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When Should a Girl Have Her First Pelvic Exam?

Pelvic exams are a crucial part of gynecological care, yet they often cause feelings of fear and anxiety, particularly among younger women. This is largely due to the use of cold, hard metal speculums that can feel uncomfortable or cause irritation. 

Understanding what to expect from your first exam can help alleviate any stress surrounding these exams and maintain your menstrual and reproductive health. 

What is a Pelvic Exam?

A pelvic exam is a general physical exam conducted by obstetricians and gynecologists (OBGYNs) during a reproductive healthcare visit. It’s an essential procedure that allows your provider to assess the health of your reproductive organs. 

The exam typically includes the following:

  • Medical history: Before the physical examination, your healthcare provider will discuss your medical history, including any previous gynecological or sexual health issues, family history and current symptoms, if any. This helps the provider understand your health needs and tailor the exam accordingly.
  • External examination: The healthcare provider will perform an external examination of the genital area. They will visually inspect the external genitalia for abnormalities like redness, swelling or skin changes.
  • Speculum examination: The next step is the speculum examination. A speculum is a metal or plastic instrument gently inserted into the vagina, allowing the healthcare provider to visualize the cervix and the vaginal walls. 

They may use a lubricant to make the insertion more comfortable. If you’re uncomfortable with the traditional speculum, you can request they use a modern, patient-friendly alternative like the Nella Speculum, designed to make the experience less stressful and more comfortable.

  • Pap smear (cervical screening): During the speculum examination, your provider may also perform a Pap smear, which involves using a small brush or spatula to collect cells from the surface of the cervix. The cells are then sent to a laboratory for analysis to check for any abnormal changes that could indicate cervical cancer, precancerous conditions or HPV (human papillomavirus).
  • Bimanual examination: After removing the speculum, the healthcare provider will insert two gloved, lubricated fingers into the vagina while placing the other hand on the lower abdomen. This allows them to assess the size, shape and position of the uterus and ovaries and check for abnormalities, tenderness or masses.
  • Rectovaginal examination (optional): A rectovaginal examination may be performed in some cases, such as suspected uterine or cervical prolapse or unexplained vaginal bleeding or discomfort. During this part of the exam, the provider inserts one finger into the vagina and another into the rectum to feel for any abnormalities in the tissues between these two areas.
  • Educational and health counseling: Throughout the exam, your provider may take the opportunity to discuss reproductive health, birth control options, sexually transmitted infections (STIs) and any concerns or questions you may have.

When Should a Girl Have Her First Pelvic Exam?

The American College of Obstetricians and Gynecologists (ACOG) recommends girls start seeing a gynecologist between the ages of 13 and 15. However, this doesn’t necessarily mean they will need a pelvic exam right away. Initial visits are usually an opportunity to establish a relationship with the healthcare provider and discuss health and lifestyle issues.

Pelvic exams are typically not performed unless the young woman is sexually active or if there are specific symptoms or health concerns. The ACOG recommends that most girls have their first pelvic exam at age 21 or when they become sexually active. This exam may include a Pap smear to check for human papillomavirus (HPV), a commonly sexually transmitted infection that can lead to cervical cancer.

Other general health checks such as height, weight and blood pressure measurements are also taken during these early visits. Discussions about HPV vaccination and birth control options may also be initiated, depending on your needs and lifestyle.

How to Make Your First OB/GYN Visit More Comfortable

While some young women may feel apprehensive about their first pelvic exam, there are several ways to reduce anxiety and ensure a stress-free experience.

  • Plan your visit at the right time: Avoid scheduling OB/GYN visits when menstruating. Cramps and the presence of menstrual blood can make the speculum insertion more uncomfortable. Menstrual blood can potentially interfere with the collection of cervical cells for analysis. 
  • Practice relaxation techniques: Try deep abdominal breathing to help relax your pelvic floor muscles during speculum insertion. This technique can also help alleviate any anxiety you might be feeling. You can also ask your healthcare provider if you can stream your favorite music or TV show through headphones during your exam to distract yourself from the procedure.
  • Empty your bladder: Unless your doctor has scheduled a pelvic or transvaginal ultrasound immediately after the exam, try to empty your bladder before the pelvic exam. 
  • Ask for a more comfortable speculum: Before your exam, you can request that your doctor use an alternative to a cold, metal speculum. The Nella Speculum is a modern, patient-friendly alternative to traditional speculums. It’s designed with the comfort of young women in mind, offering a smoother, temperature-neutral and quieter experience. 

The Nella Speculum is as narrow as a tampon, making it less intimidating and more comfortable for patients visiting a gynecologist for the first time. 

  • Bring your own kit: The Nella Comfort Kit is designed to make your gynecologic visit as comfortable as possible. The kit includes a disposable Nella Speculum and a pair of cozy socks to wear during your exam. You can purchase the Comfort Kit and have it delivered directly to your healthcare provider’s office. It’s an excellent option for young women visiting a gynecologist for the first time, helping to make the experience less intimidating.

Taking Control of Your Reproductive Health

Reproductive health is a crucial part of your overall well-being and your awareness can make a big difference in how you feel during an exam. As a young woman, knowing what to expect during your first pelvic exam can help ease anxiety and fear. Ask your healthcare provider for answers to any questions you may have, explore online resources and have a discussion with trusted adults to assist in preparing for the exam. 

With tools like the Nella Speculum and the Nella Comfort Kit, you can make your gynecologic visits more relaxed and less intimidating. Explore our range of women-created gynecological tools today to take a proactive approach to maintaining your reproductive health.
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