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Gynecological Exams

Making Sense of Gynecological Exams

For Women Ages 35-44 -- If you’re confused by what you should expect during a gynecological exam – or even how often you should have one – you aren’t alone.

Most women associate a visit to the gynecologist with a pelvic exam, and often use the terms interchangeably. And many people are still uncertain about the differences between a pelvic exam and a pap smear. So what should you expect from your gynecologist, and what kind of preventative care should be part of your annual visit?

To help you make sense of it all, keep these general descriptions in mind:

Gynecological exam. A gynecological exam should be an important part of your preventative health and wellness plan during your “family planning” years – even if you aren’t pregnant and have no plans to become pregnant. This is an opportunity for your doctor to assess your overall health, measure vital statistics, perform a breast exam and pelvic exam, review your birth control options, and have a discussion of your sexual health, and any pregnancy plans and concerns. If you are 40 or older, your doctor will likely refer you for a mammogram. Depending on your history and whether or not you have a separate primary care physician, she or he may also order routine blood tests or screenings for other issues such as cholesterol, thyroid function, diabetes, and bone density.

Pelvic exam. A pelvic exam is generally part of most gynecological visits, and includes an examination of your external genitals, vagina, and pelvic organs. A pelvic exam is important for detecting problems such as bladder or bowel leakage, infections, or the cause of painful periods or intercourse, such as cysts or endometriosis. A speculum will be inserted to allow the doctor to examine your vagina and cervix (and take a Pap smear if necessary). Then the doctor will insert two gloved fingers into your vagina while pressing on your abdomen with the other hand to check for growths or tenderness. It’s important to remember that while a pelvic exam may be uncomfortable, it should not be painful.

Pap smear. A Pap smear is a screening test that can detect cervical cancer or abnormal cells at the earliest possible stage. The procedure is done during the pelvic exam and with the speculum inserted, and involves the doctor collecting cells from your cervix (the lower end of your uterus) for testing. This is often combined with a test for human papillomavirus (HPV) -- a sexually transmitted infection that can cause cervical cancer, particularly for women over 30 who are less likely to have received the vaccine to protect against HPV prior to becoming sexually active.

So how often should you get these important screenings and exams? The American College of Obstetricians and Gynecologists and the women’s health experts at El Camino Hospital recommend a yearly gynecological and pelvic exam to help ensure that any issues or concerns are detected and treated as early as possible. Guidelines for Pap smears have changed over the years, and it’s now recommended that women get a Pap smear every three years, or a combined pap/HPV screening every five years. However, most women still need an annual pelvic exam, regardless of their schedule for Pap smear or Pap/HPV test. Talk to your doctor to be certain you are getting the appropriate exams and screenings every year. It’s your best bet for maintaining your health and wellbeing.

Because your annual gynecological exam is so important, it’s a good idea to take some time to prepare for your visit. Try to avoid scheduling your appointment during your menstrual period. Avoid intercourse and douching for two days prior to a Pap smear. Shower as normal, but avoid using any harsh soaps or scented lotions. Take a record of your immunizations, and make a list of any health issues or changes you’ve had in the past year. Everything from a decreased libido and sleep disturbances to weight issues and changes in your monthly cycle will give your doctor a more complete picture of your health as you age, and ensure that you get the personalized and appropriate care you deserve.

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