gyno visit on period

If You Get Your Period Before an Ob-Gyn Appointment, Here's What a Doctor Says to Do

If you got your period right before an ob-gyn appointment (it always has the best timing!), you wouldn't be the first to wonder if it's an issue.

Annual check-ups, pap smears, and appointments for issues like yeast infections and bacterial vaginosis typically require pelvic exams. Your doctor will have you put your feet in the stirrups, insert a speculum to widen your vagina, and visually inspect your vagina and cervix. For some appointments, they'll need to gather cell samples from your vaginal fluid, and it's only logical to wonder whether period blood can get in the way of that.

"If you're going for your annual exam, yes, 100 percent, it is fine to go during your period," said Leah Millheiser, MD, ob-gyn and director of the Female Sexual Medicine Program at Stanford Health Care. That can even include getting a pap smear done. Traditional guidelines typically asked for patients to wait until after their period was over for this exam, but according to Dr. Millheiser, newer pap smears (also called pap tests) can assess your cells even in the presence of blood. You can always check with your provider if you're unsure, but "if your appointment is already scheduled and you have your period, there's no reason to cancel it," Dr. Millheiser said.

For yeast infections and bacterial vaginosis examinations, Dr. Millheiser said, your doctor will need gather a sample of your vaginal discharge. They'll place the fluid on a slide and examine the cells under a microscope to reach a diagnosis, and "sometimes, if there's blood present, that can interfere in the doctor's ability to read that slide," Dr. Millheiser explained. Unless your symptoms are severe, it may be best to wait until after your period is over to have those tests done, so you can ensure the results are readable and accurate. That said, if the symptoms are uncomfortable or difficult to deal with, Dr. Millheiser advised seeing your doctor sooner rather than later, even if you're still on your period.

If you are going to the ob-gyn on your period, Dr. Millheiser said you can leave your tampon or menstrual cup in until right before the exam. Other than that, though, there are no special procedures or things to do before heading into the office, and you definitely shouldn't feel embarrassed or awkward in front of your healthcare provider. After all, they're an ob-gyn; they know what to expect from a women's menstrual cycle. Unless you yourself don't feel comfortable with it (or would rather stay home nursing your cramps in peace — understandable!), it's OK to keep your appointment on the schedule. "In general, having your period and going to the gynecologist is not a big deal at all," Dr. Millheiser said. "It's perfectly fine, and you should go."

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Can You Go to the Gyno on Your Period or What?

The red tide pays you a visit on the day of your doctor's appointment, and you wonder: Can you go to the gyno on your period ? Or, even more important, can you get a Pap smear or pelvic exam on your period? When it’s that time of the month, seeing your gynecologist might be the last thing you want to do. But the truth is, your gyno really doesn’t care if you’re on your period or not, and we'll explain why below.

Besides worrying about having your period when you're lying on the examination table, your mind might be racing with self-conscious thoughts from Why didn't I get a bikini wax before coming here? to Why am I sweating so much? and Do I smell ?

Chances are while you're stuck in those stirrups stressing out, your doctor isn't giving it a second thought.

Here are 10 things gynecologists say are totally NBD when you come in for an exam:

1. You're on your period during the exam.

When you book your gyno appointment months in advance, you can't necessarily control whether your period will land on the same day. If—lucky you!—your period and your check-up coincide, don't sweat it. "If you can't go to your gynecologist on your period, then who can you go to?" Leena Nathan , M.D., obstetrician-gynecologist at UCLA Health-Westlake Village, tells SELF. "We're used to bleeding."

Just be aware that in some cases, having a Pap smear on your period may make it harder to get a clear test result, but that doesn't mean you should skip your appointment. "If you're having a Pap smear on your period, I'll try to swipe away the blood and do the Pap," says Dr. Nathan. "If it comes back inconclusive, you may have to come back. But rarely would we advise patients to cancel their appointment just for that reason."

2. You didn't shave your legs or get a bikini wax.

You may feel self-conscious about body hair , but your gyno truly doesn't care and may not even notice. "Patients always mention that they haven't shaved," Dr. Nathan says. "I don't notice. I'm more interested in the health of the patient. They should not have to worry about mentioning that they haven't shaved or waxed."

3. You're worried about how you smell down there.

As you scoot down on the examination table with your legs in stirrups, it's hard not to wonder and worry about what you smell like , especially if you've started to sweat because you're nervous. "Women are obsessed with how much they're perspiring when they're in my office, thinking, 'Does it smell down there?'" Alyssa Dweck, M.D. , assistant clinical professor of obstetrics at Mount Sinai School of Medicine and coauthor of The Complete A to Z For Your V , tells SELF. "I appreciate it if someone doesn't come to the office straight out of a CrossFit class or having not showered in four days, but in general I really don't notice it much."

4. You have (gasp) discharge.

"Women often think they should be completely dry except for before or during sexual relations," says Dr. Dweck. "But many women have discharge —some have it more than others—and that's completely normal."

However, if your discharge is greenish or yellowish in color , frothy, has a strong fishy odor or a cottage cheese-like consistency, or is accompanied by discomfort like itching, those are signs of a problem like a yeast infection or bacterial vaginosis (BV) . If you're confused about what's going on, see a doctor.

5. Your Pap smear comes back abnormal.

No one likes to get an abnormal test result, but an abnormal Pap smear is usually nothing to worry about. Abnormal Pap smears are usually caused by human papillomavirus . Also known as HPV, it's the most common sexually transmitted infection. Eighty million people currently have HPV in the U.S. alone, according to the Centers for Disease Control and Prevention (CDC).

In the majority of cases your body's immune system wipes out HPV , according to the American Cancer Society . But in rare cases, the virus can persist and develop into cervical cancer along with cancers affecting other body parts like the penis, anus, vagina, vulva, mouth, and throat. "It's a slow-acting [group of viruses]," says Dr. Dweck, and the chances of HPV evolving into cancer are "very, very low."

Your doctor may ask you to come back for another Pap in a year to see if you still get an abnormal result, or they may give you an HPV DNA test to make sure that’s what you’re dealing with. Or if your abnormal Pap result showed signs of precancerous cells, your doctor may recommend a procedure like a colposcopy (cervical biopsy) to learn more. Here’s everything you need to know about an abnormal Pap smear and what comes next .

6. Your menstrual cycle has changed.

If your old reliable cycle has started to shift by a couple of days you may worry that something is wrong, but period changes are more common than you'd think. "I have patients coming in all of the time saying, 'I have always had a five-day period and now I have a three-day or a seven-day period,'" Leah Millheiser , director of the female sexual medicine program at Stanford University Medical Center, M.D., tells SELF. But what's "normal" for your period can change over time.

Anything from stress to weight fluctuations to hormonal changes can trigger this. However if your period becomes really irregular or you're skipping periods, get checked out by your gyno to rule out a possible health problem, such as PCOS .

7. You're sleeping with more than one person.

If you're single and sexually active with multiple partners, are having an affair, or suspect your partner is having one, sharing that uber-personal information with your gyno can be, well, awkward. But keep in mind that your doctor isn't there to judge you (and if they do, that's a sign that it's time to find a new one if possible). Your gyno needs to know that pertinent information so they can make sure you're using the best methods to both prevent sexually transmitted infections and an unwanted pregnancy.

"[Your] number of sexual partners isn't anything to be embarrassed about," says Dr. Nathan. Adds Dr. Dweck: "It's important to know that in general gynecologists—especially ones who have been in practice for a while—are there to do a job and not judge anything."

8. You have piercings or tattoos down there.

“Sometimes women will say: I don’t want to be examined because I have a piercing or tattoo down there,” says Dr. Dweck. “But we’re not here to judge; we just want to make sure you’re caring for things properly.” Having a piercing or tattoo on your nether regions can come with risks like infection or an allergic reaction , so it’s important to be open with your doc and let them examine you.

9. You’re dealing with vaginal dryness or a low sex drive.

Both of these issues can be embarrassing to talk about, but it’s important to bring them up with your gyno. “These are things we want to hear about,” says Dr. Dweck. Dryness and low sex drive can affect adults of all ages, she explains, so don't let concerns that you're "too young" for something like that keep you from seeking help. Your doc can help figure out what’s going on so you can start to feel better.

10. You sometimes miss a few birth control pills.

If you’re taking birth control pills , chances are good that your doc will ask about how consistent you are about taking them. (Or how consistent you are with swapping out other forms of contraception when you should, like the vaginal ring .) Be honest! “Everyone always worries about this, but it’s totally normal to forget to take a pill once in a while,” says Dr. Dweck.

The point in telling your doctor you're having issues with your pills (or any other type of birth control) isn't so they can reprimand you, but so they can help you determine if it's really the best method for you. For example, if you're forgetting to take the progestin-only birth control pill (also called the minipill) within the same three-hour window every day, you're really messing with its level of protection. Talking that over with your doctor can help you decide if another type of contraception will be easier to incorporate into your life. Remember, there's nothing to be ashamed of. Gynecologists truly have seen all of this before!

11 Reasons Your Vagina Smells a Little…Off

10 Things to Know Before Your First Gyno Exam

Can I Get a Pelvic Exam or Pap Smear on My Period?

Originally Appeared on Self

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10 Things to Know Before Your First Gyno Exam

By Kristin Canning

If you have a vagina , there will come a time when you have to see a gynecologist —it’s an essential part of maintaining your health. But that first gyno exam can seem totally foreign—and even scary. The thought of discussing sensitive health topics and letting a total stranger examine your vagina might make you want to skip the appointment altogether.

But here’s the thing: Seeing an ob/gyn doesn’t have to be intimidating or uncomfortable; in fact, it can even be pretty damn empowering. Below, you’ll find exactly what you can expect from your first ob/gyn appointment—including how to best prep for it, how to stay calm when you’re feeling uneasy, and how to leave feeling confident about your sexual and reproductive health.

The American College of Obstetricians and Gynecologists (ACOG) recommends girls have their first ob/gyn appointment between the ages of 13 and 15, with a yearly wellness visit after that. You might have specific things to bring up with your doctor during your first appointment, like period issues, birth control options, and testing for sexually transmitted infections .

It’s smart to be clear about why you’re seeing the ob/gyn, Lauren Streicher, M.D. , associate professor of obstetrics and gynecologist at Northwestern University and author of Sex Rx: Hormones, Health, and Your Best Sex Ever , tells SELF. That way, you can make sure to discuss everything on your mind and be a better advocate for yourself. “For a new patient, most doctors will schedule 20 to 30 minutes,” says Dr. Streicher. “If you prepare before you get there, you can maximize your time and get your questions answered.” Plus, preparing can help you combat pre-exam nerves.

Regardless of your age, a medical professional will do a general physical exam to check your height, weight, and blood pressure before an ob/gyn checks you out.

Your doctor typically won’t perform a pelvic exam to check out your reproductive organs during your first ob/gyn visit. The exception is if you’re sexually active, want STI testing, or have other health concerns like abnormal bleeding or very painful periods .

If you’re 21 or older, however, a pelvic exam is recommended, along with a Pap test . During a Pap test, your doctor will swab your cervix (the lower portion of your uterus that connects to your vagina) to collect a sample of cervical cells to check for abnormalities that could indicate cervical cancer (which is rare and often treatable, so try not to stress!).

Your ob/gyn may also perform a breast exam. Even though young women have a low breast-cancer risk, your doctor will likely use this as an opportunity to show you how to examine your breasts and identify any changes, says Dr. Streicher.

A typical pelvic exam consists of three parts, according to the ACOG. The first is an external genital exam to look at your vulva, which includes everything you can see on the outside of your body, like your labia, clitoris, and the opening of your vagina. If your doctor offers you a mirror so you can see what’s up down there—or if you want to request one—don’t be shy! An ob/gyn visit is the perfect time to make sure you know the name, location, and purpose of all the parts of your vulva.

By Julia Sullivan

By Tatiana Walk-Morris

Your doctor will also perform a vaginal and cervical exam with a speculum, which is a device they’ll insert into your vagina and expand to get a better view of your vaginal walls and cervix. While the speculum is inserted, your doctor will use a soft brush or a flat scraping device to take samples for your Pap test and to test for certain STIs.

Real talk: This part can be kind of weird. “Most people are uncomfortable with the speculum,” Mary Jane Minkin, M.D., professor of obstetrics and gynecology at Yale School of Medicine and creator of MadameOvary.com , tells SELF. Pro tip: Speculums come in different sizes, so if you’re worried about it hurting, you can let your doctor know and ask them to try something smaller. “And if you feel pinching or pain, you can say something,” says Dr. Streicher. The good part is that a speculum only needs to be in your vagina for around a minute for a doctor to perform a thorough exam, William Schweizer, M.D. , clinical associate professor of obstetrics and gynecology at New York University Langone Health, tells SELF.

Once that’s done, your doctor will conduct a bimanual exam to study your reproductive organs. With a hand on your lower abdomen, they’ll insert one or two of their gloved, lubricated fingers into your vagina and feel around to make sure your uterus and ovaries are healthy. This is another part that can make people anxious, but it also only takes around a minute, Dr. Schweizer says.

Most doctors don’t require a pelvic exam to prescribe birth control —they’re able to make an informed decision based on your medical history and personal habits. If you’re curious about birth control options, they’ll start by asking questions about your behavior and preferences to help figure out what’s best for you. For example, pills might not be a great option if you know you’re super forgetful, Dr. Minkin says, so your doctor may recommend a “set it and forget it” method like an IUD or an implant that can last anywhere from 3 to 10 years, depending on the type. For some methods, you can usually walk out of the office with a prescription that day.

Though you might feel exposed during your first gyno exam, remember that your doc isn’t judging any aspect of your body, whether it’s your pubic hair or the length of your labia. Their purpose is to evaluate you medically, full stop. “We really don’t care, we’ve seen it all, and honestly, we barely notice,” says Dr. Streicher. If you’re able to, you can shower and rinse your labia with water before an appointment (no douching or perfume, though, because that can boost your risk of irritation or infection). If you can’t do this, it’s so not a big deal.

You also don’t need to worry about being on your period unless you’re specifically going to have your doctor examine your discharge, adds Dr. Streicher. Having your period may also affect the results of your Pap test or any STI testing, so you should give your doctor’s office a call to see if it still makes sense to come in or if you should postpone your appointment.

You’ll need to know the first day of your last period , so make sure you’re keeping track of that in the month leading up to your exam. You should also mention any pain, cramps, heavy bleeding, irregularity, or mood changes you get with your period. Your ob/gyn can prescribe birth control to help with period symptoms or look for signs of conditions like endometriosis , a condition that can cause pain, heavy periods, and trouble getting pregnant.

Your doctor will also ask about your sexual activity. Don’t be afraid to be open and honest here—your ob/gyn will keep everything confidential and won’t judge you. “It’s their job to support you. You have to answer honestly because STI screening will be based on that,” says Dr. Schweizer. Keep in mind that your oral sex and anal sex history count here, too, as both can lead to STIs. If you’re worried you might be pregnant because you’re sexually active and you’ve missed a period, be honest about that, too, and ask your doctor for a pregnancy test.

Your doctor will ask you about any medical conditions you have, medications you’re on, and past surgeries. That stuff can be hard to remember, especially when you’re nervous, so it can help to write everything down beforehand, says Dr. Streicher. That includes any relevant dates.

They’ll also want to know your family’s medical history. “It’s especially helpful to know about your mom’s health history and any family history of blood clots, as that can inform what birth control methods are best for you,” says Dr. Minkin. Contraception that contains estrogen, like the combined hormonal birth control pill, may put users at a higher risk of blood clots, according to the Mayo Clinic. The risk is still really small overall, but there are options that pose less of a risk if you have a personal or family history of blood clots, like the arm implant, an IUD, and progestin-only pills.

Also, if you haven’t gotten your vaccine for human papillomavirus (HPV), now’s the time to ask about that. The vaccine protects against cancers caused by an HPV infection, including cancers of the cervix, vagina, and vulva, as well as cancers of the anus, back of the throat, and penis.

That starts from before you even arrive. You may find you’re more at ease talking to and being examined by either a male or female ob/gyn . It’s OK to research different medical practitioners in your area and choose based on who you think you’d feel most comfortable with. (Of course, you might be limited due to your insurance or one of your parent’s preferences, but it’s perfectly fine to do your best to choose who you’re going to see.)

Then, if you are anxious when you arrive or at any time in your appointment, tell your doctor, says Dr. Schweizer. “Let them know it’s your first time and you’re nervous. You can ask to have a nurse come hold your hand, or you can even bring in headphones and music if that helps.” If your doctor’s OK with it, you can also bring someone into the room with you—like a close friend or parent—if you need a little extra support, says Dr. Minkin.

You can even keep an eye on what the doctor is doing to ease your anxiety: “Sometimes it helps to see what the doctor is doing, so I offer to hold up a mirror if patients want to see what’s going on. And if you want to be told what I’m doing, step-by-step, I will,” says Dr. Schweizer. “It’s the doctor’s job to make you feel comfortable.”

If you got any tests done during your appointment, your doctor’s office may call to inform you of the results, or ask you to come in to review results or be retested. If you have STI testing, the results may be ready in a day to two weeks, says Dr. Minkin, and Pap test results typically come in one to two weeks.

Some offices won’t call you if your tests don’t show anything unusual, though, so be sure to clarify what you can expect before you leave your appointment. You can also sign off to have someone else, like a parent or close relative, get your test results if you’re super nervous.

Current guidelines only call for an pelvic exam every three years, though your doctor may suggest you get them more frequently, depending on your medical history or any health issues. But most women will go for a yearly wellness visit to renew their birth control prescription, have their well-woman visit, get STI testing, or check in on any other sexual health concerns they have. It’s especially important to get regular STI testing if you have new sex partners or if you’re having unprotected sex, says Dr. Minkin. Sometimes it’s difficult to get an appointment on an ob/gyn’s calendar, so it can be helpful to schedule your next appointment before you head out.

• Ob/Gyns Explain That Stuff in Your Underwear at the End of the Day
• 11 Vaginal Health Tips Ob/Gyns Actually Give Their Patients
• Is There Actually Any Way to Prevent Urinary Tract Infections?

SELF does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a substitute for medical advice, and you should not take any action before consulting with a healthcare professional.

Sustainable Menstrual

Is it Good to Go to the Gynecologist During Your Period?

Introduction.

Understanding the implications of visiting your gynecologist during menstruation is crucial for every woman. While some may feel hesitant or unsure about scheduling an appointment during this time, it’s essential to explore the advantages and any potential drawbacks. This article delves into the question: Is it good to go to the gynecologist during your period?

Table of Contents

Visiting your gynecologist during your period can be perfectly acceptable and even beneficial in certain situations. Let’s explore why:

Benefits of Visiting the Gynecologist During Your Period

Seeking medical attention during your period allows your gynecologist to assess your reproductive health comprehensively. Here are some benefits:

• Assessment of Menstrual Symptoms : Your gynecologist can evaluate any irregularities or concerns you may have regarding your menstrual cycle, such as heavy bleeding or severe cramping.
• Convenience for Routine Examinations : If your period coincides with your scheduled appointment, it can be convenient to proceed with routine examinations like Pap smears and pelvic exams.
• Opportunity for Diagnosis : Certain conditions, such as endometriosis or fibroids, may exhibit symptoms that are more noticeable during menstruation, making it an optimal time for diagnosis.

Considerations Before Visiting the Gynecologist During Your Period

While there are benefits, it’s essential to consider a few factors before scheduling your appointment:

• Comfort Levels : Some individuals may feel uncomfortable undergoing certain procedures, such as pelvic exams, during menstruation. It’s essential to communicate your concerns with your gynecologist.
• Effectiveness of Tests : Menstrual blood may interfere with certain tests or screenings, potentially affecting their accuracy. Your gynecologist can advise on whether to proceed with scheduled tests or reschedule your appointment.
• Symptom Severity : If you experience severe symptoms during your period, such as excessive bleeding or debilitating pain, it’s crucial to seek medical attention promptly, regardless of the timing of your appointment.

What to Expect During Your Visit

During your visit to the gynecologist while menstruating , you can expect:

• Routine Examinations : Your gynecologist will likely conduct routine examinations to assess your overall reproductive health.
• Discussion of Symptoms : Be prepared to discuss any menstrual symptoms or concerns you may be experiencing.
• Treatment Recommendations : Depending on your symptoms and medical history, your gynecologist may recommend further tests, treatments, or lifestyle adjustments.

FAQs (Frequently Asked Questions)

Is it Embarrassing to Go to the Gynecologist During Your Period?

Visiting the gynecologist during your period is a common occurrence and is not embarrassing. Healthcare professionals are accustomed to dealing with such situations sensitively and professionally.

Can I Still Get a Pap Smear While on My Period?

Yes, you can still undergo a Pap smear while menstruating. However, your gynecologist may advise against it if the menstrual flow is heavy, as it may affect the accuracy of the results.

Will My Gynecologist Mind if I’m on My Period During the Appointment?

Gynecologists are trained professionals who understand that menstruation is a natural bodily process. They will not judge or mind if you’re on your period during the appointment.

Should I Cancel My Appointment if I’m on My Period?

Unless you’re experiencing severe symptoms that hinder your ability to undergo examinations comfortably, there’s usually no need to cancel your appointment due to menstruation.

Can I Receive Treatment for Menstrual Symptoms During My Appointment?

Yes, your gynecologist can provide treatment recommendations or prescribe medication to alleviate menstrual symptoms, depending on the severity and underlying cause.

What Should I Do if I Experience Severe Symptoms During My Period?

If you experience severe symptoms such as excessive bleeding, intense pain, or fainting spells during your period, seek medical attention immediately.

In conclusion, visiting the gynecologist during your period can be both appropriate and beneficial, provided that you communicate any concerns or discomfort with your healthcare provider. By understanding the benefits, considerations, and what to expect during your visit, you can make informed decisions about your reproductive health.

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Gynecology exam guide: what to expect on your first 'gyno' visit.

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The day you’ve been dreading has finally arrived, and you’re most likely anxious as your palms are sweaty and knees are shaking because it’s time for your first gynecologist (gyno) visit. This experience may be compared to when a woman gets her first period, or buys her first bra, except this time, it’s more invasive and has to do with your lady parts, specifically your vagina. Before you walk into the clinic and open your legs to a world of stirrups and Pap smears, put your anxiety aside and relax with this step-by-step gynecology exam guide that will help you take control of your body and your health as a woman.

Pre-Gyno Visit

Choose your gyno.

Before you call the closest gyno near you, it’s important to do your research, ask your friends, look at reviews, and try to find a doctor that is right for you. “The first GYN visit should not be viewed with apprehension,” Dr. Georges Sylvestre , board certified in obstetrics and gynecology in New York, maternal-fetal medicine and assistant professor, Weill Cornell Medical College, told Medical Daily in an email. “Do you prefer a female doc?” “Do you prefer a doctor who can speak your first language?” “Do you need a doctor who can relate to important cultural issues about sex and womanhood?” “If you find the right doctor, he or she might the one you'll go to for your birth control in your teens and twenties, pregnancies and babies in your 30's and forties, then for your menopause,” he said.

Go Back in Time

After you choose your gyno, it’s important for you to go back in time and think about your sexual history and menstrual history. The number of partners, the age you started having sex, and how you prevent pregnancy/sexually transmitted diseases is all relevant information you should tell your gyno. Ladies, it’s also important to keep track of your menstrual cycle by recording your last period, the length of your periods, how heavy and frequent they are, and if you experience any period-related problems like cramps. Dr. Sara Mornar , obstetrician and gynecologist in Texas, tells Medical Daily women should be prepared to share their medical background and menstrual and contraceptive information with their doctor.

To Shave or Not to Shave?

The age-old question of whether to shave or not to shave your hoo-hah has crossed the minds of many women before their first gyno visit. Before you schedule a bikini wax, or run to the pharmacy to stock up on razors and shaving cream, it’s important to know there is no need to shave before seeing your gyno. Gynecologists do not expect their patients to shave their vulva since pubic hair is not as dense as the hair on the scalp, and it can easily be moved aside during the examination.

The only expectation your gyno has is to practice basic hygiene — take a shower or a bath within 24 hours . Women should not use spermicide, medications, lubricants, or douche a day before the exam because this could interfere with the accuracy of a Pap test. The night before the exam is not an ideal time to get busy between the sheets, either. Intercourse without a condom the night before a Pap smear may obscure cervical cells which then cannot be read accurately.

The Waiting Room

So you’ve made it this far and have managed to stir up the courage to bare your hoo-hah to your gyno for the very first time. The waiting room is similar to any visit at the doctors' where the receptionist will hand you a pile of forms to fill out. Questions range from the number of sexual partners you’ve had (if any) to the date of your last period. It’s important to answer these questions carefully and honestly so your gyno can accurately assess you and keep track of your health. This information stays confidential between your gyno and you.

Behind Closed Doors: The Exam Room

The most frightening part of your first gyno visit has arrived — going into the exam room. If you’re still nervous at this point, tell your nurses and doctors and let them know it’s your first time, so they can guide you step-by-step on the procedure. Like a regular doctor’s visit, the nurse will take your height, weight, and blood pressure.

After the basics, you will be left alone to change into a gown as you remove all your clothing – including your underwear. The doctor will shortly knock on your door and will ask you a series of questions ranging from if you’re sexually active to your periods and how long they last. Your gyno will even ask you if you want to have an STD or HIV/AIDs testing on the day of your first gyno exam, too.

Breast Exam

During a gyno exam, your doctor will ask you to lay back and check your breast and underarms for any lumps. According to Woman’s Hospital your gyno will check for breast abnormalities that include lumps, nipple discharge, and skin changes. Women should do breast self-exams regularly, and if you’re not sure how to do this, you can ask your gyno and he or she will show you how.

Pelvic Exam

After the breast exam comes the moment of truth for every woman — the pelvic exam. Your doctor will lay you on your back and gently press several areas of your lower stomach to see if you experience any discomfort prior to the exam. At the initial start of the exam, the dreaded instruments, the speculum and the spatula, will be used to examine your vagina. Mayo Clinic says the speculum — the plastic or metal-hinged instrument — will help spread open your vaginal walls so your gyno can view your vagina and cervix. If your pelvic exam includes a Pap test, your doctor will collect a sample of your cervical cells before removing the speculum. After this is removed, your gyno will examine your other pelvic organs for signs of abnormalities. After this the exam is officially done, you have survived your first gyno exam.

YOU Ask the Questions

Whether you choose to ask them before or after your exam, or when your gyno asks if you have any questions, it’s time to ask everything you’ve wanted to know from your periods to sex. A common misconception women have is that their gyno will judge them and therefore fear asking questions about birth control, STDs, and infidelities, among many others. However, Sylvestre says, “Again, any questions are okay: about your periods, sex, pain during sex, fear of your first intercourse, dildos, orgasm (or lack of), pregnancy, and abortion. Again, don't be shy, s/he heard it all.”

Like Sylvestre, Mornar recommends patients to ask their gynos: “Why are PAP smears necessary? How often do I need one? When do i need a mammogram? How do I prevent pregnancy and transmission of diseases? What is HPV, and do I need the vaccine for it?”

What Does Your First Gyno Visit Mean?

You’re finally done with the exam, and exit the clinic, but you may ask yourself: what does this first visit mean for your health? “The breast screening is looking for abnormalities such as lumps or masses,” Mornar said. She advises women to start getting Pap smears by the age of 21, and mammograms by the age of 40 and older, depending on family history.

Unlike the breast screening, the Pap exam can reveal signs of cervical cancer, ovarian cysts, fibroids in the uterus, and other possible reason for heavy periods. A clean bill of health at a gyno exam can signify that “her Pap is normal, that she has no STD, that her organs are fine,” Sylvestre said.

Women should have their first gynecological exam when they are 18 years old, but it is recommended earlier than 18 if they are sexually active or have a medical problem requiring a pelvic exam.

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What Is a Pelvic Exam?

What to expect when undergoing this checkup

A pelvic exam is a gynecological examination of the internal and external organs in your pelvis. This includes the vagina, vulva, uterus, cervix, rectum, ovaries, and fallopian tubes.

Your healthcare provider inserts a tool called a speculum into your vagina so they can see the organs inside your pelvis. They also examine the external area around your vagina and use gloved fingers to feel your uterus and ovaries. Any abnormal findings may prompt the need for further evaluation and testing.

This article discusses pelvic exams, why they're done, and what to expect when you have one. It also looks at some of the things that might be found during a pelvic exam.

When Are Pelvic Exams Needed?

A pelvic exam often takes place as part of your preventive care during a routine checkup. Your healthcare provider does this exam to look for changes and screen for early signs of cancer, cysts, fibroids, and sexually transmitted infections (STIs).

Pelvic exams are also used to help diagnose a medical condition when you're having symptoms such as:

• Unusual and/or persistent vaginal discharge
• Bleeding between periods
• Bleeding after sexual intercourse
• Pelvic pain  or  menstrual cramps  severe enough to disrupt your daily routine for even a few days a month
• Heavy periods, in which you have to change your sanitary napkins, tampons, or other menstrual products more often than once every two to three hours or double them up to keep from leaking
• Pain, swelling, or itching of your vagina or lower abdomen

Any of these symptoms can indicate a  vaginal infection  or an STI, which could affect your future fertility. They may also indicate other conditions like endometriosis , pelvic inflammatory disease (PID) , or a number of  other reproductive disorders .

Parts of a Pelvic Exam

The pelvic exam generally consists of three parts:

• External visual exam
• Internal visual exam
• A physical exam called the bimanual exam

If it's time for your Pap smear —a screening for cervical cancer—you'll have that as well. Most women only need to have a Pap test starting at age 21 years and then again every three to five years.

If you have symptoms of an STI or you're at high risk for contracting one, your healthcare provider may also take a sample for an STI test.

During a Routine Checkup

The American College of Obstetricians and Gynecologists (ACOG) recommends seeing a gynecologist starting between the ages of 13 and 15 for a regular health exam.  A pelvic exam isn't usually done until becoming sexually active or turning 21, whichever comes first.

There is currently no consensus among experts on how often a pelvic exam should be performed as preventive care.

The ACOG recommends that women at average risk for cervical cancer have a pelvic exam as follows:

• Age 21 or older: Every three years to screen for cancer and infection
• Under 21 : Only if having symptoms of a medical problem, such as abnormal bleeding, abnormal vaginal discharge, or pain in the pelvic area

Other professional societies have different recommendations.

Your healthcare provider likely has their own opinion regarding how often you'll need a pelvic exam based on your medical history and general health, so they'll tell you how often to schedule one.

During Pregnancy

A pelvic exam is typically performed at the first prenatal care visit. If you have a history of certain gynecological conditions, more frequent pelvic exams may be necessary.

To Diagnose a Condition

Pelvic exams are used to diagnose or look for signs of conditions, such as:

• Sexually transmitted infections (STIs)
• Gynecologic cancers
• Pre-cancerous changes in the cervix
• Pelvic inflammatory disease (PID)
• Ovarian cysts
• Uterine fibroids

How to Prepare for a Pelvic Exam

There are no food, drink, or medication restrictions for this evaluation.

Vaginal douching  is never a good idea because of the risk of infection it presents. It's particularly important not to douche for at least two or three days before your pelvic exam. You should also refrain from sexual intercourse for at least 24 hours prior to your examination.

Who Performs Pelvic Exams?

A pelvic exam is performed by a healthcare provider, physician assistant, or nurse practitioner. You can see your regular primary care practitioner or family medical professional for this or you can go to an obstetrician-gynecologist (OB-GYN) . The test is done in your healthcare provider's office or a health clinic.

The best time to schedule your annual pelvic exam and to obtain the most  accurate results  from your gynecological examination and Pap smear, if applicable, is one or two weeks after your period.

A pelvic exam itself only takes a few minutes, but planning about an hour for the whole appointment is generally a safe bet. This includes time spent waiting, filling out forms, completing your medical history, and so on.

What to Bring

You may want to keep a period diary that you can go over with your healthcare provider during your appointment. You can use a calendar or app to keep track of the dates of your periods, the amount of flow, any pain experienced, discharge, or other symptoms that occur during the month.

Bring along any questions you have about the exam or your gynecological health as well.

Have your insurance card handy, as well as your co-pay, if needed.

If you have concerns

Your healthcare provider knows how personal this exam is, so feel free to talk openly and honestly about any feelings of nervousness or anxiety so they can help you feel as comfortable as possible.

This might prompt them to take things a little slower; make sure they explain everything they're doing before they do it; and check to make sure you're doing alright as the exam proceeds.

If you really feel like you can't bear enduring a pelvic exam, you absolutely have the right to decline. However, avoiding this exam for too long can cause any problems to go undetected.

Cost and Health Insurance

Since a pelvic exam is often performed as a part of a routine physical or checkup, the cost may vary depending on factors such as whether or not you have a Pap smear or STI testing and what else is included in the cost, such as a separate physical exam. The exam alone can range from $100 to $300 or more.

If you have health insurance through the Affordable Care Act's Marketplace or other insurance that covers preventive care, an annual pelvic exam will be completely covered as part of your annual well-woman visit. This means you won't need to pay any out-of-pocket costs.

If you need a pelvic exam for diagnostic purposes because you're having symptoms, this should also be covered by your health insurance. Contact your insurance agent or company for more information, including details about any co-pay or deductible you may need to pay.

If you don't have health insurance, are under-insured, or considered low-income, check with your local or county community health clinic. Many of these offer free or low-cost pelvic exams, STI testing, and Pap smears that you pay for based on your income.

You can also find local providers who do free or lost-cost exams via the Centers for Disease Control and Prevention (CDC)'s National Breast and Cervical Cancer Early Detection Program .

What to Expect During a Pelvic Exam

After checking in and filling out any necessary forms, which may include an authorization to bill your insurance or an updated health history, it's a good idea to empty your bladder so you can be more comfortable during your exam.

If you're feeling nervous or tense during your pelvic exam try to:

• Breathe slowly and deeply
• Relax your stomach muscles and shoulders
• Relax the muscles on the inside of your legs

You can also ask your healthcare provider to describe what they're doing during the exam.

Once called into the exam room, you will usually start by having your blood pressure, weight, pulse, and potentially your urine checked. Be prepared to give the nurse the date of the first day of your last period. Also, tell the nurse about any concerns that you want to discuss with the healthcare provider such as: 

• Irregular periods
• Painful periods
• Menstrual problems
• Vaginal infections
• Painful sexual intercourse

After your initial discussion with the nurse, you'll be directed to take all your clothes off, with the exception of your socks. You will be given a gown and drape to cover yourself until your examination begins.

Your healthcare provider will knock to make sure you're ready and then enter the room. They will ask about your medical history and discuss any problems you're having. It’s important for you to be as accurate and complete as you can in answering the questions and describing any symptoms you may have.

Your healthcare provider may have a nurse present during your pelvic exam as a means of protection for both of you, but if you're not comfortable with someone else being there, feel free to request that it just be the two of you.

Conversely, if your healthcare provider doesn't have a nurse in the room and you would feel more comfortable with someone else there, you can have your partner or friend in the room or request that a nurse comes in during this part of your checkup.

Your healthcare provider may listen to your heart and lungs, check your breasts for changes or lumps , and feel your abdominal area for any irregularities.

Breast Exam

A reliable examination of your breasts takes approximately 30 seconds per breast.

During your  breast examination , your healthcare provider should discuss monthly  breast self-exams with you and also provide instructions on how to perform them if you're unfamiliar.

People at average risk for breast cancer have the choice to start screening with early mammograms as early as age 40 and all women should begin having yearly mammograms by age 45.

Pelvic Exam Procedure

The pelvic exam itself only takes a few minutes. During each part of the exam, your healthcare provider will probably tell you what they're going to do, especially if this is your first pelvic exam.

Getting into Position

First, you'll need to lie back, scoot down to the end of the table, put your feet in the stirrups or on the corners of the table, and spread your knees apart.

This feels uncomfortable, especially the first time or two, but keep in mind that your healthcare provider does pelvic exams regularly. Try taking deep breaths to help relax your muscles if you're feeling tense.

External Examination

At this point, your healthcare provider may look at the outside of your vaginal area to check for any abnormalities, swelling, sores, or irritation.

Internal Visual Examination

Next, a speculum, a metal instrument that looks like a duck's beak, is inserted into your vagina with a lubricant to make it more comfortable. The speculum widens your  vaginal walls  so your healthcare provider can view them, as well as your  cervix .

The speculum can be uncomfortable and you may feel some pressure as it's opened, but you shouldn't feel pain. If you do, be sure to tell your healthcare provider. There may be a smaller one they can use instead.

Sample Collection

If you're having a Pap smear, a sample of cervical tissue is taken with a small wand or spatula once your cervix is in view. This may cause some brief discomfort, but again, it shouldn't be painful and it only lasts for a second or two as your healthcare provider collects the tissue.

If you're also being tested for STIs like chlamydia or gonorrhea, or other infections such as a yeast infection , pelvic inflammatory disease, or bacterial vaginosis , your healthcare provider will use a cotton swab to take a sample of your cervical discharge for the STI test or your vaginal secretions to test for other infections. The speculum is gently slid out once this part of the exam is complete.

Bimanual Examination

To perform this, your healthcare provider wears gloves and inserts two lubricated fingers into your vagina, places their other hand on top of your lower abdomen, then compresses the tissue between their two hands, feeling for any abnormalities that might have occurred since your last pelvic exam.

The bimanual exam allows your healthcare provider to check the size, shape, and mobility of your  uterus to feel for any changes in your ovaries, such as  ovarian cysts , and to feel for any tenderness or other abnormalities in your uterus or the surrounding tissues like endometriosis,  fibroid tumors , or other  common uterine conditions .

The bimanual exam can be a bit uncomfortable, but should not result in overt pain. Fortunately, this part of the examination usually lasts for less than 30 seconds. Because it can give your healthcare provider important information, it's worth a bit of temporary discomfort.

Rectal Examination

After checking your vaginal area, your healthcare provider may also do a rectal exam by inserting one lubricated finger into your rectum to check for any pain or abnormalities there like hemorrhoids or tumors.

This is an optional part of a pelvic exam, but if your practitioner does do this, try to relax as much as you can.

After the Exam

Once your pelvic exam is completed, you will be given privacy to get dressed. You may be offered some tissues to wipe off any excess lubricant and a maxi pad or panty liner in case the speculum causes any spotting.

When you're ready, your healthcare provider will come back to the room to discuss the results of your pelvic exam with you.

After your visit is through, you can go home and resume your normal activities. You may have light spotting and possibly some cramping, but you shouldn't have pain. These symptoms should not last long. If you have heavy bleeding or severe cramping or pain, contact your healthcare provider.

How long does a pelvic exam take?

A pelvic exam will take a few minutes. Some parts of the exam may be a little uncomfortable, but it shouldn't be painful. If it hurts, say something. Your healthcare provider may be able to make things more comfortable.  

When to Expect Results

Your healthcare provider can usually tell you right away if they found any problems or abnormalities during your pelvic exam or if it was normal.

In cases where your practitioner took a vaginal fluid sample during your exam to look for a yeast infection or bacterial vaginosis, this sample will be looked at under a microscope for signs of fungus, bacteria, or viruses. Your medical professional may even look at the slides themselves after your pelvic exam.

The presence of these microorganisms is immediately obvious, so you will likely know before you go home if you have one of these infections and leave with a prescription to treat it.

If you had a Pap test, the results for this may take a few days and up to three weeks to get back. Your healthcare provider's office will likely mail the results to you or call you, but if you don't hear anything after three weeks, be sure to call.

Results from a cervical swab to check for gonorrhea and chlamydia will take a few days to come back.

Other Considerations

If you have any questions or concerns about the results of your pelvic exam, discuss these with your healthcare provider. This is also a good time to discuss contraception, fertility, sexual health, and any other areas or issues you're concerned about.

If your pelvic exam was normal, you'll need to schedule another one in a year or the time frame your healthcare provider recommends.

If your pelvic exam showed any abnormalities, your practitioner will talk to you about what these findings may mean, as well as about additional testing, follow-up, and/or treatment options. Some of the things that can be found or suspected during a pelvic exam include:

• Endometriosis: If you come in with symptoms of endometriosis, your healthcare provider may have felt cysts or scars on or around your reproductive organs during your pelvic exam, another piece of evidence that you could have this condition. However, you will likely need more testing to confirm this diagnosis like ultrasound, magnetic resonance imaging (MRI) , and, in some cases, laparoscopy . Treatment for endometriosis typically involves medication and/or surgery.
• Infection: If your pelvic exam and/or vaginal fluid sample revealed that you have a yeast infection or bacterial vaginosis, treatment will depend on what's behind the infection. Bacterial vaginosis is typically treated with antibiotics, while yeast infections are treated with prescription or over-the-counter antifungal medications. If you have recurrent yeast infections, your healthcare provider may also send your vaginal fluid sample to a lab to be cultured to find out exactly what kind of fungus is causing your infection in order to treat it more specifically and effectively.
• Pelvic inflammatory disease: In the case of suspected pelvic inflammatory disease, your healthcare provider will order additional cultures on your vaginal and cervical fluid and may recommend an ultrasound, blood and urine tests, and laparoscopy to confirm the diagnosis, find what's causing the infection, and to see how widespread it may be. It will likely take a few days for culture results to come back. Treatment for PID involves antibiotics for both you and your partner.
• Ovarian cysts: Your healthcare provider may have felt an ovarian cyst during your pelvic exam. If so, they'll potentially order more tests to see what kind it is and if you need treatment. These tests may include a pregnancy test, laparoscopy, and blood tests. Treatment for ovarian cysts depends on factors like your age, medical history, symptoms, and the size and kind of cyst you have, but can include monitoring your condition, medication, or surgery.
• Uterine fibroids: These are often detected during a pelvic exam. These noncancerous growths in your uterus rarely develop into cancer and can range in size from microscopic to large enough to cause your uterus to bulge out. These fibroids don't cause symptoms for most women. If your healthcare provider needs confirmation that you have fibroids, they may order additional tests such as ultrasound, blood tests, and possibly another imaging test like MRI. Treatment for this condition ranges from watching it closely to taking medications or doing a variety of procedures that can make the fibroids smaller or remove them completely.
• Cancer: A pelvic exam can be the first step in diagnosing cancers that occur in the ovaries, uterus, rectum, vulva, cervix, fallopian tubes, and bladder. Sometimes the tumors or abnormal cells can be seen or felt during your exam. In cases where cancer is detected or suspected, your healthcare provider will likely want to do additional testing. Depending on the type of cancer, tests may include ultrasound, a biopsy of your tissue, hysteroscopy , imaging tests, blood tests, and urinalysis.
• Sexually transmitted infections: Positive results on your gonorrhea and chlamydia tests will show which infection you have (though you can have both at the same time). You'll need to be treated with an antibiotic to clear up the infection.

A pelvic exam is a gynecological exam that can help identify problems with the organs inside and outside of your pelvis. During this exam, your healthcare provider uses a speculum and gloved fingers to examine these organs visually and manually.

Some of the conditions that can be discovered or suspected after a pelvic exam include endometriosis, ovarian cysts, and uterine fibroids. Further tests can confirm these findings.

Planned Parenthood. What is a pelvic exam?

American College of Obstetricians and Gynecologists. Your first gynecologic visit .

American College of Obstetricians and Gynecologists . Cervical cancer screening (update) .

American College of Obstetricians and Gynecologists. Pelvic Exams .

Office on Women's Health. Douching .

HealthCare.gov. Preventive care benefits for women .

Centers for Disease Control and Prevention. National breast and cervical cancer early detection program .

American Cancer Society. Breast cancer screening guideline .

Office on Women's Health. Endometriosis .

Centers for Disease Control and Prevention. Pelvic inflammatory disease (PID) treatment and care .

 Office on Women’s Health. Ovarian cysts .

Office on Women’s Health.  Uterine fibroids .

American College of Obstetricians and Gynecologists. Pelvic exams .

By Tracee Cornforth Tracee Cornforth is a freelance writer who covers menstruation, menstrual disorders, and other women's health issues. 

When to See a Gynecologist for the First Time and What to Expect

Knowing when to see a gynecologist for the first time can be puzzling, but for young women, meeting with an OB-GYN earlier on can set you up for a strong foundation of reproductive health, well-being and open communication.

This article is based on reporting that features expert sources.

When to See an OB-GYN for the First Time

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Usually, parents take their child to a health care specialist due to an existing health concern. A pulmonologist follows their asthma, a psychiatrist manages ADHD or diabetes is overseen by their endocrinologist.

When it comes to a first gynecologist visit, it's crucial for women and young girls to proactively receive care as an integral part of their overall health and well-being.

What Age Should Girls First See an OB-GYN?

The American College of Obstetrics and Gynecology recommends that girls establish care with an obstetrician-gynecologist, or OB-GYN, between the ages of 13 and 15.

Most girls get their first period between the ages of 10 to 16, and up to 42% of teenage girls become sexually active between ages 15 to 19. ACOG adds that adolescent girls may have a first gynecologist visit for any of the following reasons at any time:

• Have not had their period by 15 years of age.
• Heavy, irregular or painful periods.
• Puberty concerns, like acne or unwanted hair growth. 
• Sexually active.
• Questioning their gender identity.

Dr. Anne Smith, a pediatric and adolescent OB-GYN at Yale Medicine and assistant professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine, says, “The primary goal for seeing patients early is to provide preventative care.” Knowing what is normal and what is abnormal can also empower teenage girls, especially regarding puberty and menstruation.

“OB-GYNs can also have a focused discussion with teens about reproductive health, as well as healthy relationships, bone health and other lifestyle factors,” she adds.

Why See an OB-GYN Instead of a Primary Care Provider?

A primary care provider , or PCP, is a medical provider well-versed in typical health care conditions prevalent in the general population. PCPs are excellent at treating common health conditions, helping to coordinate care or recommending specialists.

So, if a teenage girl has a common concern, like a painful period, why should they see an OB-GYN rather than their PCP ? It is in the scope of a PCP to listen to these concerns and recommend a treatment plan. However, Smith suggests some adolescents could be more comfortable discussing their concerns with an OB-GYN.

“They have specialized training in these sensitive topics,” she explains.

Most teens are nervous about seeing an OB-GYN for the first time. Still, Smith explains that an OB-GYN can listen to the teen’s concerns, and they shouldn’t worry about invasive exams or procedures during their first visit.

What Happens at an Initial OB-GYN Visit?

During a first visit with an OB-GYN , the primary goal is to get to know the teenager and establish a trusting relationship.

A first gynecologist visit will often follow this structure:

• Gathering initial information.
• Checking on overall health.
• Discussing concerns.
• Conducting an assessment.

Gathering initial information 

This includes race and ethnicity, religious background, age and family structure, so the OB-GYN can be sensitive to any personal needs and preferences.

Checking on overall health 

A nurse or medical assistant will take vital signs, height, weight and last menstrual period. They will also ask if the purpose of the visit is to establish care, or if there are other health concerns.

Dr. Ashanda Saint Jean, the chair of obstetrics and gynecology at Health Alliance Hospitals Westchester Medical Center and a member of WMCHealth in Valhalla, New York, says, “At the first visit, a detailed history is obtained. Often, parents are quite useful in filling in the blanks of many early childhood medical conditions, hospitalizations, medical allergies and adverse reactions and past surgeries.“

Discussing concerns 

The provider will introduce themselves and spend some time understanding any prevalent concerns.

“Creating a safe space and opportunity to ground that experience in trust will strengthen a bond of trust and temper nerves,” Saint Jean explains.

Conducting an assessment

An assessment could be looking at acne, asking more in-depth questions about pelvic pain or discussing what to expect with physical development during puberty.

Dr. Andrea Braden, breastfeeding medicine specialist at Lybbie, a lactation innovation company, says, “Depending on the age and risk factors of the patient, bloodwork may also be drawn at a first visit as part of a preventive care workup. These blood tests can check for illnesses that require further treatment but may not be apparent on physical exam alone.”

Are you concerned about an unwanted pap smear or a pelvic exam? Pap smears are only recommended for women over age 21, regardless of when they become sexually active. Pelvic exams are only done on teenagers if it is medically necessary to address a specific concern, and only after their OB-GYN establishes trust and receives informed consent from their patient. Saint Jean adds that “patient-centered care is the bedrock of trust-promoting and fear, anxiety and stress reduction. This holds true for young teenage patients, as well.”

Patient Confidentiality at Teenage Gynecology Visits

Both parents and their teenage girls may have questions or concerns about their privacy and confidentiality. Parents want to ensure they are privy to their children’s health status, and teenagers may not want their parents to know about their sexual activity or gynecological concerns.

Rules on patient confidentiality in regard to sexual health differ in each state. The American Academy of Pediatrics says that these laws are highly variable and do not reflect any pediatric standards of care.

To check what the laws are in your state, visit your public health department website. There are differences in regulations with each of the following types of care:

• General medical care. 
• Immunizations, including the HPV vaccine.
• Sexual assault evaluations. 
• STI/ HIV testing and treatment. 
• Contraceptive care . 
• Prenatal care . 

“Given the sensitive nature of reproductive care, many young teenage patients rely on privacy and confidentiality when accessing these care pathways,” Saint Jeans says. “Honoring this patient/physician relationship contributes to building a bridge of trust with our young teenage patients, thus allowing an avenue to exist where care can be sought and delivered without the fear of divulgence and breach of confidentiality.”

Best Women's Health Medicines

The U.S. News Health team delivers accurate information about health, nutrition and fitness, as well as in-depth medical condition guides. All of our stories rely on multiple, independent sources and experts in the field, such as medical doctors and licensed nutritionists. To learn more about how we keep our content accurate and trustworthy, read our  editorial guidelines .

Braden is a board-certified OB-GYN based in Atlanta and a breastfeeding medicine specialist at Lybbie, a lactation innovation company.

Saint Jean is the chair of obstetrics and gynecology at Health Alliance Hospitals Westchester Medical Center, a member of WMCHealth in New York.

Smith is a pediatric and adolescent obstetrician-gynecologist at Yale Medicine and assistant professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine in Connecticut.

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Irregular Periods and Your Annual Exam: Can You Have Your Annual Checkup While on Your Period?

Chapel Hill Obstetrics & Gynecology Abnormal Periods , Fibroids , Hormones & Menopause , Pap Smear Testing , Vagina: What's Normal, What's Not

Ideally, your annual exam and Pap smear should be conducted when you are not on your period. While heavy menses may possibly interfere with Pap smear interpretation, we generally can see someone when they are on their period, including a pelvic exam and successfully collect their Pap. Understandably, many patients are more comfortable to be examined when they are not on their period, and we are happy to reschedule if they request.

Annual Checkup While on Period

Even if you’ve taken care to schedule your annual exam for when you aren’t menstruating, we understand that if you have irregular periods, it may be difficult to accurately determine when they will start.  If you prefer, we can usually reschedule your appointment for when you are no longer on your period. If more convenient, you may also keep your original appointment as your period will typically not interfere with your examination.

”Irregular periods are very common. We always put the comfort of our patients first,” said Dr. Sonya Williams .

While the Pap smear and pelvic exam are an important part of your yearly exam, we also believe this is an ideal time to discuss your general wellness and sexual health. We care for the whole patient, and that’s why we want to know if you have any other health issues such as high blood pressure or high cholesterol. It is also a chance to review and discuss your lab work and conduct a clinical breast exam.

If your period came unexpectedly, we’d like to talk to you about that too. Painful, heavy or irregular menses can be indicative of another health problem. If you have an irregular period, you should keep a record of when it occurs, for how long and how heavy the flow is. This will be a useful tool that will help us determine the root of the problem.  

What constitutes an irregular period?

It’s very frustrating not knowing when you are going to have your period. It can cause problems planning vacations or other activities and can cause stress, worrying about what outfit to wear or if you could be pregnant. Your period should occur every 21 to 35 days and last up to seven days.  An irregular period comprises anything that is outside of this norm.

The following are also signs that you have an abnormal period:

• Periods that cause you to feel nauseated to the point of vomiting
• Flow that is heavier than usual
• Bleeding between periods
• Passing blood clots during your period
• Extremely painful periods with severe cramping — this is known as dysmenorrhea.

If your period has stopped completely, or you are a young woman who hasn’t had your first period by the age of 16, then you may be diagnosed with amenorrhea . This means you have gone 90 days or more without a period and you are not using contraception known to stop periods, pregnant, breastfeeding, or menopausal. If you have infrequent periods (those consistently greater than 35 days apart), then you may have oligomenorrhea. ( Cleveland Clinic )

You should speak with us if:

• You have skipped two periods and you are not pregnant
• You have recently had a heavier menstrual flow than what is normal for you
• Your periods last longer than seven days

What causes irregular periods?

Irregular menstrual cycles are most common around the time your first period starts and just before you begin menopause. However, there are many causes of irregular periods such as:

• Ovarian cysts
• Certain medications for anxiety or depression
• Certain birth control methods like IUDs
• Ovulation disorders
• Eating disorders
• Hormonal irregularities
• Thyroid problems

How are irregular periods treated?

First, we’ll review your medical history and perform a pelvic exam. Then, we’ll order blood tests to rule out other medical disorders such as thyroid problems or hormonal deficiencies.

Because fibroids, polyps and ovarian cysts can cause irregular periods, we may need to perform a pelvic ultrasound to check for them. If needed, we’ll perform an endometrial biopsy, removing sample tissue from your uterine lining. This helps us diagnose precancerous changes or even certain types of cancer.

Depending upon the diagnosis, treatment may include:

• Prescribing hormones such as progestin or estrogen. These can control heavy bleeding and also induce a period if you have not had one for several months.
• Taking low-dose birth control pills
• Using gonadotropin drugs, which can reduce the size of fibroids and also control heavy bleeding

We’ll work with you to create a treatment plan that addresses your concerns.

If you have your checkup scheduled and you’ve started your period, please contact us . Usually, we can easily reschedule you for another appointment within a week.  If that isn’t possible, we urge you to keep your appointment so we can discuss why you’re having an irregular menstrual cycle. Together, we’ll tailor a treatment plan that will enable us to treat the problem.

For more than 40 years, Chapel Hill OBGYN has served women in the Triangle area, sharing the joy of little miracles and supporting them during challenges. Our board-certified physicians and certified nurse midwives bring together the personal experience and convenience of a private practice with the state-of-the-art resources found at larger organizations. To schedule an appointment , please contact us for more information.

Cleveland Clinic. “Abnormal Menstruation (Periods)” Online.

https://my.clevelandclinic.org/health/diseases/14633-abnormal-menstruation-periods

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Can You Get a Pap Smear on Your Period?

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Periods don't always come on schedule, and sometimes a person who menstruates might not track their cycle as far out when booking a Pap smear. Pap tests, or Pap smears, are cervical cancer screening tests done every three years for individuals aged 21 to 65 with a cervix—the lowest part of the uterus.

Menstruation can affect the results of these tests, which may leave you wondering if you can get a Pap smear on your period. The immediate answer is that you can, but it depends on factors like your comfort level and healthcare provider guidance. Here's what you need to know about getting a Pap smear while menstruating.

What Is a Pap Smear?

A Pap test involves taking cell samples from your cervix to look for signs of cervical cancer. The test is also a way to look for cellular changes like precancers caused by the human papillomavirus (HPV) that indicate the potential development of cancer.

During the Pap test , a healthcare provider inserts a plastic or metal speculum into your vagina to open it up. Using a soft brush, the provider will take cell samples from your cervix.

Sometimes, the healthcare provider will do co-testing, where they complete an HPV test at the same time as the Pap test. The HPV test involves taking samples from outside the cervix. The samples are then sent to a lab for testing.

When Should You Get a Pap Smear?

Individuals with a cervix are recommended to start cervical cancer screening at 25 and continue through age 65, with HPV testing every five years as the preferred method of testing. If you get an abnormal Pap result or have risk factors like a history of cervical cancer, you might need to get a Pap smear more often.

Pap tests, HPV tests, or both are sometimes done during a pelvic exam, which is a typical part of your annual OB-GYN visit. Of course, if you're experiencing unusual vaginal discharge or pelvic pain , you can make an appointment for a pelvic exam at any time.

Pap Smear on Your Period?

As for getting a Pap test on your period, there's no reason you can't have one. It may not be ideal if you're experiencing a particularly heavy flow . It could potentially affect the Pap test outcome.

You should also consider your comfort level. It's best to reschedule and go back on a period-free day if you're not comfortable getting a Pap test, HPV test, or even your annual exam while you have your period.

How It's Done

The Pap test procedure doesn't change if you happen to be on your period. Instead, the changes occur with the sample analysis. Rebecca C. Brightman, MD , a gynecologist in private practice in NYC and an assistant clinical professor of obstetrics, gynecology, and reproductive medicine at the Icahn School of Medicine at Mount Sinai, told  Health more about the analysis.

"Pap tests are typically liquid-based cytology [cell biology] evaluations with the cervical cells placed in solution, and cervical cells can then be separated from the blood in the lab to allow for proper analysis," explained Dr. Brightman. Too much blood in that sample can still obscure results.

How Heavy Is Too Heavy?

There's no right answer to the question of "how heavy is too heavy?" for menstrual flow if you plan to have a Pap test completed. Neither you nor a healthcare provider can determine how much flow will affect the results. With that in mind, it's worth calling ahead of time to get the provider's guidance about coming to your appointment during your period .

A Quick Review

In general, you may be able to get a Pap smear while on your period. To be sure, call the office where you'll be having your appointment to see what they'd prefer you to do and then go from there.

Depending on the timing of your period, your comfort level, and a healthcare professional's opinion, some may suggest you still come in for your appointment, and others may suggest you try another day.

MedlinePlus. Pap test .

Office on Women's Health. Pap and HPV tests .

MedlinePlus. Pap smear .

American College of Obstetricians and Gynecologists. FAQs - cervical cancer screening .

Office of Disease Prevention and Health Promotion. Get your well-woman visit every year .

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How to Make Your Next Pelvic Exam and Gyno Visit Easier, According to a Gynecologist

Here’s how the whole experience can be less painful.

Pelvic exam tips

Every year millions of women trek to their gynecologist or other healthcare provider and reluctantly climb into the stirrups. Though no one particularly likes a pelvic exam, most women put up with the brief discomfort to make sure all is well.

Many women, however, skip a gynecologic exam, even if they have a problem they know should be addressed. There are many reasons for this, but in one survey of over 2,000 women, one-third skipped a gynecologic exam because they were embarrassed. Of these women, 35% were ashamed of their body shape, 34% were embarrassed by the appearance of their vulva, and 38% had concerns about odor. And that doesn’t include women who avoid an exam because they find it painful or traumatic.

I’ve performed over 200,000 gynecological exams in my career—here are tips to make the most common issues I see a lot less stressful.

Gynecologist visit tips

Address body image concerns.

Many women feel they’d rather suffer from a gynecologic problem than put on a skimpy paper gown that barely covers their breasts and belly. I always provided roomy cloth gowns for my patients, and I honestly think that’s a big reason they kept coming back. It would be nice if every office did this, but there’s no rule that says you can’t bring your own exam gown. A wraparound robe or a loose dress with a front zipper is fine. Or check out Get Janes , which sells comfortable examination gowns and also donates some of its profits to help women get mammograms. Another option: Tell the medical assistant that you are on the modest side (or cold!) and would like an extra gown or cloth.

For some women, it’s a weight issue. They may be embarrassed about their body, but also just tired of a doctor being so focused on weight that their real concerns don’t get addressed. I had one patient tell me that she’d left her gynecologist because by the time he finished telling her she was at risk of dropping dead from a heart attack unless diabetes got her first, it just didn’t seem appropriate to bring up her lack of libido.

The best solution if you want to avoid a discussion about your weight? Start by saying, “I bet you’ll want to talk about my weight, but since we have a limited amount of time, I’d prefer to discuss other health concerns today.” Then whip out your list and go for it. That way, the things that are important to you will be addressed as priorities.

Also, I know some women avoid their annual exam because they don’t want to get weighed. Remember: It’s not the Army. No one is going to force you to do anything. It’s much better to get everything you need done other than being weighed rather than not to come at all. If someone declines to be weighed, I’ll generally ask for a ballpark figure. You also have the option of getting weighed “backward”—we’ll see your weight, but you won’t. Exceptions to taking a pass on getting weighed? Pregnancy, certain medications, and surgery, all of which require an accurate weight.

Don’t worry about genital odor

If this is your concern, it could be one of two scenarios. One is that there actually is no odor other than the normal healthy scent present in all vaginas—and if that’s the case, you need someone to let you know that. The second: There is a foul odor, perhaps from bacterial vaginosis or a forgotten tampon (that happens more often than you think!), in which case you need to eliminate the reason for the odor. These odors are never because of a lack of hygiene, and there will be no judgment on the part of your gynecologist!

Voice discomfort

For many women, avoiding the gynecologist is about the pain of a speculum.

A typical gynecologic exam includes a visual inspection of the external genitalia, a speculum exam to look inside the vagina, and then a bimanual exam in which the physician places one or two fingers in the vagina and the other hand on the abdomen. The external inspection checks for growths or abnormal skin changes on the vulva. The speculum exam allows the gynecologist to do a Pap test and check for abnormal discharge, abnormal growths on the cervix, or changes in the vagina such as thinning and/or dryness of the vaginal walls. The bimanual exam lets the doctor evaluate the uterus and ovaries and check for any pelvic masses.

Depending on the reason for your visit, you may not need a speculum exam. Bleeding, cervical cancer screening, and vaginal discharge do require that someone take a peek inside, but if your main concern is a sore on your vulva, bladder leakage, or a loss of libido, a speculum exam isn’t always necessary.

.css-1i46m0l{font-family:AvantGarde,AvantGarde-roboto,AvantGarde-local,Helvetica,Arial,sans-serif;font-size:1.625rem;line-height:1.1;margin:0rem;}@media(min-width: 48rem){.css-1i46m0l{font-size:1.875rem;line-height:1.1;}}@media(min-width: 64rem){.css-1i46m0l{font-size:1.875rem;line-height:1.1;}}.css-1i46m0l b,.css-1i46m0l strong{font-family:inherit;font-weight:bold;}.css-1i46m0l em,.css-1i46m0l i{font-style:italic;font-family:inherit;} “Depending on the reason for your visit, you may not even need a speculum exam.”

If you do require one, don’t be shy about telling your clinician that the speculum often hurts—and then say something if the exam goes beyond “a little pressure” and pinches, bites, or causes pain. Sometimes a minor readjustment or changing instruments can make a world of difference. Specula are not “one size fits all,” and yes, sometimes it’s just a matter of using a smaller one to ensure that the exam is not agonizing. Believe it or not, most gynecologists routinely use the smallest one possible. No one wants to hurt you! My choice of speculum is dependent not only on the size of the vaginal opening but also on the length of the vagina, the elasticity of the vaginal walls, the position of the uterus, and what I need to accomplish. For example, the amount of exposure I need to swab vaginal discharge is different from what I need to do a Pap test, a uterine sampling, or a major procedure. The speculum I use for a 16-year-old virgin is a completely different instrument than the one I would use for a 40-year-old woman with three kids or a 70-year-old who is well into menopause.

If you’re not an easy fit, you’re probably better off seeing a gynecologist as opposed to an internist or a family medicine doctor. Gynecologists are the most experienced at inserting specula, and they have multiple sizes that vary in length, width, and how far they open. Non-gynecologists typically have only one or two sizes to choose from.

Disclose past trauma or vaginismus

And then there are women who avoid an exam because of vaginismus , or a history of sexual abuse or medical trauma. Most gynecologists, if they know that to be the case, will facilitate an exam by slowing down the process, asking permission every step of the way, and telling you exactly what they are doing so you’re in control. Using a mirror so you can see what’s happening is also sometimes helpful. Some doctors specialize in trauma-informed care, but unfortunately, there’s no standardized way to find such a clinician. Sometimes the best ways to find one are by word of mouth and via trauma centers and therapists.

Can a woman get anesthesia to have an exam? Absolutely. If you know from past experience that an exam without it is truly out of the question, or if the exam is going to be prolonged or likely to be painful because of an IUD placement or some other procedure, you can—and should—request anesthesia.

• An empty bladder will take a lot of the pressure off the speculum, so pee before your Pap!
• Most gynecologists keep the speculum in a warming drawer, but if yours doesn’t, request that they run it under warm water.
• During the exam, try deep breathing or talking to your gynecologist about something unrelated. I had one patient who talked to her sister on her phone during her Pap test to take her mind off what I was doing.
• Lubricant is not automatically used, since it can affect Pap test results, but in a non-Pap exam, it can make a big difference.
• Your clinician can apply some anesthetic gel to the opening of the vagina prior to your exam.
• An anti-anxiety pill can help make things easier. Request a prescription in advance, take it about 30 minutes before your appointment, and make sure someone else is driving you.

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Antony Blinken urges Hamas to accept Israel's 'extraordinarily generous' Gaza truce plan

RIYADH, Saudi Arabia −  Secretary of State Antony Blinken  urged Hamas on Monday to swiftly accept Israel's latest and "extraordinarily generous" proposal for a Gaza truce to secure a release of hostages amid a diplomatic drive to end the  war between Israel and Hamas .

Hamas negotiators were expected to meet Qatari and Egyptian mediators in Cairo on Monday  to deliver  a response to the phased truce proposal Israel presented at the weekend ahead of a threatened Israeli assault on the southern border city of Rafah.

"The only thing standing between the people of Gaza and a cease-fire is Hamas. They have to decide and they have to decide quickly," Blinken said at a special meeting of the World Economic Forum in the Saudi capital, Riyadh.

"I'm hopeful that they will make the right decision."

A source briefed on the talks said Israel's proposal entailed a deal to accept the release of fewer than 40 of the roughly 130 hostages believed to be still held in exchange for freeing Palestinians jailed in Israel, and a second phase of a truce consisting of a "period of sustained calm" − Israel’s compromise response to a Hamas demand for permanent cease-fire.

Blinken arrived in Saudi Arabia on Monday, the first stop in the latest of a series of troubleshooting trips to the Middle East since the Gaza war ignited in October.

Blinken reiterated that the U.S. could not support an Israeli ground assault on Rafah − where Israel says Hamas' last four intact battalions are holed up − "in the absence of an (Israeli) plan to ensure that civilians will not be harmed."

He said the U.S. and Saudi Arabia had done "intense work together" over the past few months toward a normalization accord between the kingdom and Israel, a deal that includes Washington giving Riyadh agreements on bilateral defense and security commitments as well as nuclear cooperation.

Diplomats say the eruption of the Gaza war derailed progress toward Israeli-Saudi normalization.

The U.S. and Saudi components of the agreement are "potentially very close to completion," Blinken said. "To move forward with normalization, two things will be required: calm in Gaza and a credible pathway to a Palestinian state."

More: Israel poised to invade Rafah, where more than 1 million Gazans take shelter: Reports

Israeli-Saudi normalization

In return for normalization, Arab states are also pushing for Israel to accept a pathway to Palestinian statehood on land it captured in the 1967 Middle East war, something Israeli Prime Minister Benjamin Netanyahu has repeatedly rejected.

Hamas fighters attacked Israel on Oct. 7, killing 1,200 people and seizing 253 hostages, according to Israeli tallies.

Israel retaliated by imposing a total siege on Gaza, then mounting an air and ground assault that has killed more than 34,000 Palestinians, according to health authorities in Hamas-ruled Gaza. Palestinians have been suffering from severe shortages of food, fuel and medicine amid the Israeli offensive, which has demolished much of the impoverished, densely populated strip.

Blinken, speaking earlier at the opening of a meeting with Gulf Arab states, said the most effective way to address the crisis and create space for a more lasting solution was to get a cease-fire that allowed the release of hostages held by Hamas.

He is expected to discuss with Arab foreign ministers what the governance of Gaza might look like after the Israel-Hamas war ends, according to a senior State Department official.

Blinken also is expected to bring together Arab and European countries and discuss how Europe can help reconstruction in Gaza, which has been reduced to a wasteland in the six-month-long Israeli bombardment.

"We will discuss the hostages, humanitarian situation and the cease-fire. Things are progressing, but we must always remain prudent in these discussions and negotiations," French Foreign Minister Stephane Sejourne told Reuters on Monday.

Jordanian Prime Minister Bisher al Khasawneh said all parties needed to find a path toward a two-state solution to the conflict or the Middle East risked another catastrophe.

An assault on Rafah, which Israel says is the last Hamas stronghold in Gaza, has been expected for weeks, but foreign governments and the United Nations have expressed concern that such action could result in a humanitarian disaster given the number of displaced people crammed into the area.

Conversations about Gaza's rebuilding and governance have been going on for months with a clear mechanism yet to emerge.

The United States agrees with Israel's objective that Hamas needs to be eradicated and cannot play a role in Gaza's future, but Washington does not want Israel to reoccupy the enclave.

Instead, it has been looking at a structure that will include a reformed Palestinian Authority − which exercises limited self-rule in the Israeli-occupied West Bank − with support from Arab states.

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Chinese jets fly sorties over Taiwan strait in show of force as US delegation departs

End of secretary of state Antony Blinken’s three-day visit marks upsurge in military activity after period of relative calm

Taiwan has reported that a dozen Chinese warplanes flew sorties close to the island on Saturday, in a sudden surge of military activity just hours after the US secretary of state, Antony Blinken , left Beijing following talks with President Xi Jinping and top Chinese officials.

Before Blinken’s three-day visit to China , US officials had pointed to a period of relative calm in the Taiwan strait over the past few months, after years of aggressive Chinese military manoeuvres and threats, as a factor in improving US-Chinese relations since Joe Biden held a summit meeting with Xi in November.

While welcoming the thaw in relations and more frequent contact, Blinken had come with an ultimatum for Beijing, calling on it to stop Chinese companies supplying components and materials to the Russian defence industry or face new sanctions.

The US also angered China this week when Congress passed a supplemental spending bill with billions of dollars in military aid to Taiwan . At a meeting with Blinken on Friday afternoon, Xi is said to have become particularly animated on the subject of Taiwan, accusing the US of interfering in Chinese affairs and encouraging pro-independence sentiment on the island.

In his public remarks, Xi told Blinken: “The two countries should help each other succeed rather than hurt each other, seek common ground and reserve differences rather than engage in vicious competition.”

Earlier, China’s foreign minister, Wang Yi, had warned of a “downward spiral” in relations if the US stepped on Chinese “red lines”.

Blinken said that while in China he had stressed the “critical importance” of maintaining peace and stability across the strait.

Beijing has often used aggressive military manoeuvres to signal its displeasure at any moves in Washington it sees as diverging from the US’s established “one China” policy of discouraging Taiwanese moves towards separatism. A 2022 visit to Taipei by the then speaker of the House of Representatives, Nancy Pelosi, led to months of Chinese military manoeuvres in the Taiwan strait.

On Saturday morning, while Blinken was in the air on the way back to Washington, Taiwan’s defence ministry said it had detected 22 Chinese military aircraft, including Su-30 fighters, over the strait, of which 12 had crossed the median line, which in the past has been recognised by both sides as an unofficial border.

The Taiwanese foreign ministry described the sorties as “joint combat readiness patrols” with Chinese warships, adding that Taiwanese aircraft and ships responded “appropriately”, without giving details.

In the past, Taipei has scrambled jets and deployed naval vessels to demonstrate its resolve not to accept encroachment by the Chinese military.

Washington had been braced for China to ratchet up its activity in the strait, particularly with the approaching inauguration of a new Taiwanese president, Lai Ching-te , on 20 May. Beijing portrays Lai as a dangerous separatist and has refused to hold talks with him.

The Blinken team did not expect breakthroughs during his visit to Shanghai and Beijing, and was anticipating a backlash against the US threat of sanctions over support for Russia’s industrial base.

After the visit, US officials said they hoped that similar warnings from European countries – for example when Xi visits Paris early next month – would lead Beijing to recalibrate its interests. They pointed out that China had so far been dissuaded by international pressure from sending Russia weapons, and that Beijing would be instrumental in dissuading Vladimir Putin from any thought of using nuclear weapons in the conflict.

Much of Blinken’s interaction with the Chinese leadership during his visit was taken up by a mutual airing of grievances. The secretary of state told CNN in an interview just before leaving Beijing that the US had seen evidence of attempts by Beijing to “influence and arguably interfere” in this year’s US elections.

But, assessing the outcome of the trip, US officials pointed to the importance of maintaining dialogue after several years of almost no contact – a silence they said had heightened the dangers of a conflict breaking out by miscalculation.

As well as high-level dialogue involving the presidents and foreign ministers, communication channels have been re-established between the two countries’ militaries since the Xi-Biden summit in San Francisco, a connection Blinken sought to deepen on this trip.

The two governments agreed on Friday to start the first US-China talks on mitigating the risks of artificial intelligence, which are due to take place in Geneva in the coming weeks, and the two sides continued discussions with Chinese ministers on joint efforts to curb the production and trafficking of the synthetic opioid fentanyl, which Blinken noted was the leading cause of death among Americans aged 18 to 45.

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