Regardless of your sexual orientation or whether you are sexually active, GYN exams are an integral part of a woman's comprehensive health care. All women should begin having annual GYN exams at age 21. Regular GYN exams allow you to maintain an up-to-date knowledge of your reproductive health, to become familiar with what is normal for your body and to be better able to identify future health problems.
Having regular GYN exams can:
- Prevent illness
- Detect cancers such as cervical, uterine and breast cancer at an early and potentially more treatable stage
- Detect sexually transmitted infections (STIs) before they cause infertility or other damage
- Provide health care before, during and after pregnancy.
If you are under 21, and interested in obtaining a prescription birth control method, you will need to see a provider for a medical history and brief physical exam, but a pelvic exam is usually not necessary.
You also should visit your medical provider for a GYN problem visit if, at any point, you are experiencing:
- Unusual or severe abdominal, vaginal or pelvic pain
- Abnormal vaginal bleeding or discharge
- Pain or swelling or the vulva and/or vagina
- Sores, lumps or itching of the vulva and/or vagina
- Thickening, dimpling, puckering or other changes in the breasts
- Retracted nipple(s) -- if your nipples were not previously inverted -- or abnormal discharge from the nipple(s)
- Unusual or severe menstrual pain
If you are concerned or nervous about having a GYN exam, learning what the exam involves can help ease any reservations you might have about scheduling your exam. Typically, a GYN exam involves a discussion of your medical and sexual history, a brief physical exam, a breast exam, a pelvic exam, STI tests, and other lab tests and counseling as needed.
Here are the details about what you can expect to happen during each part of the GYN exam:
In a private exam room, your medical provider will ask you about your medical and sexual history. Important questions your provider will ask include:
- When was your last period?
- How regular are your periods and how long do they last?
- Do you have any spotting between periods?
- Do you experience any pain or discomfort during sex?
- Do you have any unusual genital pain, itching or discharge?
- Do you have any other medical conditions?
- Are there family members with significant medical conditions?
- If you are sexually active, do you use methods to prevent STIs?
- If you have sex with men, are you using birth control?
You can use this time to bring up any concerns you have or questions you'd like to get answered. Talking openly and honestly with your provider is important to ensure that you get accurate information and appropriate health care. Try not to be embarrassed about asking sexual health questions - your medical provider will likely have heard similar questions before.
Your provider will also ask about past health issues and whether you smoke, drink, or use other drugs. To round out the medical history, your provider will take your blood pressure, weight, and have you step out to the bathroom to empty your bladder, which will help you be more comfortable during your exam. Your provider may also ask you to give a urine sample at this time if there is any chance of pregnancy.
Next, the provider will ask you to get undressed and put on a paper gown. You can leave your socks on if you like.
Your medical provider will return to the exam room once you've changed, and will start by listening to your heart and lungs and checking your thyroid. Next s/he will ask you to lie back on the exam table and will perform a breast exam. S/he will feel your breasts to detect any lumps or thickening. If you don't know how to perform breast self-exams (BSEs), your provider will show you how.
Pelvic Exam and STI/Lab Tests
Next, the provider will ask you to move to the end of the exam table and place your feet in the footrests. Let your knees and thighs spread wide open and relax. The more relaxed your muscles are, the more comfortable your exam will be.
Your provider will first examine your vulva - your external genitalia - looking for any symptoms of irritation, growths, cysts, genital warts or discharge. You will feel your provider's gloved hands touching your vulva.
Next, your provider will use a speculum -- a plastic instrument that s/he will gently insert into your vagina. The speculum spreads the vaginal walls slightly apart so that the cervix can be seen. At this point there is usually some pressure, but if you feel pain, let your provider know so s/he can adjust the speculum for greater comfort. Your provider will look at your cervix to make sure it looks healthy. (If you would like to see your cervix you can ask your provider for a mirror at this point.) Once the speculum is in place, your provider will look for any irritation, growths or abnormal discharge from the cervix.
If you are due for a Pap Smear, your provider will use a small plastic spatula and a small, soft brush device to take a Pap Smear, a quick sample of your cervical cells. This test will be sent to a lab to determine if there are any abnormal cervical cells. The frequency of Pap Smears is determined by your age and whether you have any history of past abnormal Pap results.
Also at this time, your provider will offer to perform a test for chlamydia and gonorrhea and may suggest other STI tests as well. Talk to your provider if you are worried about symptoms you may have experienced or if you are concerned about a sex partner. Some of these tests use what looks like a long Q-tip to take samples of your cells which are sent to a lab. Some tests are performed on the sample already taken for the Pap test. All of these steps only take a few minutes.
Next, your provider will gently remove the speculum and perform a bimanual exam. With a gloved hand s/he will insert 2 fingers into the vagina and with the other hand on top of your abdomen will feel your uterus, fallopian tubes and ovaries. S/he is feeling the size, shape and position of the uterus and whether there is any tenderness or swelling. Again, some pressure is felt here and you may experience the sensation of having to urinate, but it is quick. Your provider will sometimes perform a rectal exam, again with a gloved finger to feel if there are any tears or any weakness in the muscles that separate the rectum and the vagina.
At this point the exam is complete. Your provider will tell you that you can get dressed, and will return to discuss any remaining questions you have. Use this opportunity to ask about any issues which were not addressed during the rest of the exam. Before your visit you can write your questions down if you think you'll forget or be too embarrassed to ask. You can learn a lot from your provider during your visit - make the most of it. You may have questions about:
- Birth control
- Breast self-exams
- Any other general health topic
It's a good idea to refrain from having intercourse or douching for the 24 hours before your exam. These activities can irritate the genital area and vaginal lining and obscure test results.
If you are having your period at the time you are scheduled to have a GYN exam, call your provider to see if you will need to reschedule. When you're having your period it can be difficult for the provider to clearly see your anatomy and it can obscure test results.
The actual pelvic exam may take about 5 minutes - not long at all. The entire time you're in the exam room including the question and answer session with your provider may take up to 45 minutes, especially if you have questions or are seeking a contraceptive method.
For most women, GYN exams are at worst mildly uncomfortable and a bit awkward. You can tell your provider what you're feeling during the exam so s/he can slow down or make adjustments so that you'll be as comfortable as possible. Your medical provider will take the time to describe what s/he is doing. If at any point you decide that you don't want to go further with the exam, that is ok. You are in complete control of the exam and can ask your provider to stop at any time you are uncomfortable.
Unless you have a medical problem which requires an earlier exam, you should have your first GYN exam when you reach the age of 21 or three years after you first have vaginal intercourse- whichever happens first.
After your first GYN exam, you health care provider will tell you how often you should have exams, including pelvic exams and Pap tests. How often you need your exams will depend on your medical history and individual health needs.
You don't have to be tested for STIs, but if you have been sexually active your medical provider most likely will recommend that you have a chlamydia and gonorrhea test performed. HIV testing is also recommended annually if you are sexually active, so this is another STI test that will be discussed with you.
If you are a Brown student, you can make a confidential appointment for a GYN exam at Health Services by calling 401.863-3953. Health Services provides a range of services including general health care, STI testing, and emergency medical care. We are located at 13 Brown Street on the corner of Brown and Charlesfield Streets.
Yes, of course. At Health Services, you may request a specific provider by name or by gender. If you choose, you may request a second staff person to be present during the exam. For example, a woman seeing a male provider could have a female UHS staff member present as well.
If you are under 21 and are interested in using a hormonal method of birth control, you may not need a pelvic exam, but your provider will still need to do a brief physical exam and take a medical history. If you are over 21 and have had a GYN exam in the past year, you will not need to have another exam to obtain prescription birth control. If you had this exam with a medical provider outside of Health Services, you will need to have your records sent here. You can link to the "Medical record request/ release authorization" form to authorize Health Services to obtain your records from another medical provider. If you are over 21 and it has been over a year since your last exam, or if you have experienced other sexual health problems, your medical provider will usually need to perform a GYN exam.
If, after reading this page, you still have concerns about the GYN exam and are nervous or unsure, that's ok. For example, women who have experienced sexual abuse in the past may have specific fears that relate to their experience, or in some cultures, women do not have GYN exams. You can schedule a visit with a provider to discuss the exam and to increase your comfort with that particular provider. It is important to talk openly with your provider about your fears, about any pelvic pain you have and to talk about your experience. Your provider will work with you to tailor the exam to help you feel as comfortable as possible. Also know that you can have a trusted friend or a second UHS staff member with you during the exam.
The health fee you pay each year covers the cost of your GYN visit to Health Services. Depending on the type of health insurance plan you have, your coverage for lab tests like Pap smears and STI tests will vary. Brown sponsored health insurance covers the costs of Pap smears and STI screening. For private insurance, contact your health insurance customer service representative to find out which lab tests are covered and which are not. You can also visit the Health Services page on fees and insurance.
Health Services places a high value on confidentiality. This means that information in your medical records or even the fact that you've visited Health Services cannot be released to anyone without your written permission (this includes parents, partners, friends, professors, advisors, etc.). There are a very few exceptions when information is required to be released without your written consent in the cases of emergencies or when required by law. Your medical provider can address any concerns you have during your visit.
To learn more about GYN exams, you can visit:
Disclaimer: Health Education is part of Health Services at Brown University. Health Education maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Education offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.