Annual GYN Exam

Routine Gynecological Care
Routine Gynecological care helps you take good care of your sexual and reproductive health and:

• Prevents illness and discomfort
• Allows for early detection of cancers of the breast and cervix when they are more curable
• Detects sexually transmitted infections and other conditions before they cause serious damage
• Prevents sterility
• Promotes healthy pregnancy and childbirth

You should have a routine exam every year if you have ever had sex or are over age 18. You may need to have checkups even more often if you have:

• A sexually transmitted infection or a sex partner with an infection
• A history of sexual health problems
• A mother or sister who developed breast cancer before menopause
• A history of abnormal Pap test results
• A breast lump

Many women worry about having a Gyn exam--especially if it's the first time. You will be more comfortable if you know what to expect. Regular Gyn visits and exams include:

• Talking about your personal, family, sexual, and medical history
• Counseling
• A breast exam
• A pap test
• A pelvic exam
• Screening for sexually transmitted infections (at your own or your clinician's request).

Prepare for Your Office Visit
Use this checklist to prepare for your office visit!

• Schedule your appointment for a time when you will not have your period.
• Make a list of all the questions and problems you want to talk about. It's easy to forget these things during your appointment.
  This includes:
• Vaginal Discharge  
• Spotting Between Periods
• Bleeding After Sex
• Pelvic Pain or Other Problems

Don't douche for at least 24 hours before the appointment.
Don't have vaginal intercourse or insert anything into your vagina for between 24-48 hours before your visit.

Your Medical History
Before you are examined, you will be asked to fill out a questionnaire. It will include some of these questions:

• When was your last period?
• How often do you have periods?
• How long do they last?
• Do you have any bleeding between periods?
• Do you feel any pain when having sex?
• Is there any bleeding after sex?
• Do you have any unusual genital pain, itching, or discharge?
• Do you have any other medical conditions?
• What medical problems do other members of your family have?
• Are you using birth control?
• Do you suspect you are pregnant?
• Are you trying to become pregnant?
• What method do you use to prevent sexually transmitted infections?

You will be asked about past illnesses, allergies, surgery, and pregnancy. You may be asked if you smoke, how much you smoke, or if you drink alcohol or use other drugs. Your clinician will review your contraceptive needs. If you are using birth control, you will be asked if you've had side effects. Click here if you need more information about birth control.

It is very important to be frank and honest about your sex life. One out of four women has a sexually transmitted infection in her lifetime. These infections can cause sterility, cancer, as well as problems with pregnancy, childbirth, and infant health. Some can cause death. Great harm can be done even when there are no symptoms. Very often, women have no symptoms. That's why it's important to let your clinician know whether or not you are at risk for sexually transmitted infections.

Previous pregnancies or sexually transmitted infections may be detected during the exam but your clinician will not be able to tell if you've had vaginal, oral, or anal intercourse, how many partners you have, or if you masturbate. So, don't let embarrassment become a health risk. Be precise about your sexual health risks and questions about your sex life. Being clear will help your clinician suggest the best solutions.

The Urine Test
You may be asked for a urine sample. The test can tell if you're pregnant. It can also help screen for health problems.
Urinating before a pelvic exam to empty your bladder may make you more comfortable during the exam. It will also be easier for the clinician to examine you - your cervix and uterus are located behind your bladder.

The Breast Exam
You will be covered with a drape sheet. You will be asked to lie back on the examining table. Your clinician will examine your breasts for lumps, thickening, irregularities, and discharge.
Your clinician will ask if you have noticed any changes in your breasts since your last exam. If you need to learn how to do a breast self-exam (BSE), your clinician can teach you. Breast lumps are often discovered by a woman or her sex partner. Most are not cancerous. But report anything unusual to your clinician as soon as possible.

Mammography
Annual breast exams and monthly BSEs are only two of the three important ways women can protect themselves from breast cancer. The third is mammography -- x-ray photographs of the breasts that can detect abnormalities, which can help make early diagnosis of cancer possible. Mammography can detect a lump up to two years before it can be felt.

Women over 40 should have mammograms every year. Younger women whose families have a history of breast cancer should consult with their clinicians about whether or not mammograms would be of value to them. UHPP provides referrals for mammography.

The Pelvic Exam
After your breasts have been examined, you will be asked to place your feet in the footrests at the end of the table, slide your hips down to the edge of the table, and let your knees spread apart and relax as much as possible. If you are relaxed, you will be more comfortable and the exam will be more complete. You can cover your lower abdomen and thighs with the drape sheet to feel less exposed and more comfortable during the procedure. Ask in advance if you want to see what's going on and/or know what your vagina and cervix look like. A mirror may be positioned so you can see. Usually, the exam lasts just a few minutes. There are five steps:

Step 1. The External Genital Exam
The clinician visually examines the soft folds of the vulva and the opening of the vagina to check for signs of irritation, discharge, cysts, genital warts, or other conditions.

Step 2. The Speculum Exam
The clinician inserts a metal or plastic speculum into the vagina. When opened, it separates the walls of the vagina, which normally are closed, so that the cervix can be seen.

You may feel some degree of pressure or mild discomfort when the speculum is inserted and opened. Talk with your clinician about any discomfort you feel- they will do their best to make sure you are comfortable.

Once the speculum is in place, the clinician checks for any irritation, growth, or abnormal discharge from the cervix. Tests for sexually transmitted infections may be done by collecting cervical mucus on a cotton swab. These tests may not be done unless you ask for testing. Be sure to talk with your clinician if you have symptoms or concerns about your sexual partner(s).

Step 3. The Pap Test
Usually a small spatula or tiny brush is used to gently collect cells from the cervix for a Pap test. The cells are tested for abnormalities--the presence of precancerous or cancerous cells. You may have some staining or bleeding after the sample is taken. As the clinician removes the speculum, the vaginal walls are checked for irritation, injury, and any other problems.

Step 4. Rectovaginal Exam
Many clinicians complete the annual exam by inserting a gloved finger into the rectum to check the condition of muscles that separate the vagina and rectum. They also check for possible tumors located behind the uterus, on the lower wall of the vagina, and in the rectum. Some clinicians insert one finger in the anus and another in the vagina for a more thorough examination of the tissue in between. During this procedure, you may feel as though you need to have a bowel movement. This is normal and lasts only a few seconds.

After Your Exam
This is a time for further consultation with your clinician. You will discuss the results of your exam, arrange for any follow-up or consultation that may be needed, and ask any further questions you may have. This is another opportunity to discuss your concerns about sex and sexuality, birth control, pregnancy, abortion, sexually transmitted infections, loss of urine, inherited disorders, infertility, cancer signals, breast self-exam, and menopause. Don't let embarrassment become a health risk. Speak up.

If the lab tests indicate anything unusual, you will be contacted when the results are completed. Pregnancy test results are usually ready during your visit. Other test results may take a few days or weeks. Your clinician will tell you how long you'll have to wait. Be sure your clinician has your current address and phone number.