Summarize the following:
Parts of the exam can feel awkward. Talking to your doctor during the exam can help you to feel more relaxed. Ask the doctor to explain what he or she is doing as they are doing it.  If you are being examined by a male doctor, a female nurse will be with you at all times during the exam. If one is not present in the room, ask for a nurse to be with you. The external areas will be examined, then an internal exam will be done. The external areas examined include the clitoris, labia, vaginal opening, and rectum. The internal exam includes the use of a speculum to check the vaginal canal, cervix, perform the Pap smear, and take other tissue samples if needed. A digital exam is performed to feel the uterus and ovaries.  However, the internal exam may not be necessary if you have never been sexually active. Make sure to let your doctor know if you are uncomfortable with the internal exam. If you have been sexually abused, then it may take several visits before you will feel comfortable with this type of exam. Be sure to communicate your concerns with your doctor. The entire exam takes only a few minutes. After the routine tests and medical questions are completed, you will be given a gown and asked to undress. Remove everything, including your panties and your bra, unless the nurse tells you otherwise. Gowns used for gynecological exams have openings in the front. This allows your doctor to examine your breasts. Much of the time, the gowns used are made of paper. An additional paper cover may be provided that goes over your lap. The breast exam comes first. The doctor will touch your breasts and move his or her hands in a circular and linear motion.  The doctor will check the breast tissue that extends up into your armpit area. Your doctor will also check your nipples for any abnormalities. The breast exam is done to check for any lumps or abnormalities. If you feel any discomfort during this procedure you should tell the doctor. You will need to position yourself so your feet can fit into holders, called stirrups. This allows your legs to be spread apart to aid in the next parts of the exam. Relax your legs and let them fall open. The external exams allows the doctor to examine the area for any signs of irritation, infection, or abnormalities in the tissues surrounding your vagina and urethra, which is the duct that allows you to pass urine from your bladder. The doctor will examine the area visibly, and may touch tissues in the area to examine them more closely. For example, if your labia is red or inflamed, the doctor may spread the labia to examine for any abnormalities. Next, the doctor will insert an instrument called a speculum. The speculum may be plastic or metal. A metal speculum may feel cold as it is inserted.  This will slide into your vagina, then will be gradually opened to allow the doctor to examine the vaginal canal and cervix.  This causes a feeling of pressure but should not be painful. If you feel pain, tell the doctor. Speculums come in different sizes, so another one can be tried if the first one is causing you pain. After the doctor has examined your cervix and vaginal canal, he or she will insert a small swab or brush, through the opening in the speculum, to remove some of the cells from your cervix. This is called a Pap test and is not recommended before the age of 21.  The sample taken will be sent to a lab and examined for any cells that look abnormal or cancerous. Most girls have perfectly normal Pap tests.  Typically, you will be notified of the test results from your Pap smear within 10 to 14 days. If you are having any problems, the doctor may take additional samples to be reviewed by a laboratory. The next part of the exam will involve the doctor sliding one or two fingers into your vagina, and applying pressure to your abdomen. This is done so the doctor can feel for any lumps or abnormalities around your ovaries and female organs including your cervix, fallopian tubes, and uterus. Once the exam is complete, you will remove the gown and get dressed. The nurse may escort you to the doctor’s office or a consultation area, or the doctor may review your exam with you in the room. The doctor will review your exam results with you, and answer any remaining questions you may have. He or she will also provide you with any written prescriptions that are needed, such as a prescription for birth control pills.
Ask your doctor to explain the procedures. Remove your clothes. Put on the gown. Have the breast exam. Slide to the end of the table. Have the external exam. Expect some pressure from the speculum. Know what the Pap test is. Understand the digital exam. Talk with your doctor before you leave.