Vaginal exams and the Pill

Recently a young woman wrote me asking this question:

I am 19 and just recently lost my virginity, so my mom and I talked about how I should get on the pill. I’ve never had a pelvic exam (against my mom’s wishes) because I’m really shy and nervous about it, but she said that I can’t get the pill without having a pelvic exam, that makes sense but is it true? And how soon after I start the pill is it safe to have sex without a condom? Is a pelvic exam really as scary as I’ve heard?

And here is my answer to her:

These are all really good questions. Being shy and nervous about a pelvic exam makes a lot of sense. Here is a website that describes what will happen during your first gynecological visit (they describe a pelvic exam, although they do not name it as that specifically):

Here is the factual information:
Your mom is right – you will need to get a pelvic exam in order to get on the pill. You can have sex without a condom after you have been on the pill for one complete cycle – from one period to the next.

Here is the emotional information:
It makes sense to be scared of a pelvic exam. It kind of marks a whole new beginning in your gynecological life – the need to be tested for STIs – and that’s not a pleasant thought. However, I can tell you that after you’ve had one or two, they won’t be scary any more. Don’t get me wrong – they can be uncomfortable, and if you don’t find the right person to do them, they can be embarrassing. But they do become a normal part of how you take care of your body.

So take some time and find the right person. Do you have a general doctor who you like and feel comfortable with? They will often do pelvic exams. If you don’t, then take some time and visit with several nurse practitioners or physician’s assistants. They are more likely to be female and not to be as rushed.

If money is a concern, you can go to Planned Parenthood. They are often (although not always) adept at talking young women through their first pelvic exam. They can prescribe the pill for you.

Now, I want to explain myself before the inevitable rush of comments asking why I did not explain the negative side effects of birth control pills to this young woman. First, I did not mention it in my e-mail response because the pill works really well for some women, and second because that’s not the question she asked me. Nevertheless, if this young woman reads my blog (or if her mother does), she’s just gotten access to information about how the pill can be harmful.

Do you have questions you’d like the answer to? Questions about sex, teenagers, parenting teenagers, or teenagers having sex? E-mail them to me, and I’ll post the answers here.

About Karen Rayne

Dr. Karen Rayne has been supporting parents and families since 2007 when she received her PhD in Educational Psychology. A specialist in child wellbeing, Dr. Rayne has spent much of her career supporting parents, teachers, and other adults who care for children and teenagers.