Introduction
The first visit to the gynaecologist is an exciting moment for many young women, which brings with it numerous questions and is often accompanied by fears. The reasons for taking advantage of this first visit can be very different. For example, young people may be urged to do so by their parents, others may go with the desire for a check-up or contraception, and others may go now and then because of complaints. The examination only takes a few minutes and is usually painless. The doctor can be asked any questions about periods, sexuality, sexually transmitted diseases, contraception and complaints.
When should the first visit to the gynaecologist take place?
There is no generally accepted ideal age for the first visit to the gynaecologist. Most gynaecologists recommend the first visit before the age of 18. The age depends largely on the individual needs of the patient.
One reason for the first visit to the gynaecologist may, for example, be the desire for sexual intercourse that arises at different ages and therefore a consultation regarding suitable contraceptive methods may be desired. A routine examination, the so-called cancer screening, can also be carried out at any age, starting from adolescence. Here, as with many other examinations, the earlier and the more regular the examination, the better.
The desire for HPV vaccination, for which the vaccination age recommended by the permanent vaccination commission is between 9 and 14 years, can also lead to a visit to the gynaecologist at this age. As a matter of principle, every adolescent or woman should consult a gynaecologist in case of abdominal discomfort, changes or pain in the vaginal area or pain during sexual intercourse, regardless of age. Some gynaecologists offer special teenage consultation hours.
For gynaecological complaints in childhood, both the paediatrician and a gynaecologist specialising in paediatric gynaecology can be consulted. In addition, the desire for HPV vaccination, for which the vaccination age recommended by the permanent vaccination commission is between 9 and 14 years, can also lead to a visit to the gynaecologist at the age mentioned above. As a matter of principle, every adolescent or woman should consult a gynaecologist in case of abdominal discomfort, changes or pain in the vaginal area or pain during sexual intercourse, regardless of age. Some gynaecologists offer special teenage consultation hours. For gynaecological complaints in childhood, both the paediatrician and a gynaecologist specialising in paediatric gynaecology can be consulted.
How does the first visit to the gynaecologist go?
An initial consultation with the gynaecologist is followed by a gynaecological examination. During this examination the patient undresses only as much as is necessary for the examination, i.e. she is never completely naked. Whether the breast or the lower body is examined first depends on the doctor treating the patient.
The examination only takes a few minutes and can be interrupted by the patient at any time. The breast examination is used for breast cancer prevention and is usually not performed routinely in young girls. After the patient has taken off her top, the examination of the breast follows.
Here the gynaecologist carefully palpates both breasts for nodular changes. The armpits are also examined. The doctor may ask the patient to raise her arms for the examination or to lift them up to her hips for a better examination.
After the examination is completed, the patient puts her top back on and undresses her lower body. Now the patient is seated on the examination chair. The back of the backrest is in a semi-recumbent position and the legs are spread apart and placed on the holders provided.
First, an assessment of the external genitals is carried out. Then small mirrors, so-called specula, are inserted into the vagina. This allows the vagina to be pulled apart slightly and made more visible to the examiner.
If the patient has not yet had sexual intercourse, the smallest possible specula are selected to enable the examination to be performed gently. Then the vagina and cervix are assessed with the aid of a light source. From the latter, a cell smear is taken with a cotton swab, which is then examined under a microscope.
This examination is part of the cancer prevention examination, as the most frequent tumours of the female genitals can be formed from the cervix. The last step is a palpation of the abdomen. Here the gynaecologist inserts one or two fingers with some lubricant into the vagina and places his other hand on the patient’s lower abdomen.
In this way, palpation can be performed from the inside and something can be pressed against it with the outer hand. This allows the position, size and mobility of the uterus and ovaries to be assessed. If the patient is still a virgin, this examination is not performed through the vagina but only by applying light pressure from the outside to the lower abdomen and groin. This ends the examination and the patient dresses again. Afterwards, any questions are clarified, the examination findings are discussed and prescriptions are issued if necessary.
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