You may have thought that since you don’t need a Pap test every year you’re off the hook when it comes to regularly checking in with your gyno. It’s no one’s idea of a fun 15 minutes after all, so why not skip it? According to a recent survey from Genentech and the Foundation for Women’s Cancer, 25 percent of women who haven’t been to the gyno in the last year haven’t gone because—surprise, surprise—they don’t like going.
Grumble about it as much as you want, but there are worthy reasons to get a checkup. For starters, the Pap test used to look for changes in the cells of the cervix, the entrance to the uterus (womb) from the vagina. Now the cervical screening test looks for evidence of the human papillomavirus (HPV), which can lead to cell changes in the cervix – that’s why women aged 25 to 74 years of age are invited to have a cervical screening test every 5 years.
Even before the pandemic, this could be a daunting prospect. That’s why Heli Kurjanen, founder of the Lunette menstrual cup, has compiled a guide to your gyno appointment.
Whether this is your first, or your tenth, read ahead for everything you need to prepare for your appointment.
What should I wear?
It’s more than likely that you will experience a physical examination during your appointment, so wearing clothes that are comfortable and easy to remove will make the process much easier. Jeans, leggings, and tights all make for very awkward undressing and redressing so try to stick to dresses or loose fitting trousers and skirts.
There is also a chance that you will need a breast examination, so a separate top and bottoms will help with this. A button down shirt will also make this experience a little more comfortable.
How should I prepare?
While it’s completely understandable to want to arrive at your appointment clean and fresh, be assured that there is no need to clean yourself any more thoroughly than you normally would.
In fact, too much cleaning (for example, douching) can have a negative impact on your hormonal balance and could potentially impact your exams. If you are getting a cervical exam, excessive washing can remove the cells that need to be examined. Also, any discharge that you have can help your doctor to understand your hormonal balance, so scrubbing this away means that they could miss important information, such as a shift in flora, a bacterial imbalance, or a yeast problem.
All you need to do to prepare is have a regular shower, and avoid using any powders or creams in the genital area. There’s also no need for hair removal; your gynecologist is only checking to make sure you’re healthy, they are never judging you for having hair down there. Waxing and shaving can cause swelling or inflammation that may make a pelvic exam more challenging.
You don’t need to worry too much about having sex before your exam either, as they can clear away any semen from your sample to ensure that it doesn’t impact the results of your exam. Your gyno might see the evidence of last night’s romp, but she won’t care. If you think you’ll be embarrassed about that, hold off on having sex for two days before your appointment.
Can I request a female doctor?
Many women feel nervous about seeing their gynecologist, and it’s completely understandable to prefer to have a female doctor performing your exam. Doctors certainly do not take offence to patients requesting a doctor of the same sex, and some clinics may even ask you for your preference when booking your appointment. You will never be asked to justify this request, and will be treated with complete confidentiality and professionalism.
However, not all hospitals and clinics will be able to provide a female doctor if it is short notice. In this case, if you feel uncomfortable then you are welcome to have a female family member or friend accompany you, and you can always request an additional nurse chaperone.
If you requested a female doctor, and for some reason it is a male doctor who greets you at your appointment, it’s important that you remind the doctor and staff of your request. Staff will still not question this request, but will instead act professionally and look to rectify the mistake.
Do I need a referral?
Yes, while your GP can do a lot of the things you go to a gyro for, if you would like more specialised advice, you will need a referral from your doctor.
What will the examination be like?
Initially there will be a few questions to get an idea of what the doctor needs to be looking out for, and these questions will vary depending on the patient’s age and experience. Doctors will ask about your general health, and specifically any genital pain or problems. They will also likely ask about menstruation, sexual activity and birth control.
You may also be asked questions about your family history, STD prevention, pregnancies, illnesses, surgeries, and drug and alcohol use. Don’t feel embarrassed by any of these questions, as lying at this point can risk you not getting the best possible medical advice. You can have complete confidence that everything you say is kept confidential, and you are not being judged.
If you are there for a cervical smear, you will be asked to remove your underwear and lie on your back on the exam table. The doctor will then insert a speculum to keep the vagina open enough so that a swab can be inserted to scrape a small sample of cells from the cervix.
Sometimes gynecologists also conduct a pelvic exam, which is usually the most uncomfortable part for patients. A doctor uses a speculum to examine the vagina and cervix and then places fingers of one hand inside the vagina and presses on the abdomen with the other hand. It’s used to assess whether the uterus, fallopian tubes, ovaries and cervix are a healthy size and position and an attempt to detect ovarian or other cancers.
You may also have a breast exam, which is brief and painless. The doctor will manually palpate your breast, feeling for lumps, thickening, or discharge. They will also teach you how to give yourself a personal breast exam.
Do I need to bring anything with me?
You should make a list of your questions and concerns, current medications and supplements, and any new allergies or medical issues. No matter how small or silly you think your question is, you should still ask it – you never know what could be helpful for both you and your doctor.
It can also be useful to write down the answers to your questions, as it can sometimes be difficult to remember everything that is said during an appointment.
You will definitely be asked about when you last had your period, so make it easier on yourself and your gynecologist by being prepared to answer this question. You can figure this out using the calendar in your phone, a physical planner, or a menstrual cycle tracking app.
Other than this, don’t forget your referral and medicare card!
What questions should I ask?
You can ask anything that is relevant to your sexual health, and you are encouraged to ask as many questions as you want answering. Rest assured that your gyno has heard it all before.
If you have noticed any kind of changes, smells, discharge, or pains then you should certainly mention these. However, you should also feel comfortable asking more general questions regarding sex, STIs, your libido, and even orgasms. Some doctors will feel comfortable answering all of your questions, and others may refer you to a sex therapist to address more serious issues or concerns.
Can I attend if I’m on my period?
If your visit involves a pelvic exam, it’s best to schedule it for when you are not on your period, as blood can interfere with results of tests. However, if you are having issues with heavy periods and extensive bleeding, then attending an exam on your period may be inevitable or necessary. If you aren’t sure, call your doctor and ask.
How often should I attend?
You will receive a letter from your doctor inviting you to your first cervical screening in the 6 months leading up to your 25th birthday. If you are a woman aged 25 to 74, you should have your first cervical screening test 2 years after your last Pap test
However, if you are experiencing any gynecological symptoms earlier than this, then you should schedule an exam sooner. Such symptoms include irregularities in the menstrual cycle, unusual or severe vaginal or pelvic pain, abnormal vaginal bleeding or discharge, swelling, tenderness, sores, lumps, or itching, or unusual changes in the breast.
Conditions commonly treated by gynecologists include:
- issues relating to pregnancy, fertility, menstruation, and menopause
- family planning, including contraception, sterilization, and pregnancy termination
- problems with tissues that support the pelvic organs, including ligaments and muscles
- polycystic ovary syndrome
- urinary and fecal incontinence
- benign conditions of the reproductive tract, for example, ovarian cysts, fibroids, breast disorders, vulvar and vaginal ulcers, and other non-cancerous changes
- premalignant conditions, such as endometrial hyperplasia, and cervical dysplasia
- cancers of the reproductive tract and the breasts, and pregnancy-related tumors
- congenital abnormalities of the female reproductive tract
- emergency care relating to gynecology
- endometriosis, a chronic condition that affects the reproductive system
- pelvic inflammatory diseases, including abscesses
- sexuality, including health issues relating to same-sex and bisexual relationships
- sexual dysfunction
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