Gynecological Exams
A gynecological, or ‘GYN’ exam, is an external and internal check of a woman’s body which helps assess her health.
All women should have regular GYN exams. In general, women should begin having Pap tests to screen for cervical cancer three years after becoming sexually active. Those who've had vaginal problems such as Human Papilloma Virus (HPV) or frequent abnormal Pap tests may need to be seen more frequently. Ask your practitioner about the best schedule for you. If you have pain, abnormal bleeding or think you have an infection, consult your provider immediately.
Sometimes women feel apprehensive about GYN exams. Understanding the process can help you relax and learn how your body functions. Learning about your body in a supportive atmosphere enables you to be better informed about your health and sexuality.
Before the exam
You’ll be asked to fill out a form with information about your personal and family health, your menstrual cycle, pregnancies, sexual activity and contraception use. You’ll be weighed, and temperature and blood pressure readings taken. Then you’ll be given a gown and asked to undress.
The exam
First, the clinician will examine your neck and breasts for abnormalities. This is a good time to learn how to examine your own breasts. Self-exams can be a valuable habit for women of all ages. Knowing how your breasts normally feel can help you identify unusual changes.
Next, you’ll be asked to slide to the end of the table, place your feet in stirrup-like supports and part your legs. Relax your muscles by spreading your knees as wide apart as possible and taking deep breaths; you may want to try wiggling your toes.
The external area of the genitals, called the vulva, will be examined. Then an instrument called a speculum will be inserted into your vagina, so your provider can view the vagina and cervix. This may be mildly uncomfortable, but usually isn't painful; exhaling while the speculum is inserted can help. Speculums are available in different sizes; if you've never had vaginal intercourse or used tampons, you may want to ask that a smaller sized instrument be used.
At this point, a Pap test, or Pap smear, is performed. The test is used to find cervical cancer or identify precancerous cells. Cells are taken from the cervix, preserved in a vial of liquid or on a slide and sent to a laboratory for examination. You may feel slight pressure or cramping during the test.
The speculum will be removed and the provider will insert one or two fingers of a gloved hand into your vagina. By pressing on the outside of your lower abdomen, they can feel the size, shape and position of your uterus, and check for inflammation or abnormalities of the uterus, Fallopian tubes or ovaries. A rectal exam may also be performed.
STI screening
If you are, or have been, sexually active, you may want screening for STIs; tell your clinician before your exam. Screenings may include a visual check for sores or growths, a wash with a vinegar solution to check for genital warts that may not be visible to the naked eye, and additional samples taken during the pelvic exam. If you may have been exposed to an STI, let your provider know.
Protect yourself from STIs by practicing abstinence; or by using latex or polyurethane condoms and dams correctly and consistently. The safest sexual activity is an exclusive, long-term, single-partner relationship. STI risk increases with each new partner, even if the relationship is monogamous. Take personal responsibility for being sexually active by discussing STIs and contraception with your partner.
Contraception
Prevent unplanned pregnancy by using contraception consistently and correctly every time you have sex. Your clinician can answer any questions.
If you have unprotected sex or a contraceptive accident, emergency contraception (EC) can prevent unplanned pregnancy. EC is effective up to five days after intercourse and is more effective the earlier it’s taken. EC is available without a prescription for women 18 and over, and by prescription for women 17 and younger. Talk with your healthcare provider or pharmacist for more information.
