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FAQ: Your first visit with a Women's Health provider

When should I make my first appointment?

You can make your first appointment with us any time you have questions regarding your gynecologic or sexual health. You should come in for your first exam and Pap test at age 21; even if you are sexually active, you don’t need to be seen before that.

I’m not sexually active. Do I need to see a gynecologist yet?

Unless you have concerns or symptoms you are worried about, you should still schedule your first routine appointment at age 21, so you can have your first Pap test. And even if you don’t have any symptoms or concerns, it may be useful to have the chance to discuss birth control, sexual health, and other topics with a knowledgeable women’s health provider. 

Do I need to wait until I have symptoms before making an appointment?

No, you should have a routine gynecological appointment and your first Pap test at age 21, even if you don’t have any symptoms or concerns. Of course, you should make an appointment at any time if you are concerned about any symptoms. 

Do I need to select a primary care provider (PCP) at MIT Medical before I make my appointment?

While we recommend that all our patients choose a PCP, patients covered by the MIT student or affiliate health plans do not need to have a PCP before scheduling an appointment with a women's health provider at MIT Medical. MIT employees and family members covered by the MIT Traditional and Choice plans are required to have a PCP at MIT Medical before seeing clinicians in the Obstetrics and Gynecology Service. 

What happens during a gynecological appointment?

There are four main parts to a gynecological visit: 
 
Physical exam: Your clinician will perform a typical physical exam—just like your annual physical. The clinician will also ask a number of questions about potentially sensitive topics, including your menstrual cycle, sexual history, sexual partners, drug use, and any history of sexual abuse. Although these are very personal questions, it is important that you give frank and honest answers. Our clinicians aren’t judgmental and, however odd your own experiences may seem to you, they have heard it all before.
 
Breast exam: Your clinician will feel your breasts for lumps, look for any discharge from your nipples, and teach you how to perform a breast self-exam.
 
Pelvic exam: Your clinician will examine the outside of your vagina and then insert a speculum to hold the walls of your vagina open for the internal exam. The clinician will look inside your vagina with a light to examine your vaginal tissues and secretions, your cervix, and take any samples needed for testing.
 
After the speculum is removed, the clinician will perform an exam that involves inserting gloved and lubricated fingers into your vagina while pressing on your abdomen to feel your uterus, ovaries, cervix, and fallopian tubes. The clinician will also test the strength of your pelvic floor muscles and may insert a finger into your rectum to feel for polyps, endometriosis, and other problems. 
 
If you have any questions during the exam, don’t hesitate to ask your clinician what she is feeling for and if everything feels normal. You may feel pressure and sensations similar to cramping during the exam, but it shouldn’t be painful. The more relaxed you are, the less pressure you will feel. If you need to pause and take a break, just let your clinician know. 
 
Pap test: During your pelvic exam, your clinician will use a special brush and a spatula to scrape away and collect some cells from your cervix. Those cells will be tested for any abnormalities. The Pap test also offers an opportunity to test for some sexually transmitted infections. 

What questions will the clinician ask me?

The clinician will ask you about your menstrual cycle, your sexual activity, your current and past sexual partners, any drug use, your current form of birth control, and other topics. These are personal and sensitive questions, but it’s important for you to be as honest as possible. We have heard it all before, and nobody will judge you. 

What is a Pap test? Do I need one? If so, when and how often?

A Pap test is a procedure to screen for cervical cancer. It tests for the presence of precancerous or cancerous cells. To perform the test, your clinician will take a brush and a small spatula to scrape and collect some cells from your cervix. The process is uncomfortable but not painful. Those cells will be sent to a lab to be analyzed, and, depending on the results, you may be asked to come in for a follow-up visit. You should have your first Pap test at age 21. If the test is normal, you should have follow-up tests every three years until age 30. After that, assuming your tests continue to be normal, you should have a Pap test every 3–5 years.

Can I have an exam while I have my period? If not, how long do I need to wait? What is the best time of the month for an exam?

You can have an exam when you are spotting or have your period, as long as your flow isn’t super heavy. If there is too much menstrual blood, the clinician can’t see things as clearly and can’t perform an accurate Pap test. The best time for an exam is a week after your period, but anytime you are not bleeding heavily is fine. If you have any questions about whether you should come in, just give us a call at 617-253-1315. 

How long after intercourse do I have to wait before my exam?

If you are just coming in for an annual exam and have no symptoms, you should avoid intercourse for several hours before your visit. However, if you are experiencing vaginal discharge or bleeding, you should refrain from sexual intercourse for 24 hours before your exam

When should I make an other-than-routine appointment? What symptoms should I worry about?

You shouldn’t hesitate to call us if have any concerns at all. But symptoms that are particularly worrisome would include constant or very heavy menstrual bleeding, vaginal lumps or lesions, or anything else that feels or looks strange.

When should I see my primary care provider (PCP), and when should I see my gynecologist?

In general, you should call the clinician you feel most comfortable seeing for a specific concern. Many health issues, such as urinary tract infections or abdominal pain, can be treated by either PCPs or gynecologists. Many PCPs can perform pelvic exams, and both gynecologists and PCPs can do tests for sexually transmitted infections. If you’re not sure which clinician you should see, call either one, explain your concern, and we’ll make sure you see a clinician who can care for you appropriately. One other consideration: the wait for an appointment with your gynecologist may be shorter than the wait for a routine appointment with your PCP.

I want to get pregnant; when do I need to begin obstetric visits?

If you want to get pregnant, call the Obstetrics and Gynecology Service at 617-253-1315 to schedule a “preconception visit.” This visit may include blood tests for genetic conditions, infections, or hormonal imbalances. The clinician will also discuss optimal timing of sexual intercourse and other topics related to getting pregnant and early pregnancy

I’m having difficulty conceiving; can MIT Medical help?

Yes. Call the Obstetrics and Gynecology Service at 617-253-1315. We can discuss infertility issues with you and, if necessary, refer you to specialists. 

How can I arrange to be tested for sexually transmitted infections (STIs)?

You can call your primary care provider or gynecologist. We can also perform some STI testing when you have a Pap test. All tests are confidential. Learn more about STI testing at MIT Medical.

How often should I be tested for sexually transmitted infections (STIs)?

There is no single answer to this question, because everyone is unique. Based on your sexual history, your gynecologist or PCP can advise you about how often you should be tested and for which infections. Your clinician can also provide information about safe sex methods. You do not need to be tested for STIs until you are sexually active. No baseline measures are necessary.