Unless this is your first time to see a doctor for a gynaecological examination you will more than likely be familiar with this visit. No matter if you're an old hand at this or if you're a first timer, these visits can be somewhat uncomfortable and embarrassing. By letting your doctor know that you are a little nervous or embarrassed, it may clear the air and set the stage for honest, straightforward communication.
The first few minutes with your doctor will most likely start off like any other doctor visit. First, your doctor will ask you about your medical history and any recent symptoms or changes in your health. He/she will probably focus on gynecological issues, such as "Are you sexually active?" or "Do you ever experience any menstrual irregularities or problems?" It's important to be open and honest about your sexual history and symptoms. Your doctor is not there to judge you and they won't share the information with anyone else either. The more information they have about you, the better they can serve you.
Then he/she may record your weight and blood pressure and if they need to examine you gynaecologically ask you to undress.
Next your doctor may listen to your heart and lungs, examine your thyroid and abdomen, and, in some cases, take blood and urine samples. He/she might also give you a simple breast exam and show you how to do monthly self breast checks on yourself. During a breast exam, he/she will feel around your breast by making small circular motions to check for any lumps or abnormalities. It just takes a minute.
A pelvic exam including a smear test may take place if you are due a smear or you have symptoms which indicate a smear test may be useful. Your doctor will ask you to lie on your back on an examining table with your feet up. The doctor then sits at the end of the examination table to examine your external and internal reproductive organs. If you have a male doctor, there should always be a female nurse present during your exam but a lot of female doctors will have a nurse present too. Don't be afraid to speak up and request another person be in the room if you are uncomfortable. It's your right and your doctor shouldn't be offended.
The first part of the pelvic exam may be a smear test if required. This is done with a speculum and can also be carried out by a practice nurse.
The speculum is a long, cone-shaped instrument that is inserted into the vagina and allows your doctor to see the vaginal walls and the cervix. It may be plastic or metal. If it's metal, it may be cold. You can ask your doctor/practice nurse to run it under warm water to make it more comfortable.
When your doctor/ practice nurse starts the smear test, you will feel the speculum being gently inserted. If you experience any pain or discomfort, be sure to tell your doctor/practice nurse
so that adjustments can be made to make you more comfortable.
Once the speculum is in place, the doctor/practice nurse will do something called a Pap smear. This is where the doctor uses a long device to take a tiny sample of your cervix. It's done to detect pre-cancerous cells or cancer of the cervix. It can also pick up some sexually transmitted diseases (STDs).
For most people, a Pap smear doesn't hurt. But it can cause a feeling of pressure, a sense of discomfort or sometimes even cramps. You may notice a little blood after your Pap smear. This is normal and will stop after a few hours.
You should talk to your doctor/practice nurse about smear tests when you turn 18, or when you become sexually active - whichever comes first. Before having a Pap, make sure you are not on your period and do not douche the day before. Both will interfere with the results, and you will just end up having to repeat the test.
Once the pelvic exam and Pap are done, your doctor/practice nurse will collapse the speculum and remove it. The whole process only takes a few minutes.
The doctor may do a gentle external exam.
This is where he/she uses one hand to press on your abdominal area from the outside, while one or two gloved fingers from the other hand are placed in your vagina. The doctor uses this opposing pressure, from inside and outside, to feel your reproductive organs. Your doctor is checking the size, consistency, shape, and location of the cervix and uterus.
Then the doctor will move his/her hands gently to both sides of the abdomen to locate the ovaries and to inspect for masses or tender areas. Remember to speak up if you feel any pain or tenderness. This will help your doctor to identify any potential problems.1
Reference
1 beinggirl.com, P&G, http://www.beinggirl.com/en_US/pages/questiondetail.jsp?
ContentId=ASK249, 2006; and Tampax.com, P&G, http://tampax.com/womenshealth2.php?section=1&topic=6&page_askiris=1&page_article=1&id=2, 2006.
