What to expect in your Annual visit to a Gynecologist
(Annual Gynecology exam)
Women who are eighteen, or younger if they are sexually active, should see a gynecologist yearly. In fact some experts think it's a pretty good idea in your teens, after you've started menstruating, to begin the habit of having a yearly exam with a gynecologist: all women should tend to their reproductive health at least once every year just like they should go to their general doctor for a yearly checkup.
A typical gynecological exam includes a short physical and assessment of the thyroid, breasts, heart, lungs, abdomen and pelvis. A thorough history is taken prior to the exam and the woman is instructed in how the exam will be conducted. Before the exam begins, a mirror may be provided by the gynecologist so that you can see what is happening during the exam and be able to ask questions. A metal or disposable plastic speculum is placed into the vagina in order to do the pap smear. The speculum is available in a variety of sizes to make the exam more comfortable – so you can ask the gynecologist for a different size speculum should you experience any significant discomfort during the exam
The pap is a screening test performed for the detection of cervical cancer. The collected specimen is then sealed and sent to the lab for analysis. Results are typically back within one to two weeks. If there are any abnormalities found by the lab, the gynecologist or staff will contact you for additional information or any required follow-up visits. Some women have no sensation during the pap smear and others experience it as a "pinching" or "tugging" feeling deep inside the vagina. Very few women have pain during the collection. Occasionally, the cervix will bleed for a few minutes after the pap.
Additional cultures may also be taken during the exam, especially if you have symptoms of irritation, burning, itching or abnormal discharge. The additional samples may also be sent to an outside lab or be inspected right in the doctor’s office under a microscope. A cotton swab is used for cultures which may be done for chlamydia, gonorrhea, or beta strep. A herpes culture, when collected from the actual lesion, is the only culture which may actually be "painful", all other culture collections cause little or no discomfort during the exam.
The second part of the gynecological annual exam is a pelvic exam. This is done to feel the size, shape and consistency of the uterus, tubes and ovaries. Two fingers are introduced into the vagina and the gynecologist then places the second hand on the woman's lower abdomen. The manual exam is then performed. Relaxing the abdomen and having an empty bladder makes the exam easier to perform more comfortable. If this is your first exam of this type, make sure you explain to the nurse that this is your first exam so a special effort can be made to put you at ease and to explain the equipment and the sensations you will experience.
The exam also provides an excellent opportunity for the patient to communicate any concerns and ask questions.