Gynos 101

June 20, 2011 6:24 AM

Help me get my reproductive/sexual health in order.

Okay, so I'm a 23 year old female, have never been to the gynecologist or done any of the things that you might do there (pap smear, any kind of exam, any kind of STD testing).

So I know that I'm long overdue for a general gyno visit and that's definitely on the list.

I have had one sexual partner, at age 22, almost exactly a year ago. I never got tested for STDs, but I would say said partner was probably a pretty high risk choice (both because he'd had a ton of partners and I doubt he ever got std tested), so I'd meant to get tested and I'm sure it wouldn't have been a bad idea. I only had penetrative sex with him once, using a condom, and oral (not protected) a handful of times, so I'm probably not at too big of a risk, but I'm guessing some kind of STD test would still be a good idea. (?)

And finally, I'm thinking that getting on some kind of birth control would be a good idea, because I'd like to have a little more sex in here than I have been and babies, while delightful, are terrifying from a personal standpoint.

So, my question is: what is the cheapest/easiest way to get all this done? I don't have a lot of money and I have health insurance that only covers me in the case of the world ending, so budget-friendly options are important. I'm currently in the rural midwest, so I don't have a ton of options right now, but I'll probably be moving to some kind of city within the next few months. What are my options for places that would do all of those things? Would a clinic of some sort do all of this? How do I go about finding one? Or should I make an appointment with a gynecologist-- that would be more expensive, right? Unfortunately I didn't get my act together to do this while I was a student and could use campus services, so that's not an option.

Is there anything else I should be thinking about? I feel like this is probably a lot simpler than it seems and I've just been psyching myself out about it. Help me take the plunge.

posted by anonymous to health & fitness (14 answers total)

If you're in the U.S., visit Planned Parenthood.
posted by timeo danaos at 6:29 AM on June 20, 2011 [7 favorites]

A ton of people are going to suggest Planned Parenthood, if there's one in your area -- they are very good about working out a payment plan for you, and they're also really, really good about helping you sort through all of the "what the hell do I need to be wondering about because I'm new at this" kinds of questions you've got now. They can take care of all the gyno health issues and advise you on birth control.

The fact that you used condoms also proves you've got a good head on your shoulders, so yay.

You're absolutely fine. Planned Parenthood is kind of a one-stop-shopping spot for this, and while you may not have one around you now, you'll probably be able to find one when you move. Good luck.
posted by EmpressCallipygos at 6:30 AM on June 20, 2011 [1 favorite]

Planned Parenthood would be able to help you with all of these things, if they're available in whatever city you are possibly moving to.

Do you not have health insurance? Because if you do, seeing a gynecologist is the same as seeing any other doctor, co-pay wise. Birth control, if you go with the Pill, will run you ~$20/month. If you don't have insurance you can always call a gyn's office and say that and ask if they offer a sliding scale, offer to pay in installments, or ask if they can recommend a low-cost clinic.
posted by noxetlux at 6:30 AM on June 20, 2011 [1 favorite]

If you don't have a Planned Parenthood in your area the local county health will sometimes do similar services.
posted by aetg at 6:38 AM on June 20, 2011

This is EXACTLY the kind of thing Planned Parenthood is for and I am almost certain that your nearest small, rural-area-anchoring city has a Planned Parenthood of some kind. (As someone in a small midwestern city that anchors a large rural area. We have like four branches of the local clinic in a metro area of 300,000. There are seven separate clinics within an hour's drive of me.) Look here.

You can also probably wait until you move if you're moving soon. Either way.
posted by Eyebrows McGee at 6:40 AM on June 20, 2011

You are a good age to be considering a Gardasil vaccination. I have no idea what it costs in the US, but please ask.
posted by Trivia Newton John at 6:50 AM on June 20, 2011 [1 favorite]

Even if your health insurance doesn't cover this it will sometimes restrict how much doctors can charge you for specific services, generally if the doctor is "in network" for your insurance. Of course it varies by insurance, but it's worth looking into.
posted by anaelith at 6:57 AM on June 20, 2011

Yeah, Nthing Planned Parenthood -- I used them for a gyn exam back when I was about 18 and they were incredibly comforting and informative. They were clearly used to dealing with slightly freaked out women who were not real familiar with gyn exams and general reproductive health.
posted by rmd1023 at 7:06 AM on June 20, 2011

Trivia Newton John: "You are a good age to be considering a Gardasil vaccination. I have no idea what it costs in the US, but please ask."

Definitely! Some county health clinics offer this vaccine at a much cheaper rate than a gynecologist's office, so check into that. (You may need a referral, depending on the clinic.)

FWIW, when I asked my gynecologist when I should start bringing my 15yo daughter to her (instead of to a pediatrician), she said "when she's sexually active". So you may not be as late to the game as you fear.
posted by SuperSquirrel at 7:29 AM on June 20, 2011

If they don't have a Planned Parenthood near you, see if there is a Certified Nurse Midwife group. They also do basic gynecological and reproductive services.
posted by dawkins_7 at 7:58 AM on June 20, 2011

I defer to the medical professionals, but having sex once with a condom and oral sex only a few times? It seems like the chances of having contracted something are pretty low. I'd get tested before going on to have unprotected sex with someone (and have that person do the same), but I don't think this is a situation of "OMG get tested now." FWIW, when I was young, STD testing was an outgrowth of some sort of puritan thing, sex as contamination and impurity, where any encounter however well-protected or minor made me feel like I was at risk of infecting others, and it took some half-covered smiles from people at testing facilities to realize I was erring far on the side of caution. I trust that Mefites will correct me if this is a reckless comment, but I thought I'd throw it in in case it helped with the "psyching yourself out" bit. :) Getting your overall plan in order is still a great idea, though.
posted by salvia at 9:09 AM on June 20, 2011 [2 favorites]

Planned Parenthood is indeed your best bet for budget-friendly gyno care, if you're not a college student with on-campus clinics.

However: In my local PP, if you want more testing than just the HPV/abnormal cells testing they offer for a pap, you have to ask for it explicitly. It may also take a blood draw, but that's better than not knowing, even for a weenie-about-blood-draws like me.

I will also say, on the psyching yourself up part: it's okay. I've been going for a pap every year since 17, and I'm your age. Having a stranger stare at your crotch and butt is about as fun as it sounds, but letting them know you're not enthused or are scared can get you someone to hold your hand or just a distractionary chatter about whatever. It's ok- they're used to being looked upon as only just better than the dentists in the sceme of medical phobias.
posted by Hwin at 9:35 AM on June 20, 2011

Another vote here for Planned Parenthood, but also please know that you can go to any Federally Qualified Health Center and receive high-quality primary care without regard for your ability to pay. The doctors at your local FQHC would be happy to set you up with a GYN appointment (which is considered part of primary care for a woman) and discuss STD testing and contraception with you.

This government-funded network of Community Health Centers exists to serve people who don't have health insurance, and payments for the uninsured are made on a sliding fee scale basis, depending on your income. You might also be able to arrange discount prices for birth control and medications, depending on what programs you qualify for.

I can't give you a specific place to call without knowing your location, but there is a Find a Health Center website that will let you enter your address and locate the ones closest to you.

Everyone is welcome at an FQHC, regardless of status, citizenship, age, race, financial status, etc. They're a wonderful resource that not many people seem to know about.
posted by mccxxiii at 2:51 PM on June 20, 2011 [3 favorites]

In case the OP or anyone reading this thread is interested, I took my 15yo daughter to a CVS MinuteClinic yesterday, for her first (of 3) Gardisil vaccinations. The cost for the first shot is $200 USD. Holy moly...
posted by SuperSquirrel at 7:41 AM on June 21, 2011