Why
should I get a GYN exam?
GYN exams are an integral part of a woman's comprehensive health
care. GYN exams are not only for sexually active women and
are not only for heterosexual women. ALL women, regardless
of their sexual orientation or their level of sexual activity, should
have regular GYN exams. GYN exams allow women to maintain an up-to-date
knowledge of their reproductive health, to become familiar with
what is normal for their body and in turn to be able to identify
future health problems.
Having
regular GYN exams can help you:
Prevent
illness
Detect
cancers such as cervical, uterine and breast cancer at an early
and potentially more treatable stage
What
are GYN exams?
Many women would rather do just about anything else besides having
a GYN exam. While it's true that it's not a favorite experience
of many women, it's not as bad as you may think. Learning what the
exam involves and how quick and painless it will be should help
ease any reservations you might have about scheduling your exam.
Typically, a GYN exam involves a medical history, brief physical
exam, breast exam, pelvic exam, STI tests, and other lab tests and
counseling.
Here
are the details about what you can expect to happen during a GYN
exam:
Medical
History
A medical provider will take you to an exam room and will ask you
about your medical history. Important questions s/he will ask include:
When
was your last period?
How
regular are your periods and how long do they last?
Do
you have any spotting between periods?
Do
you experience painful intercourse?
Do
you have any unusual genital pain, itching or discharge?
Do
you have any other medical conditions?
Are
there family members with significant medical conditions?
Are
you using birth control if you are heterosexually active?
Do
you use methods to prevent STIs?
Use this
time to bring up any concerns you have or questions you'd like to
get answered. Try not to be embarrassed about asking sexual health
questions - your medical providers have heard these questions before!
Talk openly with your provider and s/he will be able to help you
become much more informed. The provider will also ask about past
health issues and whether you smoke, drink, or use other drugs.
To round out the medical history, your provider will take your blood
pressure, weight, and have you step out to the bathroom to empty
your bladder, which will help you be more comfortable during your
exam. Your provider may also ask you to give a urine sample at this
time if there is any chance of pregnancy.
Breast
Exam
Next, the provider will leave the room and ask you to get fully
undressed and put on one of the lovely paper gowns. You can leave
your socks on if you like!
Your
medical provider will return to the exam room once you've changed,
and will start by listening to your heart and lungs and checking
your thyroid. Next s/he will ask you to lie back on the exam table
and will perform a breast exam. S/he will feel your breasts to detect
any lumps or thickening. If you don't know how to perform breast
self-exams (BSEs) your provider will show you how.
Pelvic
Exam and STI/Lab Tests
Next, the provider will ask you to move to the end of the exam table
and place your feet in the footrests. Let your knees and thighs
spread wide open and relax. The more relaxed your muscles are, the
more comfortable your exam will be. As you take a few deep breaths
and check out the posters on the ceiling, your provider will begin
to look at your vulva - your external genitalia - looking for any
symptoms of irritation, growths, cysts, genital warts or discharge.
You will feel your provider's gloved hands touching your vulva.
Next,
your provider will use what is called a speculum (also affectionately
called "duck lips") - a plastic instrument that s/he will
gently insert into your vagina. The speculum spreads the vaginal
walls slightly apart so that the cervix can be seen. When the speculum
is opened it is no bigger than a sex toy or penis would be. 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'd like to see your cervix you can ask your provider for a
mirror to see for yourself!
Once
the speculum is in place, your provider will look for any irritation,
growths or abnormal discharge from the cervix. S/he will use a small
plastic spatula and either a long, soft mascara brush or broom-shaped
device to take a quick sample of your cervical cells - a test called
the Pap Smear. This test will be sent off to a lab to determine
if there are any abnormal cervical cells. Also at this time, your
provider will offer to perform a test for chlamydia and s/he may
suggest other STI
tests if there are concerns that you have been exposed
to other STIs. Talk to your provider if you are worried about symptoms
you may have experienced or if you are concerned about a sex partner.
Some of these tests use what looks like a long Q-tip to take samples
of your cells which are sent off to a lab. All of these steps only
take a few minutes!
Next,
your provider will gently remove the speculum and perform a bimanual
exam. With a gloved hand s/he will insert 2 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. If you have had anal sex
play or if your uterus is positioned a certain way, your provider
will sometimes perform a rectal exam, again with a gloved finger
to feel if there are any tears or any weakness in the muscles that
separate the rectum and the vagina.
Counseling
At this point the exam is complete. Your provider will leave the
room so you can get dressed, and will return to discuss any questions
you have. Use this opportunity to ask those questions you've always
wanted to ask! Write them on a slip of paper if you think you'll
forget or be too embarrassed to ask. You can learn a lot in these
few minutes - make the most of it. You may have questions about:
Do
I need to prepare for the exam?
It's a good idea to refrain from having intercourse or douching
for the 24 hours before your exam. These activities can irritate
the genital area and vaginal lining and obscure test results.
What
if I have my period?
If you are having your period at the time you are scheduled to have
a GYN exam, you will need to reschedule. When you're having your
period it can be difficult for the provider to clearly see your
anatomy and it can obscure test results.
How
long does it take?
The actual pelvic exam may take about 5 minutes - not long at all!
The entire time you're in the exam room including the Q & A
session with your provider may take up to 45 minutes, especially
if you have questions or are seeking a contraceptive method.
Does
it hurt?
For most women, GYN exams are at worst 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 so that you'll
be as comfortable as possible. 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 are uncomfortable.
When
should I have my first GYN exam?
A woman should have her first GYN exam as soon as she becomes sexually
active or when she reaches the age of 18 - whichever happens first.
How
often do I need to have GYN exams?
A woman should have a GYN exam every year if she is sexually active
or over the age of 18. Hence, women often refer to it as their "annual."
Do I have to be tested for STIs?
You don't HAVE to do anything, but if you have been sexually active
your medical provider most likely will recommend that you have at
least a chlamydia STI
test performed. It is also good to know that your providers
are required by law to offer HIV testing, so this would be another
STI test that will be discussed with you.
Can
I request a female medical provider?
Yes, of course. If you are more comfortable having a female medical
provider, you can make that request when you call to schedule your
appointment. If there is a particular medical provider you feel
the most comfortable with, you can also request that person. It
is important to note that if you choose to have a male provider,
you may request a female chaperone to be present during the exam
as well.
Do
I need to have a GYN exam if I want to get a birth control method?
If you have had a GYN in the past year, you will not need to have
another exam to obtain prescription birth control. If you had this
exam with a medical provider outside of Health Services, you will
need to have your records faxed here. You can link to the "Request
for Medical Information" form, print it out and
have your medical provider fax it to Health Services at 863-7953.
If it has been over a year since your last exam, or if you have
experienced other sexual health problems, your medical provider
will usually need to perform a GYN exam.
What
if I'm still afraid to have the exam?
If, even after reading this page, you still have concerns about
the GYN exam and are nervous or unsure, that's ok. For example,
women who have experienced sexual abuse in the past may have specific
fears that relate to their experience, or in some cultures, women
do not have GYN exams. You can schedule a visit with a provider
to discuss the exam and to increase your comfort with that particular
provider. It is important to talk openly with your provider about
your fears, about any pelvic pain you have and to talk about your
experience. Your provider will work with you to tailor the exam
for your comfort level and will help you feel as comfortable as
possible. Also know that you can have a trusted friend with you
during the exam.
How
much does the exam cost?
The health fee you pay each year covers the cost of your GYN visit
to Health Services. Depending on the type of health insurance plan
you have, your coverage for lab tests like Pap smears and STI tests
varies. Brown sponsored health insurance covers the costs of Pap
smears and STI screening. For private insurance, contact your health
insurance customer service representative to find out which lab
tests are covered and which are not. You can also visit the Health
Services page on STI
Testing and Insurance Issues.
Can
anyone find out about my visit?
Health Services places a high value on confidentiality. This means
that information in your medical records or even the fact that you've
visited Health Services cannot be released to anyone without your
written permission (this includes parents, partners, friends, professors,
advisors, etc.). There are a very few exceptions when information
is required to be released without your written consent in the cases
of emergencies or when required by law. Your medical provider will
address any concerns you have during your visit.
Disclaimer: Health Education is part of Health Services at Brown University. Health Education maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Education offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.
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