A gynecologist is a doctor who specializes in women's reproductive health. Obstetricians care for women during their pregnancy and just after the baby is born. They also deliver babies. An ob-gyn is trained to do all of these things.
Your ob-gyn will deal with some of the most important health issues in your life, including birth control, childbirth, and menopause. An ob-gyn can also screen for cancer, treat infections, and perform surgery for pelvic organ or urinary tract problems.
Because ob-gyns deal with such personal and sensitive health issues, the thought of seeing one, especially for the first time, may be troubling to some women. You might be nervous or embarrassed at having a doctor see the most private parts of your body. Or you may be reluctant to discuss your most intimate issues with an ob-gyn.
To take the dread out of your annual appointments, here are some tips on finding an ob-gyn you feel comfortable with and a preview of what to expect at your checkups.
Finding an Ob-Gyn You Trust
You wouldn't want to trust just anyone with the most sensitive parts of your body. That's why you need to think carefully about your choice of an ob-gyn.
Don't just randomly pull a doctor's name off your health insurance list. Get a referral from a friend, family member, or your primary care provider. Usually, your primary care provider can manage most screening procedures and will have a good referral resource if a specialist is needed.
As you're making a decision, consider whether you would prefer a male or female gynecologist. Some women are more comfortable going to a woman because they will have to undress completely during the exam.
Meet with the ob-gyn before making a decision. Ask about his or her medical experience, certification, and attitude about important reproductive issues, like birth control.
Your questions might include:
- Do you accept my health insurance?
- At which hospital do you have admitting privileges?
- What are your office hours?
- If you are not available when I need to see you, who will cover for you?
Make sure you're completely comfortable before becoming a patient.
What to Expect During Ob-Gyn Visits
When should you start seeing an ob-gyn? The American Congress of Obstetricians and Gynecologists (ACOG) recommends that girls have their first ob-gyn visit when they're 13 to 15 years old or they become sexually active, whichever comes first. The first visit for teens may just include a talk with the doctor and no exam.
Then it's time for the physical exam. The nurse will take you into the exam room and ask you to undress completely. You will be given a gown that opens to the front, and a sheet to cover your lap.
Your ob-gyn will probably start by asking you some general questions about your personal and family health history. A nurse or other health professional might stay in the room with you and the ob-gyn for the pelvic exam.
The doctor will first examine the outside of your vagina, which includes the vulva area and vaginal opening, for abnormalities. The doctor will then examine your reproductive organs from the inside. While your knees are bent and your feet are in stirrups to keep them apart, the gynecologist will use a speculum -- a device that holds the vagina open -- to view the inside of your vagina and cervix (the opening to your uterus). You might feel some pressure during this exam, but it shouldn't be painful. Your ob-gyn will also examine the walls of the vagina and cervix.
A Pap test is often done during the pelvic exam in women over age 21. Your ob-gyn will remove a sample of cells from your cervix using a small brush. Those cells will be sent to a lab and checked for cervical cancer, possibly the human papillomavirus (HPV) and other abnormalities.
If you have been sexually active, the doctor might also test you for sexually transmitted diseases (STDs) like gonorrhea, chlamydia, syphilis, and HIV. To test for STDs, the ob-gyn will take a swab of tissue during the pelvic exam and/or check blood tests.
Then, the ob-gyn will do an internal bimanual exam by placing one or two gloved fingers in your vagina and the other hand on top of the lower part of your abdomen, to feel your cervix, uterus, fallopian tubes, and ovaries from outside your body. Your doctor may also, if it's needed, do a rectovaginal exam. This will involve the ob-gyn placing a gloved finger in your rectum.
Your ob-gyn should also do a breast exam to check for any lumps or other abnormalities.
Talking to Your Ob-Gyn
Use your annual ob-gyn appointment as an opportunity to ask questions. Even if your questions seem intimate or embarrassing, you can be sure that your doctor has heard them before. It's OK to ask about your periods, sex, or whatever you want to know about your reproductive health.
Your ob-gyn should also ask you a lot of questions. These questions might get very personal, but your doctor needs to know the answers to care for you properly. Questions can deal with:
- Your period and any problems with it, such as missed or heavy periods
- Vaginal discharge
- Whether you're sexually active and how active you are
- The number of sexual partners, both that you have now and have had in the past
- Sexual issues or problems
- Any sexually transmitted diseases (STDs) you've had or think you might have
- Birth control methods
- Vaccine history
Remember that your ob-gyn is your partner in reproductive health. Carry on that partnership by making and keeping your annual appointments. In between visits, let your doctor know if you have any new problems.