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Articles/When To See a Gynaecologist & What To Expect at Your First Consultation

When To See a Gynaecologist & What To Expect at Your First Consultation

Author
Dr Len Kliman Specialist Gynaecologist
8 mins mins read December 8th 2021
a headshot of dr len kliman a gynaecologist in melbourne

Women will seek gynaecological care for a number of reasons. You may be referred by your general practitioner if you experience any acute or chronic conditions relating to the female reproductive system.

Your gynaecologist will have in-depth knowledge of the reproductive system as well as women’s general health and will be able to provide specialist care for women of all ages. Whilst most gynaecological problems are not life-threatening, they can be life-altering. Most gynaecological problems can be managed in a variety of ways and can include medical, surgical and/or complementary care.

What Is a Gynaecologist?

A gynaecologist is a medical specialist who specialises in female reproductive health. They are able to diagnose and treat issues related to the female reproductive tract which include the uterus, fallopian tubes, vulva, vagina, ovaries and breasts.

What Sort of Conditions Do Gynaecologists Treat?

You may be referred to see a gynaecologist for one of the following reasons:

  • Abnormal cervical screening tests/colposcopy
  • Contraception
  • Menopause and scientifically based menopause hormonal treatment
  • Polycystic ovary syndrome (PCOS)
  • Menstrual dysfunction -heavy, painful or irregular periods
  • Premenstrual dysphoric disorder (PMDD)
  • Vulval and vaginal skin disorders
  • Investigation of infertility
  • Recurrent miscarriage
  • Pre-pregnancy consultation
  • General gynaecology

When Should You See a Gynaecologist For The First Time?

There’s no set rule that outlines when’s best to visit a gynaecologist for the first time, it’s dependant upon a multitude of factors. Some women will visit a gynaecologist for the first time if they develop a symptom or a problem that requires a gynaecological opinion – though often patients are referred to gynaecologists through their GP if they believe their symptoms/condition warrants a gynaecological consultation.

What Should I Expect At My First Gynaecological Appointment?

At your initial consultation, your gynaecologist will take a full medical and surgical history, ask about allergies, relevant family history and ask if you are currently taking any medications.
In order to get to know you, he/she will ask about your occupation and interests.
Most importantly, your gynaecologist will ask you about the reason you have come along to see him/her. Depending upon the reason for your consultation, a pelvic examination may be performed and if you are due for a cervical screening test, this will also be performed. Your gynaecologist may perform an abdominal or vaginal ultrasound if this is warranted. From here, blood tests and more detailed scans/x-rays may be recommended.

It’s worth noting that if you have never been sexually active that you will not need a gynaecological examination.

What Happens During a Gynaecological Examination?

If your gynaecologist feels that it is necessary to perform an internal examination you will be given a clean laundered gown and left alone to change out of your clothes – you will then be asked to lie down on the examination couch and given a fresh sheet to drape over and cover you.
Firstly, your gynaecologist will perform a breast examination as this will help identify any irregularities such as lumps. He/she will use his hand to palpate the breast and this also gives you the opportunity to mention any areas that you are concerned about.

During the pelvic examinations, you will be asked to try to relax and drop your legs out to the side. It is important that you try to relax your abdominal and vaginal muscles during the examination, as this will make it more comfortable for you. Your gynaecologist will use a lubricant gel on his glove and perform a gentle, manual examination. You may be asked if there are any particular areas of pain or tenderness during this examination.

Your gynaecologist may also perform a speculum examination where a sterile metal speculum is inserted into the vaginal. The speculum is gently opened helping to separate the walls on the vagina, allowing for better isolation of the cervix and the cervical canal. If a cervical screening test is required, this will be taken by using a tiny plastic spatula to collect cells from the cervix. During the insertion of the speculum, you may feel some discomfort but your gynaecologist will be gentle and the use of a lubricating gel makes the examination more comfortable. The vagina and vulva will also be inspected for any skin abnormalities. Vaginal swabs may be taken if indicated in the presence of suspected infection or excessive discharge.
If an abdominal or vaginal ultrasound is required, your gynaecologist may be able to perform this in his/her office depending upon his/her level of expertise and training in this area.

What Sort of Questions Will My Gynaecologist Ask Me?

Depending upon the reason you have been referred to your gynaecologist, some typical questions may include;

  • Do you have a regular cycle?
  • Do you experience abnormal bleeding or
  • bleeding after intercourse?
  • Are you trying to conceive?
  • Do you experience pain and if so, how would you describe the pain?
  • Do you suffer from any abnormal discharge?
  • Do you suffer from genital pain, itching or discomfort?
  • When was your last cervical screening test?
  • Are you taking the contraceptive pill?
  • If you are over 40 years of age, have you had a mammogram or bone density study?

What Should I Wear To My Gynaecological Appointment?

Every day, comfortable clothing is perfect for your first gynaecological appointment. You may need to undress for an examination so clothing that is easy to remove is recommended – you will be given a freshly laundered gown to wear in replace of your clothing during the examination.

Do I Need To Shave or Wax Prior to My Appointment?

Shaving or waxing prior to your gynaecological appointment is definitely not necessary or recommended, as it may lead to cuts, bruising and swelling of the genital area. If you have a vulval skin disorder this may inflame the area and make visualisation and diagnosis more difficult.

Can I Continue Using Vaginal Creams Prior To My Appointment?

Whilst some women will find it embarrassing to attend a doctor’s appointment with unpleasant discharge, it is very important that you do not use vaginal creams, gels, foams or pessaries for 48 hours before your appointment. It is important not to feel embarrassed about any abnormal offensive discharge or abnormal bleeding. You will be treated in a respectful manner and given privacy before and after any examination.

Should I Keep My Appointment If I Am Bleeding?

Whether you attend your gynaecological appointment or not if you are bleeding on the day depends upon the reason for your visit. If you are attending for a check-up and are due for a cervical screening test or a colposcopy (a procedure for those women who have had an abnormal cervical screening test in the past) and are bleeding on the day then it would be best to reschedule your appointment.

If the reason for your visit is abnormal bleeding or pain, then it is best to attend your appointment. If an examination is indicated then this can be rescheduled to another time.

Most gynaecologists have registered nurses working for them so if you are unsure, just contact their office and they will be able to advise you.

Can I Bring Someone With Me To The Appointment?

If it makes you feel more comfortable you may bring a family member, partner or friend with you for your appointment. Alternatively, if your gynaecologist has a registered nurse working with him they may be present to assist if a more detailed examination such as a colposcopy/vulvoscopy is required to be performed. It is normal to experience some anxiety before attending your first gynaecological appointment but you will be treated with dignity and respect. Examinations are only performed if it is deemed necessary to assist in the diagnosis of your particular concern.

Whatever condition you are experiencing, your gynaecologist would have seen women with similar conditions and be familiar with your particular challenges.

What Should I Expect After The Examination Is Completed?

You will be given privacy to dress and your gynaecologist will then discuss any findings with you, what additional tests and investigations he/she feels are warranted and when you would need to see him/her for a follow-up consultation. Your gynaecologist should advise you of when any test results will be expected. He/she should will also write to both your referring doctor and yourself to put in summary what had been discussed and what the plan will be moving forward.

What Else Can I Do To Prepare For My Initial Gynaecological Appointment With My Gynaecologist?

It’s a good idea to write down any questions you may have before attending your appointment to ensure all your concerns are addressed. These questions may or may not be related to your current condition. It’s important to be open and honest during the appointment, regardless of how embarrassing it may seem to you. It’s often helpful for your gynaecologist if you come prepared with a list of questions, as it will assist them with making a diagnosis.

Your gynaecologist and his/her staff should abide by strict patient confidentiality rules that will protect your privacy at all times.

In general you should feel comfortable with your gynaecologist and the health care recommendations that they make. The relationship between you and your gynaecologist should be respectful and honest. The frequency of gynaecological visits will be based upon the particular condition for which you have been seen.