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What's involved?
The visit will include lab tests (blood and urine), a breast exam and the
pelvic exam. A pelvic exam is a relatively quick procedure consisting of
two major parts: a pap smear, in which your clinician visually examines
your cervix and takes a small cell sample, and a bimanual exam, where your
clinician will feel the position of your internal organs with his/her fingers.
The visit will take about 1 hour, but the actual pelvic exam normally takes
about 15 minutes.
When should I go?
Annual routine checkups are the best way to screen for potential problems.
You should make an appointment with your health care provider once a year…
… if you are over the age of 18,
… if you are sexually active, or
… if you are interested in obtaining birth control.
It’s best to make your appointment around day 14 of your menstrual
cycle, or about 2 weeks after the starting date of your period. You can
also make an appointment anytime you experience a change in vaginal discharge,
burning, redness, or swelling.
If you'd like to make an appointment at the Women's Clinic in the University Health Center, you can call 706-542-8691.
Before Your Appointment
Great, you’ve taken the first step! There are a few
things you should keep in mind before your appointment:
Do not douche, have sex, or use tampons 48 hours before your exam. These
may change the cells of the cervix, which must be left undisturbed in order
to get an accurate Pap smear.
Make a list of questions to take with you to the exam. Your health care
provider is a wealth of information and should be able to answer your questions
on your body, birth control, risks associated with different sexual behaviors,
and sexually transmitted infection symptoms and prevention.
Tools of the Trade
Examination Table – the first thing you'll notice
about the exam table is that it has stirrups, or leg holders. These
are used to comfortably hold your legs apart so that the clinician
can best reach the vaginal area. It's perfectly natural to feel
very vulnerable in this position, but your health care provider should
be sensitive to this, and should try to make you feel as comfortable
as possible.
Speculum – this is a metal or plastic “duck bill”
device which is used to open the vagina so that the clinician can
have better access to your cervix. Some women are intimidated by the
speculum's appearance; however, only a small portion of the
rounded end is inserted into the vagina. Speculums come in different
sizes, are thoroughly sterilized and often warmed before each use.
Cotton swabs – these long Q-tips are used to collect
samples of vaginal fluids to test for sexually transmitted infections
and other bacterial infections.
Brushes/Spatulas – this brush has a long handle and
is used during the Pap smear to collect cells from inside the cervix.
A small wooden or plastic spatula may also be used to collect cells.
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What Should I Expect?
- At the University Health Center, you will check into the lab for a
urine and blood test. Don't worry, it's only a finger stick
test for the blood. Then you'll head to the Women's Clinic on the second floor.
- When you come into the office, you will be asked to fill out a form
of your medical history, date of your last period, and previous sexual
activity, such as number of partners and history of condom use. It's
important to be completely honest on this form, even if it's embarrassing.
Your health care provider is there to help you, and the only way s/he
can help you is if you provide truthful information. You can also obtain
a copy of the form online and complete it before your visit. Download
the Gynecological Health History form.
- A staff member will lead you to a room where she will record some
basic health information, such as your height, weight, pulse, blood
pressure, and general health.
- Next the staff member will lead you to the exam room, where you will
be instructed to undress and wait for the clinician. You will be given
a hospital gown with a slit in the front, as well as a sheet to cover yourself.
- The health care provider and an assistant will come into the room
and begin the exam. Most exams start with a thorough breast exam. Your
clinician will feel in circles around your breast tissue for any lumps
or abnormalities. S/he should also check your glands and abdomen for swelling.
- The health care provider is now ready to begin the actual pelvic exam.
S/he will position herself at the bottom of the exam table and will
visually examine your vulva, looking for any bumps, sores, or other
abnormalities. The clinician will then gently insert a heated speculum
and open it just enough to get a good look at your cervix. Swabs will
be taken of the vaginal walls, as well as a Pap smear, which checks
for changes in the cells of the cervix. This is the part that most women
dread the most, but it only takes about 2 minutes and your clinician
should be able to explain everything done during the exam. The important
part is to relax!
- Now it's time for the bimanual exam. Your clinician will insert
two gloved, lubricated fingers into your vagina, and feel around your
abdomen with their other hand. During this, s/he is checking for the
size, shape, and position of your uterus.
- Your clinician may insert a finger into your rectum to test the condition
of your muscles and check for tumors in this area. Again, it's normal
to feel a bit of discomfort and pressure, but this should only last a few seconds.
- Now comes the final and most important part of the exam – questions
and answers. In addition to explaining what they're doing, your
health care provider should spend some time talking with you about ways
to stay healthy, avoid infection, and, if you are sexually active, practice
safer sex. This is a good time to bring up that list of questions you prepared earlier!
Whether you visit the UGA University Health Center or another provider,
your experience should be similar to that listed above.
Different Kinds of Pap Smears
There are different Pap smear tests available. The conventional
Pap test has been used for over 50 years and has reduced deaths
from invasive cervical cancer in the US by 70%. In recent years, the
FDA has approved new Pap techniques; the most commonly known is the
ThinPrep Pap test.
For all Pap tests, the clinician will collect cervical cells from
your body in the same way. In a conventional Pap test, these cells
are put directly on a slide; however, with the ThinPrep Pap test,
the clinician rinses them into a vial of liquid. Because the cells
aren't "smeared", they don't clump together as much as a
conventional Pap test.
The ThinPrep technology has the potential to decrease false negatives
by detecting more potentially precancerous changes. However, it is
unknown if this will translate into a reduction in deaths or serious
illness from invasive cervical cancer. The ThinPrep technique may
also reduce the need for repeat Pap tests of an unclear result. Often
times, if the test is abnormal, the clinician will order additional
tests to detect HPV (Human Papillomavirus) from the cells that were
obtained from the ThinPrep Pap.
At the University Health Center, ThinPrep Pap tests are used as part
of an annual women's exam. If you have more questions about
the difference between a ThinPrep Pap and conventional Pap test, please
ask your clinician. |
Some Things to Think About
Relax! It sounds cliché, and it may seem impossible to relax while
lying down with your feet in stirrups, but it makes for a much more comfortable
exam. Nervousness leads to tense muscles, which leads to discomfort, which
leads to more nervousness – which is quite a vicious cycle! If you
relax your pelvic muscles, there will be far less discomfort and the exam will go smoother.
Find a health care provider whom you trust and can easily talk to. A clinician
who makes you feel at ease will help you to relax. The important thing is
that YOU feel comfortable. At the UHC, you can request a specific clinician.
Remember, you only have to do it once a year, and with regular checkups
now you can avoid some major problems down the road. It's your body – take care of it!
Resources
To make an appointment for information about prices or for a women’s
health examination, contact the University Health Center Women's Clinic at 706-542-8691.
For other information about women’s health, contact the University Health Center's Health Promotion Department at 706-542-8690.
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