health care. Follow up with your doctor to find out test results. Ask questions. See your doctor on a routine basis to be sure you have all the tests you need to stay healthy.

Glossary

Birth Control: Prevention of pregnancy.

Cervix: The lower, narrow end of the uterus, which protrudes into the vagina.

Condom: A thin sheath used to cover the penis during sex to prevent sexually transmitted diseases and pregnancy.

Menstrual Period: The discharge of blood and tissue from the uterus that occurs when an egg is not fertilized (also called menstruation).

Obstetrician–gynecologist (ob-gyn): A physician with special skills, training, and education in women’s health.

Pap Test: A test in which cells are taken from the cervix and vagina and examined under a microscope.

Pelvic Exam: A manual examination of a woman’s reproductive organs.

Sexually Transmitted Diseases (STDs): Diseases that are spread by sexual contact.

Speculum: An instrument used to hold open the walls of the vagina.

Vagina: A tube-like structure surrounded by muscles leading from the uterus to the outside of the body.

Vulva: The external female genital area.

This Patient Education Pamphlet was developed by the American College of Obstetricians and Gynecologists. Designed as an aid to patients, it sets forth current information and opinions on subjects related to women’s health. The average readability level of the series, based on the Fry formula, is grade 6–8. The Suitability Assessment of Materials (SAM) instrument rates the pamphlets as “superior.” To ensure the information is current and accurate, the pamphlets are reviewed every 18 months. The information in this pamphlet does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice, may be appropriate.

Copyright © May 2010 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

ISSN 1074-8601

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