Wait, Am I Supposed to Be Seeing a Gynecologist?!

I feel like these moments always happen on the days you’re really killing it. You remembered to get your flu shot, did some early holiday shopping, and you’re even catching up with a friend over coffee while updating your resume. You’re a star.

And then you glance over at her computer. She’s scheduling an appointment with her gynecologist. Panic sets in. How long has everyone been doing this? Is your vagina going to fall out? Are you supposed to be seeing a gynecologist?!

With the ever-changing world of health—especially gynecological health—just know this is a super common question. And the answer? It’s not the same for everybody! But we’re here to help you figure out what gynecological wellness looks like for you.

Do You Actually Need to Go to the Gynecologist?

For the under-21 crowd:

You’ll need to visit someone for gynecological care if you’re sexually active or if you’re having irregularity with your menstrual health. Some doctors recommend getting started with gynecological care between 13 and 15 to help establish a baseline. Though pediatricians (who can see patients up to age 21) handle basic gynecology—like UTIs and prescribing birth control—you’re likely better off getting a referral to a gynecologist. Look for one who specializes in adolescent or young adult gynecology. 

More on why to seek out gynecological care long before you need a Pap smear.

21+

If you’re able to hit the bars (in the US), you’re also gonna need to hit up your local gyno (or source of gynecological care). The great news is that more and more Primary Care doctors can handle your basic gynecological needs, so you might be able to get it all done at your annual physical (or well-woman exam).

Here's more on the well-woman exam from the Cleveland Clinic. 

But if you have any concerns with your menstruation, fertility, hormones, or sex, it might be time to find a gynecologist instead. Gynecologists know the ins and outs of this stuff, so if you’re looking for specialized care, don’t hesitate to seek one out. 

For more reasons to visit a gynecologist, check out this list from the American College of Obstetricians and Gynecologists. 

 Regardless of which doctor you’re seeing, your exam should include:

• A pelvic exam

• Pap smear: Recommended every 3 years if you’re 21-29, and every 5 years if you’re 30-65 when combined with an HPV test. An HPV test alone is also an option every 5 years in this age range.
• STI testing: Recommended if you’re sexually active, especially if you have new or multiple partners, or if your provider identifies a risk.
• A breast exam
• Clinical breast exam
• Mammogram: Usually recommended starting at age 40-50, depending on your personal risk factors and provider’s recommendations, with screening continuing every 1-2 years

Depending on your age, risk factors, symptoms, and health history, your visit might also include blood testing, a pelvic ultrasound, a bone density scan, or the HPV vaccine (if you haven’t gotten it yet).

Being Really Brave About the Gynecologist

A little Pap smear nervousness is practically a rite of passage. If you’re new to the gynecology game, though, it’s totally normal to feel unsure.

The first visit can definitely be intimidating, but the practitioners are used to helping patients get through this! It can be helpful to do some breathing exercises or ask the doctor to walk you through what they’re doing. Plus, you can always bring a friend!

Click here for more tips on how to get through anxiety at the gynecologist.

You never have to do anything you don’t want to do. It might sound obvious, but in practice, this means that if you don’t feel ready for a physical exam, you can ask to do it next time. You’re in complete control, and you can say you’re done at any point! Reminding yourself of that can make a huge difference.

What’s It Like?

A gynecological visit is a lot like any other doctor’s visit, meaning it’s typically pretty predictable from start to finish. 

Here’s how it’ll probably go down:

1. Check-In: Arrive 10-15 minutes early, check in at the desk, and fill out some paperwork. Don’t forget your insurance card! 
2. Pee in a Cup: You might need to provide a urine sample. It's not just for a pregnancy test—your sample can help check for bladder or kidney issues, STIs, and more. *[Link to more information on what a urine test can detect]* 
3. Chit-Chat: A nurse will take your height, weight, and blood pressure, and ask about your medications and family health history. 
4. Q&A: The provider will ask more detailed questions about your health, lifestyle, and sex life. This is where you get real answers to all the weird questions you would have googled. It’s a lifesaver.
5. Physical Exam (If Needed): This may include a breast exam and, if necessary, a pelvic exam. Don’t be afraid to ask your provider to explain things as they go. 

The Pelvic Exam: Excruciating Detail Edition

For the pelvic exam, they’ll pull out stirrups or foot rests. You’ll put your legs (stirrups) or your feet in them, and you’ll slide yourself down to the very edge of the table until you are maybe a little scared you’ll fall off. Luckily, this is kinda the worst part. 

Your provider will roll their stool up and take a quick look at your vulva, checking for any abnormalities or irritations. This is the exterior exam. 

Next, they’ll take a metal tool, called a speculum, and insert it into your vagina. Frankly, the speculum is always the wrong temperature. Again, this is weirdly the worst part of this for a lot of people. If you’re worried about it or have pain with insertion, they generally keep a smaller speculum around, which you can ask for.

The speculum is an unusual feeling, for sure, but they’re just moving stuff around so they can get a look at your cervix. If you’re due for a Pap smear, they’ll take a sample at this point. You’ll take a deep breath, and your provider will take a few cells from your cervix. This can be an odd feeling or a little painful for some.

Here are some tips for an easy Pap smear. 

Lastly, they’ll take one or two lubricated fingers and do a manual examination. With their other hand, they’ll push lightly on your lower stomach.

None of this should be super painful, so if something’s hurting, tell your provider immediately. Once they’re done with that, they’ll step out of the room to give you time to get redressed.

How to Get Ready for Your Appointment

If you’re like me and need a list to thrive, here are some of our best appointment prep tips:

- Wear comfy clothes that are easy to get on and off.

- Jot down any medical history you might forget.

- List out concerns or anything you want to talk about.

- Try to avoid scheduling during your period.

- Hydrate before your urine sample.

- Don’t shave or wax right before—your provider is not going to care!

- Avoid sex the night before a pelvic exam or two nights before a Pap smear for the most accurate results.

- Know the dates of your last menstrual cycle. Just check your Emme app!

Accessing Care When You’re On a Budget

If the price is holding you back, there are ways to cut down on costs while still getting the care you need:

• Planned Parenthood: They provide low-cost or free exams based on your income, and they’re all about making the process as easy as possible. (Plus, they have a great book club!) Get started here! 
• Community Health Clinics: Many local clinics offer sliding scale fees. Search for ones in your area using terms like “sliding scale gynecologist” or “free women’s clinic near me.” This directory of Community Health Clinics can help you find one nearby. 
• Telehealth: Some issues can be addressed virtually (think: birth control or UTI consultations). It’s not a full replacement for an in-person checkup, but it’s a great start. 

Congrats! You’re Ready to Book That Appointment

If you’re looking for a provider, a great first step is reaching out to friends or asking for a recommendation from your primary care doctor. For those with insurance, check your insurance’s online portal to stay in-network.