Gynecological Exam
Gynecology is healthcare for women. It protects your sexual and reproductive health. Routine gynecological care:
- Allows for early detection of cancers of the breast and cervix - when they are more curable, and
- Detects sexually transmitted infections (STIs) and other conditions before they cause serious damage.
It is recommended that you have your first pap by age 18 or when you start having sex, whichever comes first.
Your Medical History
Before you are examined, you will be asked to complete a questionnaire about past illnesses, allergies, surgery and pregnancy. You will be asked about STIs, calcium intake, diet, exercise, smoking, drug use, alcohol use, seat belt use, and physical/emotional abuse. If you are using birth control, you will be asked if you've had any side effects.
Some women have a higher risk of developing cervical changes. Your risk may be higher if you:
- Smoke cigarettes
- Have had more than one sexual partner or a male sexual partner who has had more than one partner.
- Had intercourse for the first time at an early age.
- Have had certain STIs such as genital warts or herpes.
- Are infected with HIV or have a weakened immune system.
In preparation for the Pap Test/Pelvic Exam:
- Do not douche or use vaginal medication, spermicides, or lubrication 48 hours before the test.
- Do not have intercourse 24 hours before the test.
- Do not schedule your exam when you expect to have your period.
The Breast Exam:
You will change into an examination gown or be covered with a drape sheet. Some healthcare providers provide both. You will be asked to lie back on the examining table. Your healthcare provider will examine your breasts for lumps, thickening irregularities, and discharge.
Your healthcare provider 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 healthcare provider can teach you. It is important to do a BSE once a month. The best time for a BSE is just after your period when your breasts are not swollen or tender. Breast lumps are often discovered by a woman or her sex partner. Most are not cancerous, but report anything unusual to your healthcare provider as soon as possible.
The Pelvic Exam:
You will be asked to place your feet in the footrests at the end of the table. Usually, the exam lasts just a few minutes. There are four steps:
- The External Genital Exam: The healthcare provider will inspect the external genital area for signs of irritation, discharge, cysts, genital warts, or other conditions.
- The Speculum Exam: A speculum is inserted into the vagina. Once it is in place, the healthcare provider checks for any irritation, growth, or abnormal discharge from the cervix. The healthcare provider will take a sample of cells for a Pap test. Usually a small spatula or tiny brush is used to gently collect cells from the cervix. The cells are tested for abnormalities - the presence of pre-cancerous or cancerous cells. You may have some spotting or bleeding after the sample is taken. Tests for chlamydia, trichomonas, gonorrhea, and vaginitis may also be taken.
- The Bimanual Exam: Wearing an exam glove, the healthcare provider inserts one or two lubricated fingers into the vagina. The other hand presses down on the lower abdomen. The healthcare provider can then feel the uterus and ovaries between the two fingers in the vagina and the fingers on the abdomen.
- The Rectal Exam: A rectal exam will be done on patients over 30; those with retroverted uterus; or with complaints of abdominal pain.
The Results:
The Pap Test is the best way to find changes that may lead to cervical cancer. Finding and treating abnormal cells can prevent cancer of the cervix. Only a very small number of women with abnormal pap test results have cancer. By understanding the Pap Test and how results are reported you can take an active part in your health care.
Pap tests and STI results will be back in approximately one week. A "positive" STI result will be treated by your healthcare provider. If your pap results are abnormal, you may need further evaluation. The majority of abnormals are treatable and do not lead to cancer. Treatment may be as simple as a repeat pap test in a few months. Sometimes your healthcare provider will refer you for an exam called a colposcopy to decide if further treatment is needed. A colposcope is a magnifying device that is used to examine the cervix. With this device, your healthcare provider may be able to see changes that suggest abnormal cells. Colposcopy helps a doctor decide whether a cervical biopsy needs to be done. For a biopsy, the doctor removes some of the cells to be studied under a microscope. You may feel a little cramping during the biopsy.
Treatment depends on the findings. In many cases, all that is required is to remove a thin layer of cells from the surface of the cervix. New cells often are normal and no further treatment is needed.
To request a gynecology exam, call the Student Health Center at 920-424-2424 at least 2 weeks prior to the date you wish to schedule your appointment. Review the Appointment Guidelines for Gynecology Exam and Calcium Food Sources/Eating Right, Staying Fit forms. Pick up or print the Health History form and bring it along to your appointment with a self-addressed envelope.