At the gynecologist, the first time

The first visit to the gynecologist can create some anxiety. For this reason, it is sometimes postponed. That is when it would be appropriate.

Obstetrics and gynecology are both branches of medicine that deal with the female genital system. If the midwife is specialized in assisting the woman during pregnancy, childbirth and puerperium, the gynecologist is one of the best allies of women’s health from the beginning of childbearing age until menopause and beyond, as well as the doctor who, together with the midwife, has the privilege of accompanying her during the very engaging period of pregnancy.

He is turned to for extemporaneous disorders, perhaps not serious, but never trivial; to prevent and treat more serious pathologies; to face sexuality and its transformations in the different stages of life with serenity.

The gynaecologist deals with the treatment of disorders of the female genital apparatus, such as irregularities of the menstrual cycle. To this end, it assesses the state of health of the external genital organs (vagina and vulva) and internal (uterus and ovaries), as well as the breast.

In addition, it gives tips on how to avoid an unwanted pregnancy, with clear and simple explanations on the various contraceptive methods, but also on how to fulfill the dream of becoming parents in the case of fertility problems. It provides clarification on the changes occurring in a woman’s body, aspects of sexual life and how to prevent the risk of contracting sexually transmitted diseases.

There is no age to wait

For every doubt or problem the gynecologist has the right answer. But, when to ask him for the first time?

There is no ideal age to start undergoing periodic gynecological examinations. In the absence of specific disorders, the first contact can occur after menarche (the appearance of the first menstruation), although there is no real need. It is a way, in fact, to trigger a positive habit, educate and raise awareness on fundamental aspects of reproductive health.

It should be noted that the age of the first visit, generally indicated around 15 years, can drop to 12 years in case of an advance of body development. If the first period has not yet occurred at the age of 14, it may be useful to contact him to identify the causes.

At this age, the gynecological examination is also important to get to know your body and to prevent inflammatory problems that very often affect adolescents. The immune defenses of the genital area, in fact, are less than in adulthood due to possible allergies to intimate cleansers and alterations in the degree of acidity of the vaginal area.

If a vaginal and cervical exploration is necessary, do not be afraid, because tools suitable for this age and absolutely non-traumatic are used.

How the visit takes place

The gynecological examination involves the observation of the external genitalia (to detect the presence of any inflammation) and the internal genitalia to examine the walls of the vagina and the cervix (using a small instrument that is inserted into the vagina, the speculum) and evaluate the shape and volume of the uterus and ovaries.

Even if the woman has not yet had sexual intercourse, there should be no fear, because the gynecologist will use a very small speculum and the hymen will remain intact, as it is a particularly elastic structure.

In case of further investigation

If the gynaecologist deems it appropriate, for a more in-depth investigation he can subject the patient to an ultrasound of the genital apparatus that can be performed with a small ultrasound probe that is placed on the abdomen, or with a special transvaginal probe. It is a painless examination that allows you to “photograph” the uterus and ovaries, also used in pregnancy to assess the development of the baby.

If necessary, the gynecologist will also decide to perform the Pap test, which consists of taking some cells from the cervix, and then analyzing them in the laboratory.

The Pap test is an examination that it is good to start doing immediately after starting to have sex. This simple procedure, in fact, serves to highlight the presence of any abnormalities of the cells of the cervix: in addition to allowing an early diagnosis of cervical cancer, it allows to highlight some types of infections.

But the gynecological examination is also important for other reasons. First of all, proper intimate hygiene or the importance of not underestimating some symptoms (such as intermenstrual blood loss, vaginal itching and burning, abnormal color secretions, too abundant or smelly) that could be considered trivial, but which instead are the indicator of some gynecological diseases, such as chlamydia or other sexually transmitted diseases.

And, last but not least, the opportunity to provide for the adoption of contraceptive methods and / or able to protect against sexually transmitted diseases. Although not immediately required, in fact, they offer the opportunity to educate to a healthy and safe sexuality, important to support the physical and psychological well-being of adolescents, to improve the perception and management capacity of their body and to start a serene dialogue.

Finally, the gynecologist also proceeds during each visit to palpation of the breast, which is performed with the patient first sitting and then lying on the bed, in order to exclude, or to recognize early, the presence of nodules.

Even more so if…

Menstruation can be very painful indeed. And this is an extremely widespread phenomenon, but often overlooked because it is mistakenly considered “natural”. Menstrual pain – or dysmenorrhea – should, however, be reported to the gynecologist from the onset.

The problem can occur from the very first cycles and, if it is not addressed early in a targeted manner, it inevitably tends to worsen over the years, significantly reducing the quality of life of the woman for several days each month.

Relieving it is not always easy, but sometimes the right analgesic taken as needed or the regular intake of an estroprogestin pill may be sufficient, which only the gynecologist can suggest with knowledge of the facts.

After the first report

If it has not already been carried out previously, a gynecological examination becomes indispensable after the first sexual intercourse. Even if there are no fears of pregnancy or other problems, a general control of the reproductive system (integrity of the vaginal mucosa, state and position of the uterus, conformation of the fallopian tubes, macroscopic characteristics of the ovaries) is important to protect yourself from more serious disorders later.

If this initial meeting takes place relatively late, around the age of 22-23, you can also take the opportunity to carry out the first Pap test, the need for which, it must be remembered, does not fail even for young women who have already been able to take advantage of vaccination against HPV, because the vaccine does not ensure absolute protection from all strains of the human papilloma virus potentially capable of causing uterine cancer.

And if it has to be done very soon

When the first visit takes place very early, around 8-10 years, due to precocious puberty or the appearance of unusual symptoms (pelvic pain not justified by intestinal or urinary disorders, abnormal vaginal discharge, etc.), the mother should prepare the child psychologically.

It is sufficient to explain to her in broad terms what the visit will consist of and reassure her with respect to the maneuvers and instrumental examinations that the gynecologist may have to perform (for example, an ultrasound).

In general, then, the preliminary interview with the doctor is able to put the little patient at ease and to establish a relationship of trust that will last for decades to come.

All the information your gynaecologist needs

To get a complete picture of each patient, the gynecologist during the first visit will need to ask some questions: at what age the first menstruation arrived and the date of the last; if the menstrual cycle is regular or irregular and if menstruation is abundant or painful; if the patient has undergone surgery or if she takes medication; if she smokes, if she has particular disorders and if she follows a proper diet.

In addition, he also wants to know his family history: whether among the closest relatives there have been cases of breast, ovarian or uterine cancer or cases of stroke or thrombosis, as well as a possible predisposition for cardiovascular disease among the parents. This information is very important for example if the patient wants to start taking the birth control pill or another hormonal contraceptive.

In case of problems or disorders, moreover, this information helps to better orient the therapy and to clearly explain the reasons for the therapeutic choice and the method of taking any drugs. In this way you can have two advantages: it facilitates the work of the gynecologist and the specialist can easily keep the patient’s medical card updated, so that no information will be lost.

On the other hand, the patient herself can ask the gynecologist questions or ask for clarifications that may also concern sexual life. Particularly suitable for this purpose are family counselling, structures designed in particular (but not only) to deal with the most intimate problems of girls and adolescents. In these facilities, in addition to the gynecologist, you can find other specialists, such as the psychologist.