Annual Gynecological Exams: What to Expect
In order to maintain good reproductive and sexual health, women have to visit the gynecologist for an exam about once a year. During each annual exam, the gynecologist typically asks questions about the woman�s sexual activity and menstrual cycle, as well as physically examines the woman�s breasts and genitals. Understandably, this doctor visit can cause a considerable amount of anxiety for women, since they must be open about fairly private parts of their bodies and their sex lives. Although the thought of going to the gynecologist may make some people uncomfortable or nervous, periodic gynecological exams are crucial to a woman�s sexual and reproductive health and should not be skipped. In addition, going to the gynecologist does not have to be a dreaded visit for women, as long as they are aware of what to expect from the exam. Prepared with the knowledge of what actually happens during an annual exam, women often find that the annual exam can be a fairly easy procedure.
When You Should See the Gynecologist
Generally, women begin to visit their gynecologist around the time when they should have their first Pap smear test, which is three years after their first vaginal intercourse or by the age of 21 (even if they are virgins at that age). However, many women visit their gynecologist before the age of 21 for numerous reasons, such as seeking treatment for irregular periods, STIs or vaginal infections and seeking information about safe sexual activity and contraceptive methods. Women who are sexually active or are considering becoming sexually active should visit a gynecologist in order to help protect their sexual health. In addition, women who are experiencing menstrual difficulties or any genital or breast health concerns should also see their gynecologist for diagnosis and treatment. After a woman has had her first visit, she normally will go to the gynecologist once a year for routine exams.
Information to Know Before Your Visit
Before a gynecological visit, there are several things that women should do to prepare. First, appointments should not be scheduled during the time of menstruation, since there is a chance that menstrual fluid can interfere with the examination as well as lab tests. Also, it is a good idea to create a list of questions and problems for the gynecologist before your appointment. The gynecologist needs to know about any irregular vaginal bleeding, discharge, odor, or pain. The gynecologist will ask questions about your menstrual cycle, so it helps to come to the appointment knowing the when your last period was and how long your periods typically last. Women should abstain from sexual intercourse and oral sex for about two days before their appointment, because sexual activity may irritate the vaginal tissue and increase the chance of incorrect Pap test results. "
What to Expect During the Exam
The typical gynecological exam can consist of discussions about personal and family medical history, sexual history, safe sex and birth control counseling, testing for sexually transmitted infections, a breast exam, and a pelvic exam. At the beginning of the visit, the nurse will usually record the patient�s weight, blood pressure, and the date of last menstrual period. It is also advised to urinate before the exam to empty the bladder, since the pelvic exam may feel uncomfortable with a full bladder. Before the exam begins, the woman will be able to privately change out of her clothes into an open-front gown and drape cloth that is provided.
During the exam, the gynecologist will ask a variety of questions about the patient�s health, including questions about her menstrual cycle, sexual history, contraception usage, family medical history, and lifestyle. While some of these topics of discussion can be very private areas of a woman�s life, it is extremely important that women are honest and straight-forward with their gynecologist during their discussions. Any private or secret information that you tell your gynecologist will remain between you and doctor, since he/she must uphold patient confidentiality. Also, being honest will best help your doctor assess your overall health and provide appropriate solutions to any problems.
The other parts of the gynecological visit are more physical in nature, and this is when some women may feel anxiety or embarrassment. It is perfectly normal for women to feel nervous with having their breasts and genitals physically examined, since these are private areas of their bodies. However, there is no need to feel overly embarrassed with exposing these areas to your doctor, since it is the gynecologist�s job to examine many women�s breasts and genitals every day. To further ease the patient�s possible anxiety, the doctor will most likely tell the patient what he/she is doing, step-by-step. In addition, many women going to the gynecologist for the first time are often relieved and surprised to find out that the breast and pelvic exams are quick and painless.
The Breast Exam:The purpose of the breast exam is to feel the woman�s breasts for any lumps or irregularities. The doctor asks the woman to lie on her back and open her gown. The doctor will then gently feel the woman�s breasts making circular and linear motions with his/her fingers. This part of the exam should generally feel as if the doctor is massaging your breasts and only lasts about a minute. If you feel discomfort or pain when the doctor is feeling your breasts, be sure to notify your doctor of this pain. The doctor may also tell the patient how to perform a breast self-exam, which is an important task for women to do on their own to check for lumps. After the breast exam, the woman will remain lying down for the pelvic exam.
The Pelvic Exam:The pelvic exam consists of the doctor inspecting the woman�s external and internal genitalia. The patient places her feet on the footrests, slides her hips towards the end of the examination table, and lets her knees spread apart. While this position can make the woman feel very open and exposed, it is important for the woman to try to remain relaxed in this position in order for pelvic exam to go easily and smoothly. A drape cloth is usually provided so that the woman can rest the cloth over her thighs and hips to feel more covered. The pelvic exam should last only about five minutes and is over quickly. It is very important for the woman to remember to relax her muscles and take deep breathes, because becoming tense will make the pelvic exam more difficult and uncomfortable.
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The doctor will first examine the woman�s exterior genitals (or vulva) to check for signs of irritation, infection, or sores. Next, the doctor will insert a speculum into the woman�s vagina, using a good amount of lubricant so that it can be inserted easily. A speculum (shown right) is a thin metal device that resembles the shape of a duckbill, and opens to help the gynecologist view the inside of the vagina. The closed speculum is inserted into the vagina and then slowly opened, separating the vaginal walls.
If the patient relaxes during this part of the exam, the speculum should not cause much discomfort, but only a slight amount of pressure. The gynecologist will look inside the vagina to examine the cervix for any irritation or abnormalities, and possibly swipe the cervical mucus with a cotton swab to test for STIs.
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After the doctor uses the speculum, he/she will then manually examine the patient�s reproductive organs. Wearing latex gloves, the doctor will insert one or two lubricated fingers into the vagina and press on the lower abdomen with the other hand, in order to physically feel the woman�s internal organs, including the ovaries and uterus.As with the other parts of the exam, this part is a quick procedure and should only cause mild pressure or discomfort. If the patient experiences any pain during this part, she should let her doctor know.
After the gynecologist has completed the physical examination, there will be a final opportunity for the patient and doctor to discuss any more concerns they may have. Remember that your gynecologist is an honest and trustworthy source, so do not be embarrassed to ask him/her about any of your questions. Regular, annual visits to the gynecologist are vital for ensuring and maintaining your sexual health and safety as a woman.
References
Planned Parenthood Gynecological Health
Added 12/03/2007