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Breast and Pelvic Exams

Your mom just made an appointment for your first gynecologic exam and you're feeling:

  1. Totally panicked. You start praying for an avalanche, four flat tires on the car, that the gynecologist will get a broken arm, anything to avoid that appointment.
  2. Pretty calm. You don't really mind going to the doctor that much, and if your friends can handle it, so can you. But how will the doctor look at the inside of your vagina, exactly?
  3. Confused. You don't feel sick at all, and you just had some vaccinations for school and a physical for sports. Why waste time going to a doctor when you're OK?

These are just some of the feelings that girls may have before their first gynecologic (or "gyn") exam, and it's not surprising. You might be asking yourself "Why me? Why now?" The answer is that you're older and have gone through puberty, so you need to have a physical exam appropriate for a young woman. That's where breast and pelvic exams come in.

Why You Need These Kinds of Exams
There are a number of reasons why yearly breast and pelvic exams are important for girls, including:

  • as a routine check. You'll want to be sure you're developing normally. Many doctors recommend that a girl get her first gynecologic exam by the time she turns 18 (sooner if a girl has become sexually active or if there is a concern about her reproductive system health).
  • to prevent pregnancy or infection. After becoming sexually active, a girl should have a pelvic exam as soon as possible to discuss methods of birth control and preventing sexually transmitted diseases (STDs).
  • to deal with a problem. There may be a number of concerns that lead to a pelvic exam. For example, if you have menstrual bleeding problems, missed periods, pain, signs of infection, and worries about development, it's a good idea to see a doctor.

Choosing the Right Doctor
If you're going to be involved in deciding who you'll see for your pelvic exam, you have a few choices. Many family doctors and pediatricians perform pelvic and breast exams and advise teens on birth control and STD prevention. So you may be able to see the doctor you know and feel comfortable with for your first pelvic exam. There are also a number of different kinds of doctors and nurses who have special training in women's reproductive health:

  • Gynecologists are doctors who have been specially trained in women's health issues. Gynecologists are the doctors who most frequently prescribe birth control and teach patients how to use it.
  • Adolescent medicine doctors have been trained in the health and management of teen issues. They are familiar with the concerns most girls have about their reproductive systems and can advise girls on birth control and STD prevention.
  • Nurse practitioners have had advanced training that allows them to give gynecological exams and pay special attention to women's reproductive health.

Whether you want to see a male or female health care professional is up to you. Some women say that they prefer being examined by a female doctor or nurse because it puts them more at ease and they feel like they can talk more openly about women's health problems and sexuality issues. Other women feel comfortable being examined by a male doctor or nurse. If the doctor or nurse is male, he will usually have a female assistant in the room with him during all parts of the exam.

It's best to involve your parents in your health care. If you want to go to a doctor's office for your exam, you may need to involve an adult for insurance purposes (it may be expensive otherwise). If for some reason you can't involve your parents, you can take advantage of health clinics like Planned Parenthood. These clinics have fully trained staffs who can often care for you at a lower cost and respect any need for confidentiality.

The most important thing is that you feel comfortable with the person who is examining you. You want to be able to talk with him or her about important personal health and relationship issues, including birth control.

What Happens When You Go for Your Pelvic Exam
You don't need to do anything special before going for your exam. When you make the appointment, try to schedule the exam for a time when you won't have your period. For many girls, that can be hard to predict, though - lots of girls have irregular periods at first. Ask the doctor's office or clinic when you make the appointment what you should do if you get your period. Some doctors say it's OK to come for an exam if your period is just beginning or just ending and it's very light, but everyone has a different policy.

When you arrive for your appointment, you may be asked to fill out some forms while you wait. These forms ask questions about any illnesses or conditions you have, your health habits (like whether you drink or smoke), any family illnesses that you know of, and your history regarding sexual activity, pregnancy, and birth control. It's important to answer everything truthfully - nothing you write will be something the doctor or nurse hasn't seen before or that they will share with anyone else. You might also be asked to write down the date of your last period (or a doctor or nurse will ask during your exam).

When you first go into the exam room, a nurse or medical assistant will do a few things that your doctor has probably done a million times before, such as recording your weight and taking your blood pressure. You'll then be left alone to change out of your clothes. It may feel weird taking off even your underwear because you may not have had to undress completely for a medical exam before. The nurse or medical assistant will leave you a paper sheet or gown - or maybe both - to cover you. If you're cold, most doctors and nurses won't mind if you keep your socks on.

The Breast Exam
After a few minutes, the doctor or nurse practitioner will knock on the door to make sure you're in your gown. If you're ready, he or she will come in and start the exam. He or she may start by going over anything you wrote down on your forms, or you may talk about these things later. If this is your first gynecologic exam, let the doctor know. That way, he or she will know to go slowly and explain everything that's going on. Now is also the time to ask about birth control or sexuality if you need to. Some doctors like to discuss these things before the exam, and some like to do it after. Your aim is to make sure you get your questions answered.

During the physical part of the gynecologic exam, you'll be asked to lie on your back on the table. You'll have the paper sheet or gown covering you, and the doctor or nurse practitioner will only uncover the parts of your body that he or she is examining.

The doctor or nurse practitioner will give you a breast exam by lightly pressing on different parts of your breasts. After finishing, he or she may show you how to examine your own breasts. This helps you become familiar with how your breasts feel so you know which lumps are normal and which may be the result of a change.

The doctor or nurse practitioner will then examine your abdomen by pressing on your belly to feel for any problems with your spleen, liver, and kidneys. You'll sit up and the doctor or nurse practitioner will use a stethoscope to listen to your heart and lungs. He or she may also look into your ears, eyes, and nose.

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