Periods, pregnancy and Pap smears: Pediatric and adolescent gynecology myths, debunked

Gynecologic care isn’t only important for adults.

Experts recommend an initial visit during the teenage years to establish a line of care for the future. It’s also an opportunity for young patients and their caregivers to ask questions when the body is rapidly changing.

As gynecologists, Julie Chor, MD, MPH, Jessica Long, MD, and Shashwati Pradhan, MD address myths and misconceptions that often come up during appointments — and the answers they give to put minds at ease.

Myth: I don't need to see a gynecologist unless I'm sexually active.

Fact: We suggest seeing a gynecologist for the first time between ages 13 and 15. This allows younger people to get accustomed to talking about things like their periods. It destigmatizes coming to the gynecologist, and it’s a low-stakes, low-pressure visit that can help us establish care and perform preventative counseling.

Myth: A pelvic exam and a Pap smear are the same thing.

Fact: Our patients often mistake pelvic exams for Pap smears; they’re different, and it’s important to know which one you’re getting and why.

A pelvic exam is a physical exam that can include visual inspection, manual palpation (examination involving use of the hands/fingers) and a speculum (medical instrument) exam to evaluate the reproductive organs. It can be done for someone who is having concerns or symptoms, such as discharge. A Pap smear is the actual lab test that involves the collection of cells from the cervix to check for human papillomavirus (HPV), other precancerous conditions or cervical cancer.  

Myth: Tampons will stretch out the vagina.

Fact: Tampons will not stretch out the vagina. Individuals who want to use tampons as a way of managing their menstrual flow should use them if they’re comfortable doing so. There are different sizes created for comfort and levels of menstrual flow. Another myth we often hear is that you’re not a virgin if you use tampons, which is simply not true. 

Myth: You can’t get pregnant while on your period.

Fact: Not all bleeding is an indicator that your period has started. Many people with irregular periods may experience spotting while they’re ovulating. While it’s unlikely to get pregnant while on your period, it can still happen if you’re having bleeding for other reasons. In general, bleeding isn’t a reliable way to confirm that you’re not at risk for pregnancy.

Myth: I need to douche or clean out my vagina.

Fact: We talk about the vagina being a self-cleaning entity. In general, that means you don’t need to do anything to clean out the inside. In some cases, we might recommend things like a sitz bath (a warm, shallow bath), but douching itself actually causes more harm than good because it flushes away healthy bacteria that are part of the vaginal environment.

Myth: I need a Pap smear every year.

Fact: Per guidelines from the Centers for Disease Control and Prevention (CDC), your first Pap smear typically starts at age 21. If results are normal, meaning the cells in the cervix do not show signs of cancer or any unusual changes, then we usually test every three years until age 30. After that, we start looking at the cells on the cervix and whether the human papillomavirus (HPV) is present, which influences how often we test.

Myth: If I get HPV, it will cause cervical cancer.

Fact: While the majority of cervical cancer cases develop in people with HPV, most people with HPV are not going to develop cervical cancer. If you have a positive HPV test, it’s important we monitor you closely afterward to prevent abnormal cells from progressing to cancer. It’s also important to get your HPV vaccines, ideally before you become sexually active.

Myth: If I'm on my period, I have to cancel my gynecology appointment.

Fact: As OB-GYNs, we’re very comfortable dealing with menstrual blood. If you have a heavy period on the day of your Pap smear, the red menstrual blood cells may lead to an insufficient sample of cervical cells. But if you’re not coming for a Pap test, you can absolutely still come to the gynecologist on your period. It won’t faze us and it’s very normal.

Myth: IUDs are dangerous.

Fact: Decades ago, there was a type of intrauterine device (IUD) that was dangerous, and it came with an increased risk of serious infection. The types we use today (hormonal and copper) are very safe. Risks of bleeding, infection and injury are well below 1%. We’re also trying to address pain management during IUD insertion. The CDC recommends a lidocaine injection or gel to decrease pain.

Myth: Birth control will make it harder for me to get pregnant in the future.

Fact: Once you stop using most hormonal contraception (and the copper IUD), you return to fertility quite quickly. The one exception to this is Depo-Provera, or “the shot.” It can take longer for your body to clear that hormone. But it does not change your body’s overall ability to become pregnant.

Myth: Access to birth control will prompt young people to start having sex.

Fact: This concept is called the moral hazard: If you provide something upfront, it will increase risky behavior. That comes up in a lot of different contexts, including contraception, and it’s just not true.

The same thing applies with providing condoms — something that we know leads to safer sexual behavior, not earlier or increased exposure to risk. 

About Pediatric and Adolescent Gynecology

Learn more about gynecologic care for children and teens. Call 773-702-6118 for more information.

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