College Corner

  1. First Pelvic Exam
  2. Cervical Cancer Vaccine
  3. Morning After Pill
  4. Common Sexually Transmitted Diseases


I have always been interested in seeing young patients. I have been performing "first" pelvic exams on young women for many years. Most of my young patients are college students but many are still in high school. Often I am asked similar questions by prospective patients and their mothers.


Is a pelvic exam painful?

A pelvic exam should not be painful if done in a relaxed trusting environment.  You, the patient should always have the option to control the situation.  You should be able to trust that if something is uncomfortable, your doctor will stop immediately, that you, the patient, should always be in charge, that even if you have never been sexually active, this exam could be done without pain.


When should I have my first pelvic exam?

There are many answers to this questions. I suggest the following:

  1. When you become sexually active, or even better, before to plan for pregnancy prevention, arrange for birth control, and to discuss emergency contraception (AKA the “morning after pill”)
  2. If you have any concerns about your period, pain with periods, heavy periods, too many or missed periods
  3. If you have not menstruated by the age of 16.
  4. If you are ready to start college
  5. For any other reason at all, to ask questions, to learn about your body.


It is not necessary to have a pelvic exam every time; I can be a resource for information and can be reached by fax or phone once you are an established patient.  I have many students who call from remote campuses to ask advice.


What is the Cervical Cancer Vaccine?

This is a three injection series of a viral particle (not a live virus) that immunizes women to the 4 most common strains of the HPV (human papilloma virus), which is responsible for 80% of all cervical cancers and genital warts.  It is very safe.  I gave it to my own daughter and would recommend it for most young women because 70% of all women are exposed to this virus by age 30!  The immunization is recommended starting at age 10 so that it will be completed long before exposure occurs.  Most pediatricians offer this as well.


What is Emergency Contraception (EC)

Emergency Contraception (AKA the morning after pill) is used for those not on hormonal contraception in case of a contraceptive failure (such as a broken condom) or lack of use at all.  It is very effective if used within 72 hours of exposure to unprotected intercourse.  Plan B is the best available at this time and is progestin given twice over 12 hours.  It may cause mild nausea but side effects are quite rare.  The period may be delayed or there may be spotting and counseling from your doctor is recommended if and when you use this.  I usually recommend getting a prescription from your doctor and filling it in advance as the need usually arises on weekends and holidays when it is difficult to find a doctor or a pharmacy who stocks this drug.  Other formulations are high doses of estrogen and progestin equal to about 4 or 5 birth control pills given twice 12 hours apart, which is effective but often associated with significant nausea and vomiting.  Plan B is better.


What STIs (sexually transimitted infections) are the most common?

In my practice these fall into a few categories; bacterial, viral, and fungal.

  • The most common infection seen is clearly monilia, or yeast which is a fungal infection, which is easily treated by over the counter medications or a prescription pill (Diflucan) or cream.  Although it is not technically an STI it can be or may not be sexually transmitted.
  • The most common bacterial infection seen in my practice is chlamydia.  I screen for this annually or if there is a new sexual partner.  If it is found, it needs to be reported to the public health service and treated with an antibiotic along with informing your sexual partner and treating them as well.
  • The most common viral infections are herpes, which is a small blister like cluster.  It can be treated but will stay in the nerve root, possibly for life.  It can be transmitted even when there are no blisters.  It can be treated with an antiviral medication such as acyclovir or any of the newer drugs for viral infections all available by prescription.