Every adult woman, no matter her age, should undergo an annual gynecological exam. Early detection of potentially fatal conditions such as breast cancer can save lives. The annual exam is also an opportunity for women to ask doctors questions pertaining to menstrual cycles, sexual health, pregnancy, menopause, or related issues.
The patient lets the doctor know about her overall health, changes since the previous year, any prescription or over-the-counter drugs she takes, and the history of cancer and other diseases in her family. The patient’s height, weight and blood pressure is also recorded.
During this exam, the doctor examines their patient’s breasts manually, feeling for lumps or any other breast tissue abnormalities. The doctor can also teach their patient how to conduct a monthly breast self-examination and show her the structure of her breast tissue so she can recognize any changes quickly. Once a woman is 40 years old– or younger if there is a history of breast cancer in her family – the doctor will likely recommend that she undergo a mammogram screening for breast cancer.
During a pelvic exam, the doctor examines the exterior vulva to check for any signs of infection or disease. An internal pelvic exam is conducted via the use of a speculum so the doctor can clearly see the cervix and vaginal walls. The doctor also examines the internal reproductive organs manually by inserting a gloved finger into the vagina while pressing on the abdomen with the other hand. This method allows the doctor to feel the internal reproductive organs and check the size and position of the uterus and ovaries, as well as search for any evidence of swelling or sensitivity in the vagina or reproductive organs. Such swelling or discomfort may indicate the presence of cysts, infection, or even pregnancy. A gloved finger inserted into the rectum can determine whether there are issues in the rectum itself, vaginal wall, or the back portion of the uterus. If the patient feels pain at any point in the exam, they should tell the doctor at once. While the doctor does not want to cause the patient pain, such pain may indicate a problem with the reproductive organs, requiring more follow-up.
During this exam, the doctor will collect a sample of cervical cells with a cotton swab for a Pap smear. This test detects the presence of cervical cancer cells. The Pap test is recommended for women ages 21 and older.
The doctor discusses birth control options for sexually active women and checks for sexually transmitted diseases (STDs). A woman planning to get pregnant can also ask what she should do to optimize her ability to conceive.
Women past menopause present different concerns. The doctor will want to know if the woman is dealing with any of the common symptoms of menopause and may discuss ways to relieve such symptoms, such as bioidentical hormone replacement therapy. The doctor may recommend testing for osteoporosis, diabetes, and other common conditions.