Annual Gynecological Exam

Teenage girls and women should have an annual gynecological exam once a year until about age 29. Women between the ages of 30 to 64 should generally visit their gynecologist every other year.

At the exam, you will be asked about your sexual history and menstrual cycles. A physical exam will be done for your breasts and genitals. These examinations are routine and relatively painless, but please discuss any concerns you have with your provider.

You may also need a gynecological exam for treatment of irregular periods, sexually transmitted infections (STIs) and vaginal infections. During your visit, you may be provided with contraceptives for pregnancy prevention and receive helpful information if you want to get pregnant.

How to Prepare

Here are some suggestions for getting the most out of your annual gynecological exam:

  • Schedule your appointment for when you are between menstrual periods. Menstrual fluid can interfere with the exam as well as lab tests.
     
  • Do not have vaginal intercourse or insert anything into the vagina, including douches or vaginal products, for at least 24 hours before the visit. Sexual activity may irritate the vaginal tissue and increase the chance of incorrect Pap test results.
     
  • Prepare a list of questions and concerns you may have.
     
  • Tell your provider about any irregular vaginal bleeding, discharge, odor or pain.
     
  • Make a note of the start date of your last period and how long your periods usually last.

What to Expect

At the beginning of your visit, basic measurements, such as weight and blood pressure, will be recorded. Before the exam begins, you will be given a paper or cloth gown and privacy to undress.

A gynecological exam can include:

  • Discussions about personal and family medical history
  • Sexual history
  • Safe sex practices
  • Various contraceptive options.

It's a great time to talk about any concerns you have, including questions about irregular periods, vaginal discharge, STIs and pregnancy.

The Breast Exam

During a breast exam, your provider checks for any lumps or irregularities in the tissue by making gentle circular and linear motions with his/her fingers. The exam lasts about a minute and if you feel any discomfort or pain, be sure to speak up. Your provider may also show you how to perform a breast self-exam because it is important to check for lumps or irregularities between gynecological visits. Depending on your age and medical history, it may be recommended that you receive a mammogram screening for breast cancer.

The Pelvic Exam

For the pelvic exam, you will be asked to lie down on the exam table and place your feet on the footrests to keep your knees apart. Your provider will stand or sit at your feet to inspect your external and internal genitalia. It may feel uncomfortable if your bladder is full so try to urinate before the exam, which should last about five minutes. Deep, slow breathing will help you relax.

Here are some things you can expect during a pelvic exam:

  1. Your provider will examine your vulva (exterior genitalia) for signs of irritation, infection or sores.
     
  2. A speculum will then be inserted into your vagina. This is a thin metal device that will be opened slowly to allow your provider to examine your vaginal walls and cervix at the lower end of your uterus. If your muscles are relaxed, the speculum should only cause a slight amount of pressure or discomfort. Be sure to speak up if you feel pain.
     
  3. Your provider will do a Pap smear, swiping the cervical mucus with a cotton swab to collect a sample of cells. Pap smears can detect abnormalities that may be caused by cervical cancer, vaginal infections or STIs.
     
  4. While wearing latex gloves, your provider will insert one or two lubricated fingers into your vagina and press on your lower abdomen with the other hand to physically feel your internal reproductive organs. This procedure checks the size, shape, and position of your uterus, which can affect fertility and the type of contraception that should be used. It also checks for swelling or tenderness in your vagina and reproductive organs. These may be signs of an infection, pregnancy or cysts. As with the other components of your pelvic exam, this procedure should be quick and cause only mild pressure or discomfort. If you experience pain at any point in the exam, be sure to let your provider know.
     
  5. Your provider may also insert a gloved finger into your rectum to check for abnormalities behind your uterus, vaginal wall or rectum.

After the physical exam is completed, there will be a final opportunity to discuss any other questions or concerns you may have. Your clinician is a trustworthy source of information, so do not be embarrassed to ask about any topic. Health care providers must abide by strict confidentiality agreements. Any information you share will remain private.

To make an appointment for an annual gynecological exam or if you have questions, please call us at (206) 223-6191.