Help! I’m scared for my first trip to the gynecologist!

Totally normal, so let’s talk it out!

First, the current recommendations for someone with a vagina to visit the gynecologist is to start when you’re 21 in the United States. Why is that?

This brings us to the second point—what is done during many trips to the gynecologist. A pap smear. A pap smear (named after the guy who figured out its utility, Dr. Papanikolaou) is a sampling of cervical tissue to see if there are cancerous cells. How does the gynecologist get to the cervix?

Here’s the third point—the exam. You will be asked to sit on the exam table without underpants on (but covered with a drape and/or gown) and will have your legs spread. The doctor will insert something called a speculum (see picture) into your vagina. They will then open it little by little so that they can see your cervix (check out more on anatomy here). They will then take a sample of your cervical tissue.

So back to the original point—waiting until you’re 21. We now know that the chance of developing cervical cancer before you are 21 is extremely low, so it’s not worth putting you through the exam if it’s really not necessary. That said, you may have symptoms at an earlier age which will make a doctor want to do a pap smear sooner. That’s okay, too, but you don’t need one without a specific reason.

Cervical cancer is primarily driven by HPV. HPV rarely causes cervical cancer changes before 21. Even more importantly, we have a vaccine for HPV, so you can potentially prevent most cervical cancers (and the need for extra pap smears in the future!) by getting the vaccine.