The First Gynecological Examination

For many young women, the first visit to a gynecologist is often their first adult encounter with a physician. There is often a long hiatus between their last visit to a pediatrician during their teenage years and their first visit to a doctor as a young adult.

When a woman is college bound, or in college, she may need to see a doctor because she’s now sexually active and needs contraception, or because she develops a common vaginal condition, like vaginitis or a urinary tract infection. A primary care physician can conduct the gynecological exam if no gynecologist is available.

It’s very important that a young woman’s first encounter with a gynecologist not be traumatic. I think young women should see their gynecologist for the first time by the age of 18 or so; it’s essential that they learn their pelvic organ status, and begin to develop a health portfolio, especially if they’re thinking of having children one day.

During the gynecological examination, a doctor will perform a physical exam of the vaginal area, first by paying attention to the outside anatomy to make sure that it’s well developed. Next, the doctor will use a speculum, or polished plate used as a reflector, to inspect the cervix and the vaginal walls. Then, employing something similar to a Q-tip, the doctor will scrape from the cervix some tissue that will later be tested for precancerous and cancerous cells; this is called a Pap test, or Pap smear. The Pap test is designed primarily to detect cervical cancer, which is treatable if found early, but it can also identify hundreds of other minor problems, such as inflammation and the presence of HPV, the human papilloma virus.

The doctor will also examine the patient’s breasts for lumps and other changes. Not only will this exam detect lumps or abnormalities, but it should serve as a perfect opportunity, in the first few gynecological visits, for a young woman to learn how to do a breast self-examination. Often the breast self-exam is what alerts a woman to a potential problem, so it’s important that she become familiar with her anatomy at an early age to be able to detect any changes that may occur later on.

Click here to check out Dr. Manny's book The Check List (Harper Collins, 2007), from which this article was excerpted.

Dr. Manny Alvarez is the managing editor of health news at, and is a regular medical contributor on the FOX News Channel. He is chairman of the Department of Obstetrics and Gynecology and Reproductive Science at Hackensack University Medical Center in New Jersey. Additionally, Alvarez is Adjunct Professor of Obstetrics and Gynecology at New York University School of Medicine in New York City.