Gynecological examination – a step-by-step course

Proven content

The gynecological examination includes several elements: viewing the external genitalia, examination in a speculum with cytological smear and possibly bacteriological examination material, basic internal examination – two-handed (vagina, uterus, ovaries) and – sometimes – combined examination vagina-rectum (often performed in women who have not yet started intercourse).

Characteristics of the genital organs

The sexual organs are divided into external and internal. The latter include the uterus, vagina and appendages (ovaries and fallopian tubes). In the cross section of the uterus, the cervix and the body are distinguished; in the vaginal part of the cervix, the disc and the cervical canal are distinguished. For a gynecologist, each of the listed parts of the internal genitalia is a kind of a separate organ for which there are separate diagnostic procedures.

Gynecological examination – the course of the examination

A gynecological examination is performed on a gynecological chair. During it, you will be lying down with your legs properly inverted on special supports. The test site is adequately lit (lamp).

Immediately before the test try to urinate to empty the bladder and thus make the doctor’s work easier. It is also worth emptying the intestines of any remaining fecal masses in advance. This will reduce the risk of you experiencing discomfort during the test.

Gynecological examination – an important choice for every woman

Every woman of childbearing age (i.e. all the years when she has a period) should visit her gynecologist every year. Postmenopausal women may do it less often, especially if they have more than 60 years. All girls who have started menstruating should visit a gynecologist with their mother for the first time.

Annual gynecological examination allows to detect the so-called silent killers: breast cancer and cervical cancer. Regularly performed cytology and breast examination allow to detect possible early forms of these neoplastic diseases. Some of us are afraid of being examined by a gynecologist. However, this fear is unfounded, because every woman should take care of her health. Tests carried out in a gynecological office may be embarrassing, but rarely, if ever, painful.

Remember that it is up to you to choose a gynecologist. It’s worth it to be someone you trust. If you have not yet decided to choose a doctor, ask your friends if they can recommend someone to you. Also pay attention to the hygienic conditions in the office itself. Remember that it will be much easier for you to overcome possible shame or fear if the environment is clean and pleasant.

Do you want to have a cytology test without visiting a gynecological office? You can choose a mail-order cytology on the LBC liquid medium, which consists in collecting the sample yourself using a special kit, and then sending it to the laboratory. Another option is LBC liquid cytology with gynecological consultation. The LBC thin-layer liquid method shows greater detectability of intraepithelial lesions compared to traditional cytology.

Gynecological examination – a step by step visit

It is best to make an appointment for a gynecological examination in the first half of the menstrual cycle – preferably not during menstruation.

Step 1 Do not wash your intimate area immediately before visiting the gynecologist. If you notice any vaginal discharge on your underwear, please inform your doctor. He can take a sample of the secretion for testing and, if the situation requires it, administer treatment.

Step 2 At the beginning of the visit, the doctor will want to obtain information from you about your health, previous diseases, operations, medications, past births, miscarriages, allergies and diseases of the genital tract in your family. This information is especially important during the first visit to the gynecologist. Therefore, try to organize the above information before going to the doctor, so that you can efficiently convey all the messages during the visit. If you are concerned that you may have problems remembering the names of the medications you are taking, take their packaging with you. In some clinics, you may have to wait longer for your appointment, so take your favorite book or magazine with you. Thanks to this, you will reduce the stress associated with the expectation and the visit itself.

Step 3 The test may start with your weight, height, blood pressure, breast and abdominal examinations. If you experience any discomfort of the parts of your body tested (e.g. stomach pain or breast pain), please inform your doctor about it before starting the test.

Step 4 The next step is the examination of the reproductive organs, including the collection of material for cytological examination, which will allow for the possible detection of cervical cancer. The doctor will ask you to undress from the waist down and get on the gynecological chair. First, sit on the armchair (for this you will probably have to use the footrest). Sit deep in the chair and then gently lean back – you can even lie down completely. Then slide even deeper into the chair – so that you can freely lift your legs and place them on the backrests one by one. Once that’s done, you can gently slide off the back of the chair – so that your buttocks are touching the edge of the seat. Remember to keep your legs on the backrests at all times. Once you are in the right position, the doctor, wearing gloves, will proceed to the examination.

Step 5 The next step is a speculum examination. To do this, the doctor opens your labia. He will then insert one finger into the vagina to find the position of the cervix and the angle it makes with the vagina. Then, with the other hand, he will push the speculum into the vagina. It is a small metal or plastic tool that resembles a duckbill. The speculum will be gently inserted into the vagina and then gradually opened. Thanks to this, the doctor will first see the target and then the cervix. After opening the speculum, the gynecologist will also be able to collect material for a Pap smear. After that, it will close the speculum and then slowly pull it out of the vagina.

Step 6 The next stage is a two-handed examination. It is because of this examination that it is recommended to empty the bladder and intestines beforehand (the doctor will put pressure on the area of ​​the bladder and rectum). The two-handed test is obviously performed with gloves. The doctor applies a lubricant to them to reduce the discomfort you feel during the test. Sliding two fingers gently in one hand, the doctor will press the skin of the lower abdomen with the other hand. Thanks to this, he will be able to assess the size and mobility of the uterus and appendages. You may experience slight discomfort during this part of the test, but there should be no pain. However, if it does occur, it may be a signal of an infection in the smaller pelvis. During the test, try to relax your abdominal muscles. Thanks to this, the doctor will be able to better and faster assess your genital tract. After the examination is complete, the doctor will extend the fingers into the vagina. Some gynecologists also examine the patient by right (look down).

Step 7 After the examination is completed, you can leave the gynecological chair. The best way to do this is as follows: While lying down, pull yourself up into the chair until your knees are straight. You can do this by pushing yourself off the legrests. When your knees are straightened with your hands on the seat of the armchair, sit down in the armchair. Then, remove your legs from the backrests, join them in front of you and go down the platform next to the chair. In case of any problems, do not be shy to ask for help from a nurse or a doctor. Before leaving the chair, you can also ask for lignin, thanks to which you will remove the remains of the lubricant remaining in the intimate areas. Then you can get dressed.

Step 8 If you are older than 40, your doctor may recommend that you have a routine mammogram. However, if there has been a history of breast cancer in your family, your first mammogram should be done at the age of 35.

Step 9 If you are under 26, you can ask your doctor about the possibility of getting vaccinated against the human papillomavirus (HPV), which is the leading cause of cervical cancer.

Step 10 If you are of childbearing age, but do not plan to become pregnant, please inform your doctor. He will show you the options and help you choose the best contraceptive method for you.

In addition to the aforementioned activities, the gynecologist may also perform or order additional tests, including:

• bacteriological examination

• research by right

• general urine test.

Bacteriological examination. Inoculation for pathological strains of bacteria or fungi may be helpful in diagnosing the causes of labia or vaginal symptoms, such as pain, burning, and itching. If the test shows the presence of bacteria, your doctor will prescribe the appropriate medications. If you notice purulent discharge from the urethra or vagina, your doctor may test you for gonorrhea or chlamydia, the two most common causes of sexually transmitted diseases.

Research by right. Some doctors perform the examination routinely by right in all patients, while others choose them only in certain situations, e.g. in women over 50 years of age. Anyway, this examination is extremely important in the early detection of benign and malignant neoplastic lesions of the rectum and the perianal area.

Also read: Two methods of describing the cytology