Updated 31 July 2014

First gynae visit guide

A gynae visit can be a daunting, especially if you are going for the very first time. Here's a step-by-step account of what to expect.

A gynae visit can be a daunting experience, especially for those going for the very first time.

Health24 spoke to gynaecologist Dr Stan Sandler, author of What Worries Women, to get a step-by-step account of what to expect when you're going for that first gynae visit.

Ask Gynaedoc a question

When should you go for your first gynae visit?

  • Once a woman/girl becomes sexually active she should see a gynae. The gynaecologist will advise her on contraception and protection against sexually transmitted diseases (STIs).
  • A woman/girl of any age, whether sexually active or not, should see a gynae if she, or her mother, thinks something might be wrong – for example, an unusual discharge, abnormal periods, etc.
  • Young women who are not sexually active but use tampons, should go for their first gynaecological check-up around the age of 21. The use of tampons facilitates an internal examination, which might not be possible otherwise.

Read more: menstruation

Why should you see a gynae?

  • A gynaecologist instructs you on how to look after yourself when having sex - what contraceptionis best for you, and how to protect yourself from STIs.
  • A gynae will help you understand how your body works and instruct you on how to do breast self-examination.
  • A gynae will also detect problems early – such as cysts or cancer – and treat it before it gets worse.

Where to find a gynae?

  • The best way to find a good gynae is by way of a referral from your mother, friend, or someone else you trust. "Ask someone who has actually been to the doctor, and knows he/she has a good 'bedside manner'," says Sandler. A personal recommendation gives you confidence that the doctor has a good reputation.
  • Your GP can also refer you a good gynaecologist.

Read more: How to choose the right GP

Does it have to be a gynae, or can your GP do a check-up?

Yes, your GP can do a check-up and Pap smear. However, Sandler believes that a gynaecologist will probably be better equipped to spot and deal with any irregularities, as this is his/her field of expertise.

Preparing for the visit

The Pap smear checks that the cells on your cervix are normal and can detect certain infections as well. The doctor will swab your cervix during your pelvic exam to gather cells, but if the sample is mixed with menstrual blood it will be difficult to get an accurate reading.

  • Workings of your body
    As part of the consultation the gynae will ask you routine questions about yourself, so get familiar with the workings of your body. The questions may include: When did you have your last period? At what age did you start your period? etc.

    Time of the month
  • Don't go for the check-up and Pap smear while you are menstruating. Gynaecologists often recommend you time your visit for halfway through your menstrual cycle.

What to expect?

  • History
    The gynae will ask questions about your medical history, menstrual cycle, sexual activity, and so on. This gives him/her necessary background information about your lifestyle and needs.

    After the talk, the doctor will ask you to undress completely in a private area, and to put on a gown. The doctor will only expose the areas that he/she is examining and you should never be fully exposed.
  • General check-up
    The doctor will check your blood pressure, do a urine test, and possibly a finger prick to check for haemoglobin, and record your weight. He/she should also check your heart, lungs, chest and thyroid gland. This enables the gynae to detect any abnormalities.
  • During the breast exam the doctor will check your breasts to make sure you don't have abnormal lumps or pain.
  • Internal Examination
    The pelvic exam enables the doctor to check if your reproductive organs are healthy. First he/she will check the outside of your genital area (the vulva, clitoris and urethral opening).

    Thereafter an instrument called a speculum will be used to widen the opening of the vagina to enable the doctor to see your cervix.

    Finally the doctor will feel through the vagina to make sure your ovaries and uterus are healthy.

    During the speculum examination the gynaecologist will also do a pap smear to ensure that the cells in your cervix are normal. The doctor will swab your cervix during the pelvic exam to gather cells that will be sent to a laboratory for tests. If there are any abnormalities, the doctor will contact you after he/she received the results back.

Is it painful?
According to Sandler the procedure does cause some discomfort, but the actual pain level depends to a certain extent on the patient.

"For some women it's not uncomfortable at all while others experience it as mild to moderate discomfort. Rarely is there severe pain."

He stresses that it is the doctor's responsibility to make the patient feel comfortable, because the more relaxed a woman is, the less painful it should be. If she is tense, her muscles will contract, and it is this tension that might cause pain.

What to expect afterwards
Your gynae will send the Pap smear to a laboratory for analysis. Usually, irrespective of the results, they or their receptionist will phone you to confirm that the results are available.

If some irregularities are exposed, they may want to repeat the smear, or ask you to come back to the consulting rooms to discuss the nature of the irregularities, and the way forward.

Wilma Stassen, Health24

Read more:

Everything you need to know about a pap smear
Some men are really jealous of your visit to the gynae


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