how often for gynecologist visit

How Often Should I Go to the Ob-Gyn? Here’s What Experts Say

By Rosemary Donahue

Another day, another reason to put off making that appointment. But for every reason you can think of not to go, there’s a better reason to book it, experts say. After all, the more time that lapses between visits, the more changes in your life occur. You may need to get that Pap test you’ve been putting off, reassess your thoughts regarding hormonal birth control and other forms of contraception, or have a general checkup with your doctor.

But how often should you actually be seeing your ob-gyn or your general health care provider to talk about your reproductive health-care options? That all depends on a few things.

How often should I go to the ob-gyn?

It’s good practice to make an annual visit to see either your ob-gyn or your general health-care practitioner for an exam, according to all the experts Allure spoke to for this story. However, you may not need a Pap test every year. “The annual exam needs to be really thought of as a health screening exam of both the breasts and the pelvis,” says Taraneh Shirazian , M.D., a board-certified ob-gyn and gynecological surgeon at NYU Langone Health. “You may not get a Pap smear at your annual; it depends on your history.” Dr. Shirazian explains that many only need a Pap test every three to five years, the exception being those who have HPV, for whom a yearly is still recommended.

As far as when these annual exams should start, Mary Jane Minkin , M.D., clinical professor of obstetrics and gynecology at Yale School of Medicine, says age 21, though she emphasizes the importance of STI [sexually transmitted infection] testing for those who are sexually active at any age, as well as contraception for anyone who isn’t trying to get pregnant. For those who aren’t using another form of birth control and aren’t in a mutually monogamous relationship, “the key thing is using condoms 100 percent of the time and, if having sex with different partners, you definitely want to be getting STD-checked or STI-checked at least once a year,” advises Dr. Minkin.

However, if you’re experiencing certain conditions, you may want to schedule a visit in between your annual exam. “There are many reasons why patients may see an ob-gyn more frequently, including uterine fibroids , ovarian cysts, infertility, pregnancy, irregular bleeding, breast concerns,” explains Leena S. Nathan , M.D., ob-gyn at UCLA Health Westlake Village in California. If this sounds like you, don’t wait until it’s time for your next yearly visit — make an appointment to see your ob-gyn or general health care provider.

What can I expect during a visit?

During a routine visit with your ob-gyn (or your general health-care provider), they’ll take a comprehensive history of your medical health. Dr. Nathan tells Allure that a breast and pelvic exam will be performed during a visit, as well as a Pap test, if deemed necessary. “After the history and examination, we counsel patients on any issues or needs they may have,” she says.

Your doctor may discuss STI- or STD-testing with you, as well as your current methods of birth control.

Some practitioners may also include a rectal exam, depending on certain risk factors. “[For people] over the age of 40, I usually do a rectal exam as part of my pelvic exam,” says Dr. Minkin. “Some people don't. But colon cancer is something we're paying more attention to.”

What do I need to know about hormonal birth control?

Hormonal birth control is one of the topics Dr. Shirazian gets asked about the most. She explains that it has therapeutic value beyond its use as a contraceptive:

“It offers women who have underlying gynecological conditions some treatment or therapy. For example, it's good to use birth control or hormonal therapy if you have endometriosis, if you have chronic pelvic pain, if you have heavy periods, if you have fibroids, because it can help mitigate those symptoms.”

Hormonal birth control can help decrease or eliminate periods, says Dr. Nathan, and it's a reliable form of contraception. However, for it to be as effective as it should be, you have to take it as directed , which may be difficult for some. She also cautions that “there can be a risk of irregular bleeding or blood clots with estrogen-containing contraception,” so you’ll want to talk to your health care provider about your own risk factors before taking it.

And it may not be a good option for those who suffer migraines with aura, says Dr. Minkin, as it can increase the risk of stroke in people who suffer from those particular migraines. However, this is a small percentage of the population, and many people looking for contraceptive options are great candidates for hormonal birth control.

What if I haven’t been for a while and I’m anxious about booking an appointment?

It’s understandable to be anxious about booking any doctor’s appointment, especially if you haven’t been for a while. However, your health is important, and getting a checkup is too. Dr. Shirazian emphasizes the importance of screening and preventive care. “It's so important to come in for yearly visits, because often your doctor will pick up things that you didn't even know you had, like a lump in the breast , or a cyst,” she says. During the pandemic, she’s had a few patients who missed visits and later found irregularities during mammograms. She says it’s a missed opportunity not to come in for a yearly exam.

By Aliza Kelly

By Taylore Glynn

By Kara Nesvig

However, all the experts Allure spoke to acknowledged that getting an appointment may not be as easy as it once was. Dr. Minkin says that even though many doctors have reopened their brick-and-mortar offices, they’re often still willing to do telehealth visits whenever possible. While you can’t exactly get a breast or pelvic exam over Zoom, you can ask questions about your health or meet a new doctor for a consultation. “Let's say you need to discuss contraception, that's a very good thing to do a telehealth visit,” she suggests.

Dr. Nathan distills it down to this: “Find a doctor you trust and feel comfortable with. Ask your friends for recommendations. The right doctor will make all the difference in your experience,” she says. This is sometimes easier said than done, and it can be time-consuming, but if the alternative is just not making an appointment, it’s time well spent. Dr. Shirazian agrees: “If you feel uncomfortable going back to someone because you've had a bad experience, there are lots of choices. Come in to see another provider, but don't sacrifice your health.”

Read more about health and wellness:

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• How Often Should You Visit the Gynecologist?

Based on your age and other health factors, this is how often you should see your gyno

• OB/GYN Knowledge Center

Many women associate visits to their gynecologist with birth control prescriptions or pregnancy check-ups . However, a gynecologist is an important part of your healthcare team who is needed for more aspects than just these visits.

For instance, your gynecologist can help you understand how your reproductive system works, teach you about protecting yourself during sex, and answer any questions or concerns you may have about your reproductive system and sexual health.

Regular well-woman care visits are important to ensure you are healthy and to prevent problems from arising in the future.

When to see a gynecologist

You should see a gynecologist if you suspect that you have reproductive issues, are pregnant, for pre- and post-menopausal care and for annual visits. Other reasons to see a gynecologist include:

• Checking for sexually transmitted infections (STI)
• Learning more about your birth control options and what is right for you
• Confirming a pregnancy
• Discussing menstrual problems or concerns
• Asking questions about any concerns you have regarding vaginal discharge, pain, redness or itching
• Checking the breasts if you discover a lump or tender area

First gynecologist visit

When should you see a gynecologist for the first time?

Going to the gynecologist for the first time may seem a little intimidating. Determining when is the right time depends on your own situation.

Experts recommend that between the ages of 11 and 18, young women should continue to see their pediatrician or family doctor for most concerns. Any health concerns regarding the female reproductive system, however, warrant a visit to the gynecologist. This may include changes in menstruation , delayed puberty or the inability to use a tampon.

Ideally, the first visit should happen before a woman becomes sexually active. This is a good time to talk about reproductive health, what is and isn't normal, and to figure out contraception. Women who are 21 years old or older need to visit the gynecologist to have regular Pap smears .

Gynecologist visits before, during and after pregnancy

If you are ready to have a baby, visiting the gynecologist before conception may help. Gynecologists who also provide pregnancy care are known as obstetrician-gynecologists, or OB/GYNs. You can learn more about ovulation, get a check-up to ensure you are healthy and begin taking prenatal vitamins.

If you are having problems with conception , the OB/GYN can help determine if there are any problems and refer you to a fertility specialist if necessary.

During pregnancy, you should regularly visit your OB/GYN. Visits will be scheduled approximately:

• Before or at 12 weeks of pregnancy
• Every 4 weeks until you are 28 weeks along
• Every 2 weeks from 28 to 36 weeks
• Every week from 36 weeks until birth

Your OB/GYN will help prepare you for birth and deliver your baby. After you give birth, you will visit your OB/GYN several more times. They will check to see if your uterus is shrinking as normal, check your C-section or episiotomy incisions, look for symptoms of postpartum depression and help you choose safe contraceptives you may want going forward.

Pre- and post-menopausal gynecologist appointments

The average age that a woman goes through menopause is 51 years old, though it can begin as early as in her 40s. Menopause marks the end of menstrual cycles and fertility. Perimenopause is the time before menopause as the body prepares to enter the process. This can be marked with lighter, heavier or irregular periods. Visiting the gynecologist when you are perimenopausal is a good way to ensure your period irregularities are expected rather than abnormal.

Women who are past menopause should also continue to visit their gynecologist. Doctors recommend that Pap smears continue through the age of 65. Visits after menopause may also be needed for vaginal or vulva irritation or dryness, incontinence or suspected pelvic organ prolapse .

Annual well-woman checkups

According to the American College of Obstetricians and Gynecologists, pelvic exams are recommended annually. Pap smears should occur at least every 3 years as long as previous tests have been normal. Abnormal Pap smears may warrant more frequent tests or exams. During these exams, your gynecologist will screen you for any problems with your vagina, uterus, cervix, ovaries or Fallopian tubes.

A breast exam should also be performed regularly to check for lumps or changes in your breast tissue. Your gynecologist can also help you schedule your yearly mammogram after the age of 40.

Your gynecologist will be with you for many important stages of life, so it’s important to find one who you trust. Find a doctor that offers high-quality, compassionate care so that you will feel comfortable regularly visiting them for all of your health needs.

If you live in North Florida, we invite you to consider All About Women for your gynecologist needs. Schedule a consultation with one of our compassionate and knowledgeable doctors today and we’ll be happy to answer any questions you have.

When to See a Gynecologist for the First Time and What to Expect

Knowing when to see a gynecologist for the first time can be puzzling, but for young women, meeting with an OB-GYN earlier on can set you up for a strong foundation of reproductive health, well-being and open communication.

This article is based on reporting that features expert sources.

When to See an OB-GYN for the First Time

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Usually, parents take their child to a health care specialist due to an existing health concern. A pulmonologist follows their asthma, a psychiatrist manages ADHD or diabetes is overseen by their endocrinologist.

When it comes to a first gynecologist visit, it's crucial for women and young girls to proactively receive care as an integral part of their overall health and well-being.

What Age Should Girls First See an OB-GYN?

The American College of Obstetrics and Gynecology recommends that girls establish care with an obstetrician-gynecologist, or OB-GYN, between the ages of 13 and 15.

Most girls get their first period between the ages of 10 to 16, and up to 42% of teenage girls become sexually active between ages 15 to 19. ACOG adds that adolescent girls may have a first gynecologist visit for any of the following reasons at any time:

• Have not had their period by 15 years of age.
• Heavy, irregular or painful periods.
• Puberty concerns, like acne or unwanted hair growth. 
• Sexually active.
• Questioning their gender identity.

Dr. Anne Smith, a pediatric and adolescent OB-GYN at Yale Medicine and assistant professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine, says, “The primary goal for seeing patients early is to provide preventative care.” Knowing what is normal and what is abnormal can also empower teenage girls, especially regarding puberty and menstruation.

“OB-GYNs can also have a focused discussion with teens about reproductive health, as well as healthy relationships, bone health and other lifestyle factors,” she adds.

Why See an OB-GYN Instead of a Primary Care Provider?

A primary care provider , or PCP, is a medical provider well-versed in typical health care conditions prevalent in the general population. PCPs are excellent at treating common health conditions, helping to coordinate care or recommending specialists.

So, if a teenage girl has a common concern, like a painful period, why should they see an OB-GYN rather than their PCP ? It is in the scope of a PCP to listen to these concerns and recommend a treatment plan. However, Smith suggests some adolescents could be more comfortable discussing their concerns with an OB-GYN.

“They have specialized training in these sensitive topics,” she explains.

Most teens are nervous about seeing an OB-GYN for the first time. Still, Smith explains that an OB-GYN can listen to the teen’s concerns, and they shouldn’t worry about invasive exams or procedures during their first visit.

What Happens at an Initial OB-GYN Visit?

During a first visit with an OB-GYN , the primary goal is to get to know the teenager and establish a trusting relationship.

A first gynecologist visit will often follow this structure:

• Gathering initial information.
• Checking on overall health.
• Discussing concerns.
• Conducting an assessment.

Gathering initial information 

This includes race and ethnicity, religious background, age and family structure, so the OB-GYN can be sensitive to any personal needs and preferences.

Checking on overall health 

A nurse or medical assistant will take vital signs, height, weight and last menstrual period. They will also ask if the purpose of the visit is to establish care, or if there are other health concerns.

Dr. Ashanda Saint Jean, the chair of obstetrics and gynecology at Health Alliance Hospitals Westchester Medical Center and a member of WMCHealth in Valhalla, New York, says, “At the first visit, a detailed history is obtained. Often, parents are quite useful in filling in the blanks of many early childhood medical conditions, hospitalizations, medical allergies and adverse reactions and past surgeries.“

Discussing concerns 

The provider will introduce themselves and spend some time understanding any prevalent concerns.

“Creating a safe space and opportunity to ground that experience in trust will strengthen a bond of trust and temper nerves,” Saint Jean explains.

Conducting an assessment

An assessment could be looking at acne, asking more in-depth questions about pelvic pain or discussing what to expect with physical development during puberty.

Dr. Andrea Braden, breastfeeding medicine specialist at Lybbie, a lactation innovation company, says, “Depending on the age and risk factors of the patient, bloodwork may also be drawn at a first visit as part of a preventive care workup. These blood tests can check for illnesses that require further treatment but may not be apparent on physical exam alone.”

Are you concerned about an unwanted pap smear or a pelvic exam? Pap smears are only recommended for women over age 21, regardless of when they become sexually active. Pelvic exams are only done on teenagers if it is medically necessary to address a specific concern, and only after their OB-GYN establishes trust and receives informed consent from their patient. Saint Jean adds that “patient-centered care is the bedrock of trust-promoting and fear, anxiety and stress reduction. This holds true for young teenage patients, as well.”

Patient Confidentiality at Teenage Gynecology Visits

Both parents and their teenage girls may have questions or concerns about their privacy and confidentiality. Parents want to ensure they are privy to their children’s health status, and teenagers may not want their parents to know about their sexual activity or gynecological concerns.

Rules on patient confidentiality in regard to sexual health differ in each state. The American Academy of Pediatrics says that these laws are highly variable and do not reflect any pediatric standards of care.

To check what the laws are in your state, visit your public health department website. There are differences in regulations with each of the following types of care:

• General medical care. 
• Immunizations, including the HPV vaccine.
• Sexual assault evaluations. 
• STI/ HIV testing and treatment. 
• Contraceptive care . 
• Prenatal care . 

“Given the sensitive nature of reproductive care, many young teenage patients rely on privacy and confidentiality when accessing these care pathways,” Saint Jeans says. “Honoring this patient/physician relationship contributes to building a bridge of trust with our young teenage patients, thus allowing an avenue to exist where care can be sought and delivered without the fear of divulgence and breach of confidentiality.”

Best Women's Health Medicines

The U.S. News Health team delivers accurate information about health, nutrition and fitness, as well as in-depth medical condition guides. All of our stories rely on multiple, independent sources and experts in the field, such as medical doctors and licensed nutritionists. To learn more about how we keep our content accurate and trustworthy, read our  editorial guidelines .

Braden is a board-certified OB-GYN based in Atlanta and a breastfeeding medicine specialist at Lybbie, a lactation innovation company.

Saint Jean is the chair of obstetrics and gynecology at Health Alliance Hospitals Westchester Medical Center, a member of WMCHealth in New York.

Smith is a pediatric and adolescent obstetrician-gynecologist at Yale Medicine and assistant professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine in Connecticut.

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When should a female start seeing a gynecologist?

With several choices in health care professionals and specialties, determining whom to see and when can be confusing. As an OB-GYN, one of the most common questions I hear from patients is, “What are the differences between the services offered by an OB-GYN and Family Medicine?” The second most common question is, “When should my daughter start seeing an OB-GYN versus her pediatrician or family medicine professional?” Both are excellent questions. However, the answers are not as straightforward as one might hope.

OB-GYN or Family Medicine?

OB-GYN and Family Medicine can complete preventive health exams for women. Both departments can screen for health diseases. So when do you see a gynecology professional and when should you see a family medicine professional?

Family Medicine is best suited if:

• You have a chronic medical condition that requires medication or regular lab work, such as diabetes, high blood pressure or cholesterol, or chronic pain.
• You have an acute condition that might require antibiotics, such as ear infections, strep throat, cellulitis or upper respiratory symptoms.
• You have any new onset of pain or recent injury.

OB-GYN is best suited if:

• You have questions or concerns regarding the female reproductive system, including breasts, uterus, ovaries and vulva. It also can include some urological or gastrointestinal symptoms.
• You have menstrual, pregnancy, fertility or contraception questions or issues.
• You have sexual health concerns, such as libido, pain or abuse.

Some services provided by Family Medicine and OB-GYN overlap, such as birth control, thyroid disorder and mood changes. In these cases, it’s best to start with whomever you feel most comfortable with, and they can guide you further if your concerns cannot be addressed fully.

At what age should a female see an OB-GYN professional?

A female could see an ob-gyn beginning at age 11 if she has concerns with:.

• Delayed puberty (no breast tissue changes before age 14) or delayed menarche (no menstrual cycles before age 16)
• Painful menstrual cycles, especially if missing school or activities due to symptoms
• Unable to wear a tampon or questions about genital anatomy
• Any sexual health questions or contraceptive needs

For other young females, family medicine or pediatric professionals can address most other health needs, including general questions about puberty. Sports exams and immunization reviews are best in those departments.

When to begin Pap smears

It’s important to understand Pap smear screening recommendations continue to change over time as more is learned about HPV. As a result, many parents remain uncertain about when their daughter should begin this screening. The recommendation is to begin Pap smear screenings at age 21, regardless of sexual activity or birth control needs.

At times, a pelvic exam or evaluation of the genitalia might be warranted. But this is not for Pap smear screening purposes. Also, HPV vaccination is recommended during the early teenage years — before sexual activity — to help prevent cervical cancer. Your health care team can give you more information regarding HPV vaccination at your appointment.

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What Is a Pelvic Exam?

What to expect when undergoing this checkup

A pelvic exam is a gynecological examination of the internal and external organs in your pelvis. This includes the vagina, vulva, uterus, cervix, rectum, ovaries, and fallopian tubes.

Your healthcare provider inserts a tool called a speculum into your vagina so they can see the organs inside your pelvis. They also examine the external area around your vagina and use gloved fingers to feel your uterus and ovaries. Any abnormal findings may prompt the need for further evaluation and testing.

This article discusses pelvic exams, why they're done, and what to expect when you have one. It also looks at some of the things that might be found during a pelvic exam.

When Are Pelvic Exams Needed?

A pelvic exam often takes place as part of your preventive care during a routine checkup. Your healthcare provider does this exam to look for changes and screen for early signs of cancer, cysts, fibroids, and sexually transmitted infections (STIs).

Pelvic exams are also used to help diagnose a medical condition when you're having symptoms such as:

• Unusual and/or persistent vaginal discharge
• Bleeding between periods
• Bleeding after sexual intercourse
• Pelvic pain  or  menstrual cramps  severe enough to disrupt your daily routine for even a few days a month
• Heavy periods, in which you have to change your sanitary napkins, tampons, or other menstrual products more often than once every two to three hours or double them up to keep from leaking
• Pain, swelling, or itching of your vagina or lower abdomen

Any of these symptoms can indicate a  vaginal infection  or an STI, which could affect your future fertility. They may also indicate other conditions like endometriosis , pelvic inflammatory disease (PID) , or a number of  other reproductive disorders .

Parts of a Pelvic Exam

The pelvic exam generally consists of three parts:

• External visual exam
• Internal visual exam
• A physical exam called the bimanual exam

If it's time for your Pap smear —a screening for cervical cancer—you'll have that as well. Most women only need to have a Pap test starting at age 21 years and then again every three to five years.

If you have symptoms of an STI or you're at high risk for contracting one, your healthcare provider may also take a sample for an STI test.

During a Routine Checkup

The American College of Obstetricians and Gynecologists (ACOG) recommends seeing a gynecologist starting between the ages of 13 and 15 for a regular health exam.  A pelvic exam isn't usually done until becoming sexually active or turning 21, whichever comes first.

There is currently no consensus among experts on how often a pelvic exam should be performed as preventive care.

The ACOG recommends that women at average risk for cervical cancer have a pelvic exam as follows:

• Age 21 or older: Every three years to screen for cancer and infection
• Under 21 : Only if having symptoms of a medical problem, such as abnormal bleeding, abnormal vaginal discharge, or pain in the pelvic area

Other professional societies have different recommendations.

Your healthcare provider likely has their own opinion regarding how often you'll need a pelvic exam based on your medical history and general health, so they'll tell you how often to schedule one.

During Pregnancy

A pelvic exam is typically performed at the first prenatal care visit. If you have a history of certain gynecological conditions, more frequent pelvic exams may be necessary.

To Diagnose a Condition

Pelvic exams are used to diagnose or look for signs of conditions, such as:

• Sexually transmitted infections (STIs)
• Gynecologic cancers
• Pre-cancerous changes in the cervix
• Pelvic inflammatory disease (PID)
• Ovarian cysts
• Uterine fibroids

How to Prepare for a Pelvic Exam

There are no food, drink, or medication restrictions for this evaluation.

Vaginal douching  is never a good idea because of the risk of infection it presents. It's particularly important not to douche for at least two or three days before your pelvic exam. You should also refrain from sexual intercourse for at least 24 hours prior to your examination.

Who Performs Pelvic Exams?

A pelvic exam is performed by a healthcare provider, physician assistant, or nurse practitioner. You can see your regular primary care practitioner or family medical professional for this or you can go to an obstetrician-gynecologist (OB-GYN) . The test is done in your healthcare provider's office or a health clinic.

The best time to schedule your annual pelvic exam and to obtain the most  accurate results  from your gynecological examination and Pap smear, if applicable, is one or two weeks after your period.

A pelvic exam itself only takes a few minutes, but planning about an hour for the whole appointment is generally a safe bet. This includes time spent waiting, filling out forms, completing your medical history, and so on.

What to Bring

You may want to keep a period diary that you can go over with your healthcare provider during your appointment. You can use a calendar or app to keep track of the dates of your periods, the amount of flow, any pain experienced, discharge, or other symptoms that occur during the month.

Bring along any questions you have about the exam or your gynecological health as well.

Have your insurance card handy, as well as your co-pay, if needed.

If you have concerns

Your healthcare provider knows how personal this exam is, so feel free to talk openly and honestly about any feelings of nervousness or anxiety so they can help you feel as comfortable as possible.

This might prompt them to take things a little slower; make sure they explain everything they're doing before they do it; and check to make sure you're doing alright as the exam proceeds.

If you really feel like you can't bear enduring a pelvic exam, you absolutely have the right to decline. However, avoiding this exam for too long can cause any problems to go undetected.

Cost and Health Insurance

Since a pelvic exam is often performed as a part of a routine physical or checkup, the cost may vary depending on factors such as whether or not you have a Pap smear or STI testing and what else is included in the cost, such as a separate physical exam. The exam alone can range from $100 to $300 or more.

If you have health insurance through the Affordable Care Act's Marketplace or other insurance that covers preventive care, an annual pelvic exam will be completely covered as part of your annual well-woman visit. This means you won't need to pay any out-of-pocket costs.

If you need a pelvic exam for diagnostic purposes because you're having symptoms, this should also be covered by your health insurance. Contact your insurance agent or company for more information, including details about any co-pay or deductible you may need to pay.

If you don't have health insurance, are under-insured, or considered low-income, check with your local or county community health clinic. Many of these offer free or low-cost pelvic exams, STI testing, and Pap smears that you pay for based on your income.

You can also find local providers who do free or lost-cost exams via the Centers for Disease Control and Prevention (CDC)'s National Breast and Cervical Cancer Early Detection Program .

What to Expect During a Pelvic Exam

After checking in and filling out any necessary forms, which may include an authorization to bill your insurance or an updated health history, it's a good idea to empty your bladder so you can be more comfortable during your exam.

If you're feeling nervous or tense during your pelvic exam try to:

• Breathe slowly and deeply
• Relax your stomach muscles and shoulders
• Relax the muscles on the inside of your legs

You can also ask your healthcare provider to describe what they're doing during the exam.

Once called into the exam room, you will usually start by having your blood pressure, weight, pulse, and potentially your urine checked. Be prepared to give the nurse the date of the first day of your last period. Also, tell the nurse about any concerns that you want to discuss with the healthcare provider such as: 

• Irregular periods
• Painful periods
• Menstrual problems
• Vaginal infections
• Painful sexual intercourse

After your initial discussion with the nurse, you'll be directed to take all your clothes off, with the exception of your socks. You will be given a gown and drape to cover yourself until your examination begins.

Your healthcare provider will knock to make sure you're ready and then enter the room. They will ask about your medical history and discuss any problems you're having. It’s important for you to be as accurate and complete as you can in answering the questions and describing any symptoms you may have.

Your healthcare provider may have a nurse present during your pelvic exam as a means of protection for both of you, but if you're not comfortable with someone else being there, feel free to request that it just be the two of you.

Conversely, if your healthcare provider doesn't have a nurse in the room and you would feel more comfortable with someone else there, you can have your partner or friend in the room or request that a nurse comes in during this part of your checkup.

Your healthcare provider may listen to your heart and lungs, check your breasts for changes or lumps , and feel your abdominal area for any irregularities.

Breast Exam

A reliable examination of your breasts takes approximately 30 seconds per breast.

During your  breast examination , your healthcare provider should discuss monthly  breast self-exams with you and also provide instructions on how to perform them if you're unfamiliar.

People at average risk for breast cancer have the choice to start screening with early mammograms as early as age 40 and all women should begin having yearly mammograms by age 45.

Pelvic Exam Procedure

The pelvic exam itself only takes a few minutes. During each part of the exam, your healthcare provider will probably tell you what they're going to do, especially if this is your first pelvic exam.

Getting into Position

First, you'll need to lie back, scoot down to the end of the table, put your feet in the stirrups or on the corners of the table, and spread your knees apart.

This feels uncomfortable, especially the first time or two, but keep in mind that your healthcare provider does pelvic exams regularly. Try taking deep breaths to help relax your muscles if you're feeling tense.

External Examination

At this point, your healthcare provider may look at the outside of your vaginal area to check for any abnormalities, swelling, sores, or irritation.

Internal Visual Examination

Next, a speculum, a metal instrument that looks like a duck's beak, is inserted into your vagina with a lubricant to make it more comfortable. The speculum widens your  vaginal walls  so your healthcare provider can view them, as well as your  cervix .

The speculum can be uncomfortable and you may feel some pressure as it's opened, but you shouldn't feel pain. If you do, be sure to tell your healthcare provider. There may be a smaller one they can use instead.

Sample Collection

If you're having a Pap smear, a sample of cervical tissue is taken with a small wand or spatula once your cervix is in view. This may cause some brief discomfort, but again, it shouldn't be painful and it only lasts for a second or two as your healthcare provider collects the tissue.

If you're also being tested for STIs like chlamydia or gonorrhea, or other infections such as a yeast infection , pelvic inflammatory disease, or bacterial vaginosis , your healthcare provider will use a cotton swab to take a sample of your cervical discharge for the STI test or your vaginal secretions to test for other infections. The speculum is gently slid out once this part of the exam is complete.

Bimanual Examination

To perform this, your healthcare provider wears gloves and inserts two lubricated fingers into your vagina, places their other hand on top of your lower abdomen, then compresses the tissue between their two hands, feeling for any abnormalities that might have occurred since your last pelvic exam.

The bimanual exam allows your healthcare provider to check the size, shape, and mobility of your  uterus to feel for any changes in your ovaries, such as  ovarian cysts , and to feel for any tenderness or other abnormalities in your uterus or the surrounding tissues like endometriosis,  fibroid tumors , or other  common uterine conditions .

The bimanual exam can be a bit uncomfortable, but should not result in overt pain. Fortunately, this part of the examination usually lasts for less than 30 seconds. Because it can give your healthcare provider important information, it's worth a bit of temporary discomfort.

Rectal Examination

After checking your vaginal area, your healthcare provider may also do a rectal exam by inserting one lubricated finger into your rectum to check for any pain or abnormalities there like hemorrhoids or tumors.

This is an optional part of a pelvic exam, but if your practitioner does do this, try to relax as much as you can.

After the Exam

Once your pelvic exam is completed, you will be given privacy to get dressed. You may be offered some tissues to wipe off any excess lubricant and a maxi pad or panty liner in case the speculum causes any spotting.

When you're ready, your healthcare provider will come back to the room to discuss the results of your pelvic exam with you.

After your visit is through, you can go home and resume your normal activities. You may have light spotting and possibly some cramping, but you shouldn't have pain. These symptoms should not last long. If you have heavy bleeding or severe cramping or pain, contact your healthcare provider.

How long does a pelvic exam take?

A pelvic exam will take a few minutes. Some parts of the exam may be a little uncomfortable, but it shouldn't be painful. If it hurts, say something. Your healthcare provider may be able to make things more comfortable.  

When to Expect Results

Your healthcare provider can usually tell you right away if they found any problems or abnormalities during your pelvic exam or if it was normal.

In cases where your practitioner took a vaginal fluid sample during your exam to look for a yeast infection or bacterial vaginosis, this sample will be looked at under a microscope for signs of fungus, bacteria, or viruses. Your medical professional may even look at the slides themselves after your pelvic exam.

The presence of these microorganisms is immediately obvious, so you will likely know before you go home if you have one of these infections and leave with a prescription to treat it.

If you had a Pap test, the results for this may take a few days and up to three weeks to get back. Your healthcare provider's office will likely mail the results to you or call you, but if you don't hear anything after three weeks, be sure to call.

Results from a cervical swab to check for gonorrhea and chlamydia will take a few days to come back.

Other Considerations

If you have any questions or concerns about the results of your pelvic exam, discuss these with your healthcare provider. This is also a good time to discuss contraception, fertility, sexual health, and any other areas or issues you're concerned about.

If your pelvic exam was normal, you'll need to schedule another one in a year or the time frame your healthcare provider recommends.

If your pelvic exam showed any abnormalities, your practitioner will talk to you about what these findings may mean, as well as about additional testing, follow-up, and/or treatment options. Some of the things that can be found or suspected during a pelvic exam include:

• Endometriosis: If you come in with symptoms of endometriosis, your healthcare provider may have felt cysts or scars on or around your reproductive organs during your pelvic exam, another piece of evidence that you could have this condition. However, you will likely need more testing to confirm this diagnosis like ultrasound, magnetic resonance imaging (MRI) , and, in some cases, laparoscopy . Treatment for endometriosis typically involves medication and/or surgery.
• Infection: If your pelvic exam and/or vaginal fluid sample revealed that you have a yeast infection or bacterial vaginosis, treatment will depend on what's behind the infection. Bacterial vaginosis is typically treated with antibiotics, while yeast infections are treated with prescription or over-the-counter antifungal medications. If you have recurrent yeast infections, your healthcare provider may also send your vaginal fluid sample to a lab to be cultured to find out exactly what kind of fungus is causing your infection in order to treat it more specifically and effectively.
• Pelvic inflammatory disease: In the case of suspected pelvic inflammatory disease, your healthcare provider will order additional cultures on your vaginal and cervical fluid and may recommend an ultrasound, blood and urine tests, and laparoscopy to confirm the diagnosis, find what's causing the infection, and to see how widespread it may be. It will likely take a few days for culture results to come back. Treatment for PID involves antibiotics for both you and your partner.
• Ovarian cysts: Your healthcare provider may have felt an ovarian cyst during your pelvic exam. If so, they'll potentially order more tests to see what kind it is and if you need treatment. These tests may include a pregnancy test, laparoscopy, and blood tests. Treatment for ovarian cysts depends on factors like your age, medical history, symptoms, and the size and kind of cyst you have, but can include monitoring your condition, medication, or surgery.
• Uterine fibroids: These are often detected during a pelvic exam. These noncancerous growths in your uterus rarely develop into cancer and can range in size from microscopic to large enough to cause your uterus to bulge out. These fibroids don't cause symptoms for most women. If your healthcare provider needs confirmation that you have fibroids, they may order additional tests such as ultrasound, blood tests, and possibly another imaging test like MRI. Treatment for this condition ranges from watching it closely to taking medications or doing a variety of procedures that can make the fibroids smaller or remove them completely.
• Cancer: A pelvic exam can be the first step in diagnosing cancers that occur in the ovaries, uterus, rectum, vulva, cervix, fallopian tubes, and bladder. Sometimes the tumors or abnormal cells can be seen or felt during your exam. In cases where cancer is detected or suspected, your healthcare provider will likely want to do additional testing. Depending on the type of cancer, tests may include ultrasound, a biopsy of your tissue, hysteroscopy , imaging tests, blood tests, and urinalysis.
• Sexually transmitted infections: Positive results on your gonorrhea and chlamydia tests will show which infection you have (though you can have both at the same time). You'll need to be treated with an antibiotic to clear up the infection.

A pelvic exam is a gynecological exam that can help identify problems with the organs inside and outside of your pelvis. During this exam, your healthcare provider uses a speculum and gloved fingers to examine these organs visually and manually.

Some of the conditions that can be discovered or suspected after a pelvic exam include endometriosis, ovarian cysts, and uterine fibroids. Further tests can confirm these findings.

Planned Parenthood. What is a pelvic exam?

American College of Obstetricians and Gynecologists. Your first gynecologic visit .

American College of Obstetricians and Gynecologists . Cervical cancer screening (update) .

American College of Obstetricians and Gynecologists. Pelvic Exams .

Office on Women's Health. Douching .

HealthCare.gov. Preventive care benefits for women .

Centers for Disease Control and Prevention. National breast and cervical cancer early detection program .

American Cancer Society. Breast cancer screening guideline .

Office on Women's Health. Endometriosis .

Centers for Disease Control and Prevention. Pelvic inflammatory disease (PID) treatment and care .

 Office on Women’s Health. Ovarian cysts .

Office on Women’s Health.  Uterine fibroids .

American College of Obstetricians and Gynecologists. Pelvic exams .

By Tracee Cornforth Tracee Cornforth is a freelance writer who covers menstruation, menstrual disorders, and other women's health issues. 

This Is How Often You Should Be Going to the Gynecologist

While cervical cancer used to be a leading cause of death in women, the rates are dropping. In response, the screening guidelines have been changed. The American Cancer Society 's updated screening guidelines recommend that regular cervical cancer screenings begin at 25 years old. Additionally, you should have a primary HPV test every 5 years from 25 to 65 years old. Previously, those screenings began at 21 years old, but the starting age has increased because of the low number of cervical cancer cases in the 20 to 24 age range due to the increase in vaccine use .

Since primary HPV testing isn't currently available to everyone, as laboratories are still transitioning to the new testing methods, "screening may be done with either a co-test that combines an HPV test with a Papanicolaou (Pap) test every 5 years or a Pap test alone every 3 years," says the ACS. While the old method is still an acceptable option, experts say the new guidelines and testing methods can help prevent even more cervical cancer cases, since HPV tests are even more accurate than Pap tests.

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"We estimate that compared with the currently recommended strategy of cytology (Pap testing) alone beginning at age 21 and switching to co-testing at age 30 years, starting with primary HPV testing at age 25 prevented 13 percent more cervical cancers and 7 percent more cervical cancer deaths," said Debbie Saslow, PhD, managing director, HPV & GYN Cancers for the American Cancer Society, in a press release . "Our model showed we could do that with a 9 percent increase in follow-up procedures, but with 45 percent fewer tests required overall."

So book that appointment. It only takes up a small amount of your time—and it could save your life.

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How Often Should You Visit the Gynecologist?

• January 2, 2020

Women are often in charge of arranging medical care for the whole family, but often neglect their own healthcare. Seeing a gynecologist is one of the best ways to ensure that you stay healthy and can continue to take care of your loved ones.

Gynecology is an important part of healthcare for women. Gynecology focuses on the female reproductive system. A gynecologist women can trust not only takes care of the reproductive system but looks at the bigger picture. They are often the trusted medical professional that a woman feels comfortable talking to about other medical concerns.

Pelvic Exams and Pap Smears

Two of the most common things that will occur when you have your gynecology appointment are your Pap smear and a pelvic exam. The Pap smear is done to detect cancer cells in the cervix. The pelvic exam is done to detect any abnormalities.

A Pap smear is critically important. Testing can mean discovering cancer in its early stages and initiate life-saving early intervention treatment. Around 13,000 women are diagnosed with this type of cancer every year and around 4,000 women die from it. Experts agree one of the best ways to fight cervical cancer is with early intervention treatment. The sooner the cancer is identified, the better odds of survival.

The pelvic exam can identify medical problems with the vulva, STDs, and other health issues. These two exams can help to keep your reproductive system healthy.

How Often Should You Be Seeing Your Gynecologist?

How often you need care largely depends on two things: your age and your health. Women between the ages of 21 and 29 should be visiting their gynecologist every year for a regular exam, as well as in between visits for any issues that arise. If you become sexually active before you turn 21, you should also visit your gynecologist every year. Young women under the age of 21 who are not sexually active can typically see a gynecologist every other year. The ideal time to make that first appointment is around the age of 16. If you are not sexually active, then a pelvic exam is not usually necessary. However, if you have had issues or concerns, a pelvic exam may be done.

How Often Should I See My Gynecologist After Age 30?

If you are in good health, not pregnant, and not being treated for a disease, you can see your gynecologist every other year after age 30. At each appointment, you will have a pelvic exam and a Pap smear. Official recommendations have actually lessened the number of Pap smears women should receive if they have no history of pre-cancerous cells in prior exams. These changes were made based on new understanding surrounding the development of cervical cancer progression.

When to Call the GYN

Outside of your regularly scheduled annual or bi-annual exams, you should schedule a visit with your gynecologist if you experience any of the following:

• Changes in menstruation
• Unusual discharge from the vagina
• Odors or other developments

If you notice changes to your menstruation — which can include heavy periods, skipped periods, or spotting between periods — make an appointment to see the GYN. Anytime you are experiencing vaginal discomfort or pain, make an appointment to get things checked out. If you notice a change in discharge, it can be a sign of an infection, so it is important that you make an appointment with your GYN.

Get the health care that you deserve from a team of compassionate gynecologists. For more information on how gynecology can help you protect your health, contact us today.

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5 Reasons to See a Gynecologist After 50

An ob-gyn explains why annual gynecological check-ups remain important for women as they get older..

Save this to read later.

A gynecologist is often seen as a one-stop resource for all women’s health. But many women stop seeing their gynecologist as they get older and are no longer in their reproductive years.

“They might think, ‘I’m done having kids,’ or ‘I’ve entered menopause, I don’t need to see a gynecologist anymore,’” says Dr. Mary Rosser , an OB-GYN at NewYork-Presbyterian/Columbia University Irving Medical Center.

In fact, Dr. Rosser explains, for those over the age of 50, it’s as important as ever to put your gynecological health first. “Women should see a gynecologist every year in order to get specialized care at every stage of life,” she says. “An annual OB-GYN visit gives women the chance to get educated about the changes in their body, be screened for certain cancers and chronic conditions, and practice preventive measures.”

She recommends a visit to a person’s primary care physician and their gynecologist annually for everyone assigned female at birth.

Health Matters spoke with Dr. Rosser, the Richard U. and Ellen J. Levine Assistant Professor of Women’s Health in Obstetrics and Gynecology at Columbia University Vagelos College of Physicians and Surgeons, to understand the reasons to see a gynecologist after 50 to stay on top of your health.

Dr. Mary Rosser

1. Screening for cancer

The risk of gynecological cancers — cervical, uterine, ovarian , vaginal, and vulvar — increases with age. An annual visit to the gynecologist helps provide early detection for these cancers.

To check for cervical cancer , your gynecologist will do an HPV test, a Pap smear, or an HPV /Pap co-test (one swab is used for the combined test), when you’re due until age 65. If you’ve had abnormal results in the past or have a history of cervical cancer, you may be advised to continue screening past 65.

A pelvic exam also checks for noncancerous conditions such as ovarian cysts and fibroids as well as a variety of conditions that may develop with age. The exam may include the vulva, vagina, pelvic/reproductive organs, and urinary tract. While guidelines vary on how often you should get a pelvic exam, Dr. Rosser advises women to get a pelvic exam every year so that they can be checked for early signs of disease. “Ultimately, you and your OB-GYN should talk about what makes sense for you, depending on your individual situation and medical history,” she says

The risk of breast cancer also increases with age . At your visit, your OB-GYN will perform a breast exam, checking for any changes including abnormal lumps, and refer you for a mammogram, the hallmark screening method to detect breast cancer. For women of average risk, screening guidelines recommend getting a mammogram every one or two years until age 74. The American Cancer Society recommends continuing screening as long as a woman is healthy and expected to live at least 10 more years.

2. Treating menopause symptoms

Menopause can cause uncomfortable symptoms like hot flashes, mood swings, insomnia, night sweats, irregular periods, vaginal dryness, and weight gain. The average age of menopause is 51. An OB-GYN visit is an ideal time to discuss and learn about these changes and treatment strategies, says Dr. Rosser.

Depending on your symptoms, there are several nonhormonal and hormonal treatment options. Because menopause causes a decline in estrogen, hormone therapy — in the form of pills, creams, gels, foam, ring, or transdermal patches — can relieve symptoms. Low-dose antidepressants can also be an option, as well as lifestyle strategies like yoga and meditation. Your OB-GYN can help decide what treatments might be right for you.

3. Sexual health and intimacy counseling

Declining estrogen levels, thanks to menopause, are a major factor behind low libido as well as vaginal dryness and vaginal thinning (also known as genitourinary syndrome of menopause), which can cause pain during sex.

Sexual health can be overlooked during health checkups, but it’s an area that is important to overall well-being, says Dr. Rosser. “I counsel many women around menopause and beyond who come to me with concerns about low libido and pain during sex,” she says. “Thankfully, there are treatment options to resolve these problems.”

These include hormonal therapies like vaginal estrogen and nonhormonal therapies such as over-the-counter vaginal moisturizers and lubricants. For women over 50, “vulvar and vaginal moisturizers are just as important as facial and body moisturizers,” Dr. Rosser says. She also advises her patients to use water-based lubricants during intercourse. In sexually active patients, a gynecological exam includes screening for sexually transmitted infections (STIs).

“I try to normalize talking about sex among this age group by openly discussing it and giving out information,” Dr. Rosser says.

“An annual OB-GYN visit gives women the chance to get educated about the changes in their body, be screened for certain cancers and chronic conditions, and practice preventive measures.” — Dr. Mary Rosser

4. Addressing urinary and pelvic floor disorders

Many women over 50 may have urinary problems, like urgency and incontinence, and other pelvic floor disorders , such as pelvic prolapse, which is when the pelvic floor muscles are weak and the pelvic organs slip down from their normal position. These issues can be due to many things, including decreased estrogen levels during menopause, pregnancy, childbirth, excess weight, smoking, and genetic factors, Dr. Rosser explains.

“A gynecologist can really help to educate a woman about her unique issues and help determine what kind of exercises, strategies, and treatment methods can help. Pelvic floor therapy, such as Kegels, is a terrific tool for many women. Being able to have these open conversations and know exactly what’s going on can be extremely beneficial,” says Dr. Rosser.

5. Preventive care

A visit to your OB-GYN also covers basic preventive screenings to check blood pressure, cholesterol, bone density, and more. Tests like these can help women stay healthy and active as they age. And the visit is a great time to discuss lifestyle factors such as eating well and exercising that can prevent many chronic diseases, like heart disease and type 2 diabetes.

“The gynecologist’s exam room allows women to open up and talk about a variety of issues,” says Dr. Rosser. “It allows for education, screening, prevention, and early intervention. We can improve the lives of women for many years to come by having yearly visits with them.”

Additional Resources

Learn more about women’s health at NewYork-Presbyterian.

Mary L. Rosser, M.D., Ph.D. , is an OB-GYN at NewYork-Presbyterian/Columbia University Irving Medical Center. She is also the Richard U. and Ellen J. Levine Assistant Professor of Women’s Health in Obstetrics and Gynecology at Columbia University Vagelos College of Physicians and Surgeons, where she is director of Integrated Women’s Health and director of the Columbia Women’s Postpartum Health program.

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How Often Should Women See Their Gynecologist?

You know you should visit the dentist every six months and head in for a physical every year, but there’s a lot of conflicting information for women about how often you should see your gynecologist. At Darin Swainston MD. FACOG in Las Vegas, Nevada, our board-certified OB/GYNs want to set the record straight.  

Routine gynecology visits

While it’s easy to think about your gynecologist as someone who you visit when you need birth control medication or if you’re pregnant or struggling to become pregnant, the truth is that your OB/GYN is a key member of your overall health team. 

First OB/GYN visits

Generally, experts recommend that girls begin visiting a gynecologist during adolescence (between 13-15 ) for any concerns related to their reproductive system. These visits generally don’t include a pelvic exam unless medically needed. Instead, it’s a chance for the young woman to get to know her gynecologist and get answers to questions, such as:

• What’s normal and what’s not when it comes to menstruation
• What to expect during puberty and times of hormonal change
• Information on birth control and sexuality, including STDs

The goal of these visits is to get to know the OB/GYN provider by building trust and rapport. 

Regular Pap smears

Full pelvic exams with a Pap smear aren’t typically recommended until age 21 . Starting at 21, every woman should have a baseline Pap smear. Depending on your health history and the results of this first test, Dr. Richards may recommend retesting every 1-3 years .     

Well-woman checkups

The American College of Obstetricians and Gynecologists recommends annual well-woman checkups with your gynecologist. At this time, your provider conducts an annual pelvic exam, which may or may not include a Pap smear, depending on your needs.

This visit also includes a breast exam to check for changes in your breast tissue. If you’re over 40, your OB/GYN will also help you schedule your annual mammogram screening. 

Your well-woman checkup is also a great time to discuss any concerns you may have about birth control , fertility, irregular periods , conditions related to your reproductive organs, like fibroids or endometriosis , and menopause. 

Other times to visit the OB/GYN

At Darin Swainston MD. FACOG, we know that different women have different needs. When considering your trips to our office, it’s important to keep in mind other factors that may influence how often you should schedule appointments. Here’s a closer look. 

Different stages of your reproductive life

If you’re at the stage when you’re ready to begin your family and want to get pregnant, it’s important to discuss your reproductive health with your OB/GYN. Our team offers a full line of obstetrics services , from preconception counseling through postnatal care.  

If you’re struggling with infertility , you should schedule additional OB/GYN appointments. Your provider at Darin Swainston MD. FACOG helps identify the underlying cause(s) and makes treatment recommendations. 

Women who are approaching perimenopause and menopause may also seek help for troublesome symptoms, like hot flashes, vaginal dryness, and prolapse. Our team offers many solutions for women in this later stage of the reproductive cycle. 

There’s no need to wait for your annual exam if you need help during any stage of your reproductive life. Our team can give you the answer you need with a variety of testing, medications, and robotic surgery options.  

Medical concerns

It’s also important to keep in mind that if you have any gynecological medical problems arise, you shouldn’t wait for your annual well-woman visit. Getting medical attention sooner rather than later is always best. Some concerns that may bring you in include:

• Painful intercourse or other issues related to sexual dysfunction
• Abnormal uterine bleeding, including heavy, painful periods or no periods
• Abdominal pain beyond normal menstrual cramps
• Vaginal infections and other vaginal issues, like unusual discharge 

It’s also important to come in for confidential sexually transmitted disease (STD) testing if you have unprotected sex or sex with more than one partner. The team at Darin Swainston MD. FACOG follows the CDC guidelines for scheduling different STD tests. 

Learn more about when to see your gynecologist by calling the office of Darin Swainston MD. FACOG in Las Vegas, Nevada, or booking a consultation online now. 

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Prenatal care: 1st trimester visits

Pregnancy and prenatal care go hand in hand. During the first trimester, prenatal care includes blood tests, a physical exam, conversations about lifestyle and more.

Prenatal care is an important part of a healthy pregnancy. Whether you choose a family physician, obstetrician, midwife or group prenatal care, here's what to expect during the first few prenatal appointments.

The 1st visit

When you find out you're pregnant, make your first prenatal appointment. Set aside time for the first visit to go over your medical history and talk about any risk factors for pregnancy problems that you may have.

Medical history

Your health care provider might ask about:

• Your menstrual cycle, gynecological history and any past pregnancies
• Your personal and family medical history
• Exposure to anything that could be toxic
• Medications you take, including prescription and over-the-counter medications, vitamins or supplements
• Your lifestyle, including your use of tobacco, alcohol, caffeine and recreational drugs
• Travel to areas where malaria, tuberculosis, Zika virus, mpox — also called monkeypox — or other infectious diseases are common

Share information about sensitive issues, such as domestic abuse or past drug use, too. This will help your health care provider take the best care of you — and your baby.

Your due date is not a prediction of when you will have your baby. It's simply the date that you will be 40 weeks pregnant. Few people give birth on their due dates. Still, establishing your due date — or estimated date of delivery — is important. It allows your health care provider to monitor your baby's growth and the progress of your pregnancy. Your due date also helps with scheduling tests and procedures, so they are done at the right time.

To estimate your due date, your health care provider will use the date your last period started, add seven days and count back three months. The due date will be about 40 weeks from the first day of your last period. Your health care provider can use a fetal ultrasound to help confirm the date. Typically, if the due date calculated with your last period and the due date calculated with an early ultrasound differ by more than seven days, the ultrasound is used to set the due date.

Physical exam

To find out how much weight you need to gain for a healthy pregnancy, your health care provider will measure your weight and height and calculate your body mass index.

Your health care provider might do a physical exam, including a breast exam and a pelvic exam. You might need a Pap test, depending on how long it's been since your last Pap test. Depending on your situation, you may need exams of your heart, lungs and thyroid.

At your first prenatal visit, blood tests might be done to:

• Check your blood type. This includes your Rh status. Rh factor is an inherited trait that refers to a protein found on the surface of red blood cells. Your pregnancy might need special care if you're Rh negative and your baby's father is Rh positive.
• Measure your hemoglobin. Hemoglobin is an iron-rich protein found in red blood cells that allows the cells to carry oxygen from your lungs to other parts of your body. Hemoglobin also carries carbon dioxide from other parts of your body to your lungs so that it can be exhaled. Low hemoglobin or a low level of red blood cells is a sign of anemia. Anemia can make you feel very tired, and it may affect your pregnancy.
• Check immunity to certain infections. This typically includes rubella and chickenpox (varicella) — unless proof of vaccination or natural immunity is documented in your medical history.
• Detect exposure to other infections. Your health care provider will suggest blood tests to detect infections such as hepatitis B, syphilis, gonorrhea, chlamydia and HIV , the virus that causes AIDS . A urine sample might also be tested for signs of a bladder or urinary tract infection.

Tests for fetal concerns

Prenatal tests can provide valuable information about your baby's health. Your health care provider will typically offer a variety of prenatal genetic screening tests. They may include ultrasound or blood tests to check for certain fetal genetic problems, such as Down syndrome.

Lifestyle issues

Your health care provider might discuss the importance of nutrition and prenatal vitamins. Ask about exercise, sex, dental care, vaccinations and travel during pregnancy, as well as other lifestyle issues. You might also talk about your work environment and the use of medications during pregnancy. If you smoke, ask your health care provider for suggestions to help you quit.

Discomforts of pregnancy

You might notice changes in your body early in your pregnancy. Your breasts might be tender and swollen. Nausea with or without vomiting (morning sickness) is also common. Talk to your health care provider if your morning sickness is severe.

Other 1st trimester visits

Your next prenatal visits — often scheduled about every four weeks during the first trimester — might be shorter than the first. Near the end of the first trimester — by about 12 to 14 weeks of pregnancy — you might be able to hear your baby's heartbeat with a small device, called a Doppler, that bounces sound waves off your baby's heart. Your health care provider may offer a first trimester ultrasound, too.

Your prenatal appointments are an ideal time to discuss questions you have. During your first visit, find out how to reach your health care team between appointments in case concerns come up. Knowing help is available can offer peace of mind.

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• Lockwood CJ, et al. Prenatal care: Initial assessment. https://www.uptodate.com/contents/search. Accessed July 9, 2018.
• Prenatal care and tests. Office on Women's Health. https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/prenatal-care-and-tests. Accessed July 9, 2018.
• Cunningham FG, et al., eds. Prenatal care. In: Williams Obstetrics. 25th ed. New York, N.Y.: McGraw-Hill Education; 2018. https://www.accessmedicine.mhmedical.com. Accessed July 9, 2018.
• Lockwood CJ, et al. Prenatal care: Second and third trimesters. https://www.uptodate.com/contents/search. Accessed July 9, 2018.
• WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization. http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/anc-positive-pregnancy-experience/en/. Accessed July 9, 2018.
• Bastian LA, et al. Clinical manifestations and early diagnosis of pregnancy. https://www.uptodate.com/contents/search. Accessed July 9, 2018.

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Shy about talking to your gynecologist? Here are some answers to difficult questions

Emily Kwong

Malaka Gharib

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A visit to the gynecologist isn't just an essential part of your health routine. It's an opportunity for anyone who has a cervix, vagina or ovaries to ask questions about their reproductive health, from painful periods to a decreased libido.

If talking to your provider about this kind of stuff makes you feel shy or squeamish, you're not alone, says Dr. Rachel Bervell . She's a physician with training in obstetrics and gynecology and the co-founder of The Black OBGYN Project .

"I come from a strict immigrant household," she says. "I never had the birds and the bees talk. I never had any of those types of conversations."

Take charge of your gyno visit

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Today, Bervell is much more outspoken about this topic — in fact, there's a viral video on Instagram of her talking about what happens during a pap smear ... at her family's Thanksgiving dinner.

You shouldn't be afraid to speak up, either — especially when your health is on the line, says Bervell. To give you an idea of what kinds of questions you can ask your provider, Bervell answers queries from our listeners. Whether you're a woman, trans or non-binary, this story is for you. This interview has been edited for length and clarity.

I have terrible anxiety surrounding pap smears. Are there any changes I can make during a routine exam that gynecologists would be willing to accommodate?

Sometimes anxiety is because of a bad experience, whether that's conditions like vaginismus [an involuntary tensing of the vagina] or other pain, or because of prior [sexual] assault.

There are things you can do to make the pap smear easier for you. Think of your provider as a partner in your care. If you feel like there will be a concern with pain or discomfort, ask the provider to use a smaller speculum. Ask them to use more lubrication. And [get them to help you] understand why you're doing this exam. At the end of the day, it's to prevent cancer. But it can be done in a way that prioritizes your needs and comfort.

I have intense period pain. How do I know when my pain isn't normal?

Excessive pain during or outside your cycle can be noteworthy because it can indicate an underlying health issue — something isn't "quite right" and is contributing to the subsequent pain/discomfort. In that case, it's important to seek medical attention to identify the source of that issue, diagnose the underlying cause and receive treatment. The last thing we want to do is wait for worsening conditions or complications.

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Conditions like endometriosis , when [endometrial-like] tissue that's supposed to be within the womb [grows] outside the womb, can cause debilitating pain and discomfort for patients.

If you're having intense period pain andyou can't get relief from an over-the-counter medication like Tylenol or ibuprofen, consider talking to your physician or your provider about other ways to ease that pain.

I'm a post-menopausal woman with both ovaries removed and I am not taking any hormone replacement therapy. How do I get my libido back?

When we stop our ovarian function, which is really what menopause is all about, you are no longer releasing eggs. You're no longer able to have those eggs fertilized. And there will be a decrease in estrogen. Estrogen is needed to maintain the lubrication, elasticity and blood flow in the vagina. When estrogen drops, vaginal dryness occurs.

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I recommend an open honest conversation with your health provider. They might suggest hormone replacement therapy, vaginal estrogen, lubricants and moisturizers or meds to address sexual dysfunction. They may ensure you are maintaining positive health habits and assessing stress/psychological factors overall. Enjoying sex and having a libido is not just biological, it's also lifestyle and behavioral.

I deal with multiple sclerosis, which causes severe spasticity. In order for me to get a simple gynecological exam, two people must support my knees and keep them open. But most doctors' offices have said they cannot accommodate me. As a result, I do not see a gynecologist as often as I should, simply because it's uncomfortable and embarrassing when my foot kicks the doctor without my control. What should you do if you're struggling to find a gynecologist who can meet your needs?

This isn't the best answer, because it's telling the patient they have to do the work for themselves. But No. 1 is, you know what you need. And you know providers are supposed to take care of your needs as a patient that has a disability.

Making sure the clinic is accessible to you should be your priority, and the clinic should be able to respect that and respond accordingly, because that's our duty. So speak up, send a message ahead of time.

If your provider cannot accommodate you, find someone else who will respect how you are coming to the provider and ensure you are getting the care that is necessary.

How should I talk to a gynecologist about birth control?

The first question is to figure out what your goals are. Is it because you don't want to get pregnant and you're not ready to start a family at the moment? Are you concerned that your periods are not regular and you want some consistency? Or is it to help with other health conditions like acne or heavy bleeding [during your period]?

Recurring UTIs: The infection we keep secretly getting

Once you figure that out, your provider can talk to you about the full scope of options. One of the organizations I always refer to is Bedsider.org . They've done a wonderful job of listing all the birth control types with their effectiveness and what it does, what's included, what it looks like, where it goes.

The digital story was edited by Margaret Cirino and Meghan Keane. The visual editor is Beck Harlan. We'd love to hear from you. Leave us a voicemail at 202-216-9823, or email us at [email protected].

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'Planet Parade' 2024 coming Monday as 6 planets align: What to know, how to watch

Get an early start this Monday for a chance to see six planets align in the sky.

A planetary alignment, or " planet parade ," will see six planets — Jupiter, Mercury, Uranus, Mars, Neptune, and Saturn — align in the sky during the predawn hours on Monday.

Here's a look at what to know ahead of Monday's planetary alignment.

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What to expect

Planets continuously orbit the sun in the solar system and slowly catch up to one another over time.

As the planets travel along the same ecliptic path, as they pass the Earth it appears as though they are aligned, according to NASA . However, the alignment formation will be short-lived since each planet moves at different speeds, depending on its distance from the sun.

Planetary alignments occur several times per year, especially with two to four planets. With five or more planets aligning, it is less common. The last planetary alignment seen in the Northern Hemisphere occurred on April 8.

Viewing chances

Looking in the eastern sky, the planetary alignment will be visible almost everywhere in the Northern Hemisphere, weather permitting.

You'll need high-powered binoculars to view the majority of the planets — Mercury and Jupiter will be extremely low in the sky. Uranus will be fairly dim and Neptune will appear star-like with binoculars due to its distance from Earth. But Mars and Saturn should be visible to the naked eye.

To catch a glimpse of the planetary alignment, start your viewing an hour before sunrise. Tall buildings may obstruct your view of the alignment, so look for an open area and clear skies.

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Alignment schedule

The six planets will align in the night sky during the early morning hours Monday. Keep an eye on the weather forecast for optimal viewing.

Saturn and Neptune will be in the sky from late night, then Mars will rise a bit later, followed by Uranus, Jupiter and Mercury appearing on the eastern horizon at dawn, according to StarWalk.space .

The next six-planet alignment will happen on Aug. 28, when Mercury, Mars, Jupiter, Saturn, Uranus, and Neptune align, according to StarWalk.space.

This article originally appeared on Detroit Free Press: 'Planet Parade' 2024 coming Monday as 6 planets align: What to know, how to watch

Days after Trump's guilty verdict, Hunter Biden heads to court

WASHINGTON — Three days after Joe Biden proclaimed that “no one is above the law,” his lone surviving son faces a criminal trial on federal gun charges that could potentially land him in jail.

Biden was speaking about Donald Trump , the once and possibly future president who was convicted on 34 counts of falsifying business records.

Now Biden must practice the high-minded principle he defended in his White House remarks Friday, waiting for a verdict in Hunter Biden’s case like any other anxious parent and trusting that the judicial system will be fair.

The younger Biden’s trial opens Monday in Wilmington, Delaware, with the guilty verdict in Trump’s case still reverberating through the presidential race.

A question surrounding Trump’s conviction is what it all means to voters. Will they pull away from Trump as he awaits sentencing, or rally behind him in the belief he was unfairly prosecuted?

In Hunter Biden’s trial, the electorate isn’t so much the issue. Voters aren’t likely to blame Biden even if his son is convicted, polling shows. More than half credited Biden with being a good father by supporting his son through myriad legal difficulties, a Reuters-Ipsos survey in January showed.

A bigger question is whether Hunter Biden’s fate will distract or distress a sitting president in the throes of a tough re-election bid. The son’s trial is the father’s as well, in that sense, testing Joe Biden’s focus and mental discipline during a pivotal stretch of his presidency.

Soon after the trial gets underway, Biden will leave for his first overseas trip of the year. He’ll give a speech in France on Thursday marking the 80th anniversary of the D-Day landings that led to the allied victory in World War II.

Later in the week, he’ll meet privately with French President Emmanuel Macron, where they are expected to discuss a grinding war between Russia and Ukraine that has cost U.S. taxpayers $175 billion.

Biden will return to Europe midmonth for a summit meeting in Italy with America’s closest democratic allies, and at the end of June he’ll take part in his first debate with Trump.

“He has always put his family at the center of his life,” Sen. Chris Coons, D-Del., a friend of the president’s, said in an interview. “He will be able to do both. He has shown for decades an ability to both tend to difficult and pressing family needs and carry out his office.”

The Bidens are a family drawn close by tragedy. Hunter Biden and his brother Beau were both seriously injured in a car crash in 1972 that killed their mother and baby sister, just weeks after Joe Biden won his first Senate bid.

Beau Biden died of brain cancer at age 46 in 2015, leaving what Hunter Biden described in his 2021 memoir as a “hole that was hard to fill.” He used the book to describe a crack cocaine addiction that could have killed him.

“It will likely be very personal and very painful,” an adviser to the president said of of Hunter Biden’s trial.

In the run-up to the trial, the two have been virtually inseparable. Privately, some Biden allies have questioned whether it’s smart for Biden to give his son a public platform that makes the entire family a target for GOP attacks. Yet if anything, Biden wrapped himself around Hunter more tightly ahead of the trial.

The younger Biden was a guest at a state dinner at the White House on May 23 for the visiting president of Kenya.

He joined his father and other family members on Thursday as they visited Beau’s gravesite in Wilmington on the ninth anniversary of his death. The next day, Hunter Biden joined his father on Air Force One as they flew to Washington.

On Saturday, as the president bicycled during his stay at his Rehoboth Beach home in Delaware, his son cycled behind him, according to a White House press pool report.

Michael LaRosa, a former spokesman for first lady Jill Biden, said that “the Bidens are remarkably normal parents and when their kids are hurting, they’re hurting, too.”

“Biden communicates daily and directly with his children and I would not expect that to change during the trial,” LaRosa added. “This is a father and son who have had an especially close relationship their entire lives, and based on how often they talk to and rely on each other, I expect the president will always be in the loop on the developments, no matter where he physically is in the world.”

The Biden and Trump campaigns are taking vastly different approaches to the trial. Trump’s team is drawing an equivalence between the ex-president’s predicament and that of Hunter Biden. In a Fox News appearance on Thursday after the verdict, Trump spokesman Jason Miller was asked what Trump would say if Biden were to start calling his rival a “convicted felon.”

“Where’s Hunter?” Miller replied.

Biden allies say they aren’t worried about that line of attack. “Where’s Hunter?” was a Trump mantra during the 2020 campaign. Yet Trump lost.

“It hasn’t stuck. So, it doesn’t strike me as likely that a trial of Hunter Biden in a crowded media environment will break through,” said Dmitri Mehlhorn, a Democratic strategist and fundraiser.

As the trial unfolds, the Biden campaign plans to keep quiet. There won’t be any rapid-response statements coming from the Wilmington headquarters about developments inside the federal courthouse, people familiar with the matter said.

One of Biden’s aims is to show that he’s not abusing presidential powers by meddling in independent law enforcement investigations. He said little about Trump’s case until the verdict was rendered. Though he told MSNBC’s Stephanie Ruhle last year that his son had “ done nothing wrong ,” he wants to avoid any impression that he’s trying to influence the outcome one way or another, Biden advisers said.

A hands-off approach could also help undercut Trump’s claim that Biden has weaponized the justice system to sway the election.

“Maybe this [Hunter Biden’s trial] addresses all those Trump disciples who believe that the federal government is out to get Donald Trump,” said Alan Kessler, a Philadelphia-based attorney and longtime Democratic fundraiser. “If anything, it levels the playing field and shows there is not some great conspiracy by the government to just go after Donald Trump.”

Hunter Biden was indicted in September on three counts involving possession of a gun while using narcotics. He has pleaded not guilty. The trial may feature moments of personal drama and anguish. Prosecutors have been permitted to delve into Hunter Biden’s past drug use. They are expected to call as witnesses his ex-wife Kathleen Buhle, as well as Beau Biden’s widow, Hallie Olivere Biden.

A hope among Biden advisers is that voters prove sympathetic to Hunter Biden’s struggle with addiction, a nationwide scourge. In 2022, the most recent year in which data was available, nearly 49 million people in the U.S. over the age of 12 had a “ substance use disorder ” involving alcohol or drugs, according to the U.S. Department of Health and Human Services.

Many voters have struggled with drug or alcohol dependence and should be able to empathize with what the Bidens have endured, said a Democratic fundraiser who is close to the Biden campaign.

“Twenty-five years ago, this might have been scandalous. But things have changed,” this person said, speaking on condition of anonymity to talk freely. Voters are more accepting of “imperfect families” and don’t tend “to look down on them and think he [Joe Biden] must be a bad dad.”

A verdict in the case doesn’t end the Hunter Biden saga. In September, he is scheduled to go on trial in California in a separate case involving tax charges . He has pleaded not guilty.

Biden aides are anxious about the timing of the tax trial. It will happen just two months before the election and may spill into the early-voting period in some states.

Though Trump was indicted in three other cases, he isn’t expected to face any more trials before the election. That could set up an unhelpful split screen, as Biden’s advisers see it: Trump will be out campaigning, while the president’s son will be sitting in a courtroom defending himself against charges that he failed to pay taxes.

But a focus group conducted in December with swing voters in North Carolina suggests that people may be forgiving. When the moderator asked one woman whether she was troubled by Hunter’s indictment on tax charges, she replied: “No.”

“Why not?” the moderator asked in the focus group conducted by Engagious / Sago  as part of its  Swing Voter Project .

“He’s not the president,” she said. “I’m not voting for him.”

Peter Nicholas is a senior national political reporter for NBC News.

Monica Alba is a White House correspondent for NBC News.

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Lucid CEO says Tesla is 'losing its way'

• Lucid CEO Peter Rawlinson criticized Tesla  in a recent interview.
• Rawlinson, a former Tesla engineer, said that Tesla has lost its way.
• The executive said that "there's a clear distraction there from leadership."

Lucid CEO Peter Rawlinson isn't a fan of Tesla's recent trajectory under Elon Musk .

Rawlinson, who served as a chief engineer at Tesla from 2009 to 2012 before joining Lucid in 2013, said that Tesla seems to have lost its sense of purpose during an interview with BBC's Wake Up to Money that aired Monday.

"Tesla was truly at the cutting edge developing the most advanced technology with a clarity of vision and purpose and an absolute singularity of mindset," Rawlinson said of his time at the EV company. "And what I'm seeing now is I'm seeing a worrying trend towards a sort of distraction."

The Lucid CEO said he feels Tesla is "losing its way" and doesn't have the same sense of purpose it once did. While Rawlinson did not directly say Elon Musk by name, he said that "there's a clear distraction there from leadership." He also mentioned things that line up with Musk's actions in recent years, appearing to allude to the Tesla CEO's purchase of Twitter and politics.

"There's an interest in social media, even politics, and it's kind of losing its way. I don't see it having that singular sense of purpose, and I think it really falls to Lucid to take the technology to a whole new level now," Rawlinson said.

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Rawlinson is far from the first to question Musk's focus on Tesla. Since Musk acquired Twitter in 2022 , some Tesla investors have questioned his commitment to the electric carmaker. After all, Musk is directly involved in at least six different companies.

While Rawlinson told BBC that Lucid is "many years ahead" of other automakers, including Tesla, when it comes to some of its technology, the company has only a fraction of the market share compared to Tesla. Lucid only delivered about 6,000 vehicles in 2023. Tesla delivered more than 1.8 million.

Both automakers have faced headwinds in recent months due to slumping EV sales. Over the past month, Tesla initiated a series of layoffs, and on Wednesday, Lucid kicked off a round of job cuts as well, slashing its workforce by 6%.

Lucid declined to comment further when contacted by Business Insider. Tesla did not immediately respond to a request for comment ahead of publication.

Rawlinson and Musk have traded barbs on social media in the past. In 2021, Musk said Rawlinson was "never chief engineer."

"He arrived after Model S prototype was made, left before things got tough & was only ever responsible for body engineering, not powertrain, battery, software, production or design," Musk posted on X in 2021.

Rawlinson told Axios at the time that Musk's view of his role was an example of "historical revisionism."

Do you work for Tesla or have a tip? Reach out to the reporter via a non-work email and device at [email protected] or at 248-894-6012

Watch: What happens when Elon Musk moves markets with a tweet

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