The Gynecological Exam
Regular gynecological examinations are an essential part of any woman's health care. All women should have their first gynecological exam approximately three years after beginning penetrative sexual activity or by age 21, whichever comes first. However, if a woman detects any pain or unusual vaginal discharge or menstrual irregularities, an earlier medical exam is advised. The exam should be done once a year unless the clinician advises differently.
The purpose of a yearly exam is to determine the position and state of health of the internal reproductive structures, as well as the external genitals. The reproductive system consists of: the vagina (passage leading from outside the body to the uterus), the cervix (opening to the uterus), the uterus (womb), the fallopian tubes (transport eggs from ovaries to uterus) and the ovaries (glands containing the eggs). The clitoris, labia majora and labia minora make up the external genitals. The Pap smear is done to assure early diagnosis of any change in the cells within the cervix, which may indicate cancer. The gynecological exam is important for prevention and early detection.
Many women feel some anxiety about their first gynecological exam. Knowing what to expect can relieve anxiety and help you feel more relaxed. Ask your provider any questions you have during the exam. If your provider is a male there will be an escort or chaperone in the room during the exam as well. You may also ask to be seen by a female provider if you wish.
Things to remember
- It is important for all women to have GYN exams, including lesbian, bisexual and transgender women.
- For best results, it is recommended not to use anything inside the vagina 1-2 days prior to the exam. This includes vaginal lubricants, spermicides, medications, douches, sex toys. Abstain from sex 1-2 days prior to your exam.
- Ask any questions you have.
- Keep track of the first day of your last menstrual period.
- Try to relax; muscle tension may cause discomfort. Take a few slow, deep breaths and relax the muscles in your abdomen and legs.
- Pap smears cannot be done during your menstrual period.
- Patients with abnormal results will be notified by phone.
- If your results are normal or as expected you will br notified via an email and by accessing MyMcKinley using your secure sign on and password. This option for obtaining your lab results is voluntary and you must elect to have this service. This can be done by bringing your I-Card with you and checking in using the automated check-in system.
- Some women feel anxious before their exam and may forget questions they may have. It is recommended you write your questions down before coming to your appointment to ensure you get the answers you need.
What happens
- First, your weight and blood pressure will be taken and you will be given a medical history form to complete.
- You will then be shown to the examination room and asked to completely undress (you can keep your socks on). You will be given a sheet to cover yourself.
- The clinician will review the history form with you. This is a good time to ask any questions or talk about any concerns. If you need birth control, you can get information about different methods.
- After sitting on the table, a brief physical exam of your heart, lungs, neck and abdomen will be done.
- The clinician will do a breast exam and will teach you how to do your own monthly breast self-exam (printed material is available).
- You will be asked to place your feet in the foot rests and slide to the end of the table. The clinician will examine your external genitals (vulva).
- Next, a speculum is inserted into the vagina. The speculum is a metal or plastic instrument that holds the vaginal walls apart in order to facilitate a clear view of the vaginal walls and cervix. You may feel some pressure when the speculum is inserted. If you are nervous, the pelvic muscles may tense and make it uncomfortable. Take slow, deep breaths and try to relax. If you feel any discomfort, let your clinician know. You may also hear some clicking sound as the speculum is opening.
- With the speculum in place, the clinician will take a flat spatula and special brush and gently take a sample(s) of cells from the cervix. This is called the Pap smear. A culture for gonorrhea and chlamydia may also be taken. The speculum is then removed.
- Last, the clinician will do the bi-manual exam. You may find this exam slightly uncomfortable. The clinician puts on a glove and inserts one or two fingers into the vagina and, at the same time, presses gently on the abdominal area with the other hand. This is done to determine the size, shape and mobility of the uterus and ovaries. It is not uncommon to have a small amount of discharge or spotting after the examination.
- After the exam is over, you will get dressed and have the opportunity to talk with your clinician about other questions you may have. You will also receive any prescriptions and instructions at this time.
