Regardless of your sexual orientation or whether you are sexually active, gynecological (GYN) exams are an integral part of a woman's comprehensive health care.
Women should begin having an annual gynecological exam as early as 13-15 years of age, and begin cervical cancer screening (Pap tests) every two years starting at age 21.
Regular GYN exams allow you to maintain an up-to-date knowledge of your reproductive health, become familiar with what is normal for your body and be better able to identify future health problems.
How Can Regular GYN Exams Help?
- Prevent illness
- Detect cancers such as cervical, uterine and breast cancer at an early and potentially more treatable stage
- Detect sexually transmitted infections (STIs) before they cause infertility or other damage
- Provide health care before, during and after pregnancy
If you are concerned or nervous about having a GYN exam, learning what the exam involves can help ease reservations you might have. Typically, a GYN exam involves a discussion of your medical and sexual history, a brief physical exam, breast exam, pelvic exam, STI tests, and other lab tests and counseling as needed.
About GYN Exams
Your provider will use an instrument called a speculum that s/he will gently insert into your vagina.
The speculum spreads the vaginal walls slightly apart so the cervix can be seen. At this point there is usually some pressure, but if you feel pain, let your provider know so s/he can adjust the speculum for greater comfort.
Your provider will look at your cervix to make sure it looks healthy. If you would like to see your cervix, you can ask your provider for a mirror. Once the speculum is in place, your provider will look for any irritation, growths or abnormal discharge from the cervix.
If you are due for a pap test/pap smear, your provider will use a small plastic spatula and a small, soft brush device to take a a quick sample of your cervical cells. This test will be sent to a lab to determine if there are any abnormal cells. The frequency of pap tests is determined by your age and whether you have a history of abnormal results.
Next, your provider will gently remove the speculum and perform a bi-manual exam. With a gloved hand s/he will insert two fingers into the vagina and, with the other hand on top of your abdomen, will feel your uterus, fallopian tubes and ovaries. S/he is feeling the size, shape and position of the uterus and whether there is any tenderness or swelling. Again, some pressure is felt here and you may experience the sensation of having to urinate, but it is quick.
It's a good idea to refrain from having intercourse or douching 24 hours before your exam. These activities can irritate the genital area and vaginal lining, and obscure test results.
If you are having your period at the time you are scheduled to have a GYN exam, call your provider to see if you will need to reschedule. When you're having your period, it can be difficult for the provider to clearly see your anatomy, which can obscure test results.
For most women, GYN exams are mildly uncomfortable and a bit awkward. You can tell your provider what you're feeling during the exam so s/he can slow down or make adjustments to increase your comfort level. Your medical provider will take the time to describe what s/he is doing. If at any point you decide that you don't want to go further with the exam; that is OK. You are in complete control of the exam and can ask your provider to stop at any time you feel uncomfortable.
Vaginal Health Issues
A vaginal yeast infection is irritation of the vagina and the area around it called the vulva. Yeast is a type of fungus. Yeast infections are caused by overgrowth of the fungus Candida albicans.
Small amounts of yeast are always in the vagina. But when too much yeast grows, you can get an infection. Yeast infections are very common. About 75 percent of women have one during their lives, and almost half of women have two or more.
- Extreme itchiness around the vagina
- Burning, redness and swelling of the vagina and the vulva
- Pain when urinating
- Pain during sex
- A thick, white vaginal discharge that looks like cottage cheese and does not have a bad smell
- A rash on the vagina
You may only have a few of these symptoms. They can be mild or severe.
Testing & Treatment
You need to see your doctor to know for sure if you have a yeast infection. The signs of a yeast infection are much like those of sexually transmitted infections, so it's hard to be sure you have a yeast infection and not something more serious. If you've had vaginal yeast infections before, talk to your doctor about using over-the-counter medicines.
Yeast infections can be cured with anti-fungal medicines that come as creams, tablets, ointments and other suppositories that are inserted into the vagina. These products can be bought over the counter at a drug or grocery store.
Infections that don’t respond to these medicines are becoming more common. Using anti-fungal medicines when you don't actually have a yeast infection can raise your risk of getting a hard-to-treat infection in the future.
Bacterial Vaginosis (BV) is a condition where the normal balance of vaginal bacteria is changed. All women are susceptible to BV and often don’t know because it doesn’t always present symptoms.
Testing & Treatment
BV is tested for by looking at a sample of vaginal fluid and checking for bacteria. It can be easily treated by a doctor to avoid further complications.
Amenorrhea is the abnormal absence of menstrual periods. Generally speaking, there are three categories of women who have experienced amenorrhea:
- Women who have never had a menstrual period by age 16
- Women who have not had a period for two to three months or longer
- Women who have irregular periods that may vary from 35 to 90 days
If you menstruate fewer than four times per year, or if you miss three consecutive periods, you need to see a health care provider.
If you are sexually active, you should see a provider for a pregnancy test after one missed or late period. You should also see a provider if you notice breast/nipple discharge, or if you notice unusual facial hair or other body hair growth.