Going to the doctor for an annual physical is one of the many responsibilities that fall under the “adulting” umbrella. If you’re a woman — or assigned female at birth — then those responsibilities also extend to the yearly gynecological exam.
Since we usually think of these exams as only pertaining to women, not girls, it might come as a surprise that your first gynecological wellness visit should take place when you’re still a teenager (around 15 or 16 years old). At this stage, the visit may just consist of a discussion with your doctor about your menstrual cycle and whether or not you’re sexually active. Cordelia Nwankwo, M.D., a board-certified OB/GYN based in Washington, D.C., says the exams more synonymous with a gynecological well visit, like a pelvic exam and Pap smear, usually aren’t necessary until age 21, “unless other symptoms are present that require evaluation.”
Considering that annual gynecological exams cover such a broad spectrum, we asked Dr. Nwankwo to walk Rescripted’s readers through what they can expect at a typical well visit.
Breaking down the yearly gynecological exam
The first thing to keep in mind when making an appointment for a gynecological well-visit is you don’t have to see an OB/GYN (a physician who specializes in obstetrics and gynecology). “Annual well visits can be conducted by other providers such as nurse practitioners and physician assistants,” says Dr. Nwankwo. While it is possible to have a gynecological visit with a general practitioner, it’s preferable to schedule your exam with someone in the field of gynecology, because this is their area of expertise.
The first part of the well visit helps your provider assess your preventative and treatment needs: There will be a conversation about “your personal history, family history, and risk factors,” says Dr. Nwankwo. “Common topics discussed include recommended routine screening, reproductive goals, menstrual cycles, etc.”
From there, your provider will determine the necessary exams for this visit. They can include a general physical, a breast exam, and/or a pelvic exam. The pelvic exam “may or may not include Pap testing for cervical cancer screening, cultures, and STI testing,” says Dr. Nwankwo. Your provider will order specific routine labs and testing depending on “age, history, risk factors, and patient preference.”
Why is an annual gynecological well visit important?
Now that Pap smears and HPV testing are recommended every few years instead of annually, it can be easy to let your gynecological well visit fall to the wayside. That could be a poor decision in the long run because seeing a gynecologist is critical preventative care. “The annual gynecological exam isn't just about the Pap smear,” says Dr. Nwankwo. These visits include vital discussions about your “sexual and reproductive health, and reproductive life planning (contraception, fertility, pre-pregnancy).” They also ensure “you’re up to date on recommended screenings.” Most importantly, gynecological well visits “ultimately minimize health risks and promote early detection of certain issues.”
What’s the difference between a Pap smear and a pelvic exam?
Although a Pap smear takes place during a pelvic exam — as in, that uncomfortable part of the visit where your feet are in stirrups and your provider is telling you to slide down just a little farther — these are two separate parts of the gynecological well visit.
The pelvic exam “involves visualizing the external genitalia, vagina, and cervix as well as checking for noticeable abnormalities in the uterine size/shape, and ovaries,” explains Dr. Nwankwo. “The Pap smear is just obtaining a sample from the cervix for cervical cancer screening.”
Not every pelvic exam includes a Pap smear, however. While an annual gynecological exam is a vital component of female preventative care, that doesn’t mean you have to get a Pap smear at every well visit. “If your Pap smears/HPV testing have been normal or negative, then you don’t need to have one with every annual [visit],” says Dr. Nwankwo. “You should still have a yearly well visit, but you may not need a Pap at each one.”
Preparing for your yearly gynecological exam
It’s always a good idea to go into a doctor’s appointment armed with specific questions, but if nothing springs to mind, Dr. Nwankwo offers these suggestions to ensure you get the most out of your visit:
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Know your body and your family's medical history. “[Your family history] affects what we recommend for you. There are general topics your provider will review with you, but gather whatever questions you might have about contraception, screening, symptoms, etc.”
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Familiarize yourself with the experience if it’s your first-ever gynecological visit. “Your provider should walk you through what to expect, but it's a good idea to do some research beforehand so you can feel a bit more comfortable.”
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Write down your questions and concerns. “Try to narrow down to one or two main topics you might want to discuss. It's not always possible to address everything at one wellness visit, but if that's the case your provider may recommend a dedicated visit to address and evaluate other concerns.”
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram or Twitter.