You can schedule a GYN visit because you are due for a PAP smear, wish to start a birth control method, or to discuss any GYN concern or questions you may have. Here are the details about what you can expect during each part of a GYN visit:

Medical History
In a private exam room, your medical provider will ask you about your medical and sexual history. Important questions your provider will likely 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 are at risk for pregnancy, 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 so that you get accurate information and appropriate health care. Don't hesitate to ask sexual health questions, even if it may feel awkward or embarrassing. Your medical provider will have heard the same or similar questions before.

You can discuss whether you would like STI testing. Talk to your provider if you are worried about symptoms you may have experienced or if you are concerned about risks you have had. An internal exam is not usually required for STI tests, which can be done with urine or blood samples.

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 and weight. Your provider may also ask you to give a urine sample if there is any chance of pregnancy.

Physical Exam

You and your provider will discuss whether a breast exam, physical exam, or internal pelvic exam are necessary for you based on your age, medical history, and preferences.

Next, the provider will ask you to get undressed and put on a paper gown. You can leave your socks on if you like. Sometimes you will only be asked to undress from the waist up.

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, if indicated, they will ask you to lie back on the exam table and will perform a breast exam. They will feel your breasts to detect any lumps or thickening. If you don't know how to perform self-exams, your provider will show you how.

Pelvic Exam and STI/Lab Tests
Next, if a pelvic exam and/or PAP is to be done at the visit, 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 they 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 they 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 results. Sometimes, STI or other GYN tests are done as well by taking samples with a Q-tip. 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 they 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. They are 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 abnormalities in the muscles that separate the rectum and the vagina or to get a better feel of the uterus.

Counseling
At this point the exam is complete. Your provider will leave so 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:

• Sexuality

• STIs

• Birth control

• Pregnancy

• Abortion

• Infertility

• Breast self-exams

• Any other general health topic 

The entire visit including paperwork and the question and answer session with your provider will usually take about 40 minutes, especially if you have questions or are seeking a contraceptive method. A pelvic exam and/or PAP smear as part of the visit may take about 5 minutes - not long at all. 

After your first GYN visit, your health care provider will tell you how often you should have exams, including pelvic exams and Pap tests. How often you need to be seen will depend on your medical history and individual health needs. 

In general, an annual GYN visit is still advised for people using prescribed hormonal contraceptives (pill, nuvaring, etc.) regardless of age or whether a Pap is due. This is an opportunity for your provider to update your medical and sexual health history, offer STI screening and important vaccines such as HPV, and renew your prescription for contraceptives. Sometimes a brief physical exam may be needed but having a pelvic exam at annual visits can be a shared decision between you and your provider.

For those not  using  hormonal  contraceptives, including those with an IUD, a periodic GYN visit is still a recommended part of routine health care, regardless of age or whether a Pap is due. Your primary health care provider at Health Services can address any sexual health concerns, offer STI screening, etc., and get to know your unique history. Again, the decision to do a pelvic exam at periodic GYN visits can be a shared decision between you and your provider.

If you are a Brown student, you can make a confidential appointment for a GYN visit at Health Services by calling 401.863-3953.  All Health Services providers are trained in routine gynecological care. Health Services provides a range of services including general health care, STI testing, and emergency medical care. Health Services is located in the Health and Wellness building at 450 Brook Street.

Yes, at Health Services, you may request a specific provider by name or by gender. If you choose, you may also request a second staff person or a trusted friend be present during the exam.

If, after reading this page, you still have concerns about the GYN visit and are nervous or unsure, that's ok. For example, people who have experienced sexual abuse or assault in the past may have specific fears that relate to their experience, or in some cultures, pelvic exams are not done. You can schedule a separate 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 can 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 visit. 

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.