Home' Trinidad and Tobago Guardian : August 24th 2014 Contents | HEALTH |
By Dr. Vanessa Harry, MBBS, MD, FRCOG
FOR MANY WOMEN, a yearly check up at the gynaecolo-
gist is usually associated with anxiety and trepidation.
However, before you start dreading your appointment day,
it's important to note that this visit can be one of the most
empowering things you do for yourself.
It's a general misconception that main purpose of this visit
is only for an annual Pap smear test (which checks for cer-
vical pre-cancer and cancer), but your visit to the gynae-
cologist is, in fact, an ideal time to address many other
issues surrounding your health, such as sexually transmit-
ted diseases, period problems and contraception.
When should a woman have her first annual exam?
Your first annual exam should occur by age 18, but some
other reasons for visiting the gynaecologist even sooner
include the following:
• Not having a menstrual period by age 16
• Prolonged vaginal bleeding
• Menstrual problems that cause significant interruption
in work, school or personal activities
• Missed periods, especially if you are sexually active
• Pain in your lower abdomen or genital areas
• Sores, cuts, bumps or unusual discharge in the vaginal or
• Sexual activity of any kind
What happens at this visit?
1. Personal History Questions
Your doctor will ask several questions about your personal
and family medical history. Some of these may include:
• When was your last period?
• Do you have regular periods, and how long do they last?
• Have you ever been sexually active?
• Do you have any bleeding other than your normal period
or any bleeding after intercourse?
• Do you think you may be pregnant?
• Are you using any form of contraception?
• What medical conditions do you have?
• What surgeries have you undergone?
• What medicines do you take?
• Do you smoke, and if so, how much and for how many
• Have any of your relatives been diagnosed with cancer?
2. Examination: This will include
• an abdominal examination -- your doctor will gently press
on your abdomen, checking for scars, lumps and other ab-
• speculum and pelvic examination -- a vaginal speculum is
used to visualise the vagina and cervix, which can be in-
spected for irritation, masses, or abnormal discharge. A
cotton swab may also be used to test for infections. For
the Pap smear, a small brush will be used to collect cells
from the cervix and the endocervix (the opening canal of
the cervix). The cells will be tested for signs of infection,
dysplasia (abnormality) and cancer. A bimanual pelvic ex-
amination is then done to check the pelvic organs, for in-
stance the size of the uterus (womb). In some cases, if
there are any concerns, an ultrasound scan can be done to
assess the pelvic organs, and can detect abnormalities
such as uterine fibroids and ovarian cysts.
Why is it important to have a gynaecological check-up?
Regular health exams and tests can help find problems be-
fore they start. They also can help find problems early,
when your chances for treatment are better. This is par-
ticularly relevant with screening tests. Screening tests look
for diseases before you have symptoms, and can detect
diseases early, when they're easier to treat. The Pap smear
test is an ideal example of an effective screening test as it
actually picks up changes in the cervix which can be
treated, and therefore reduces the risk of cancer.
Specialist Gynaecologist and Gynaecological Oncologist
Other topics to follow soon:
Signs/Symptoms of gynaecological cancers
Abnormal Pap smear -- now what?
Tips on Breastfeeding
Breastfeeding is a skill that needs to be developed and would become
easier over time when mother and baby get the hang of it. Read and
view all you can on breastfeeding while you are pregnant. When the
time comes to put all that knowledge to use, you will feel more
confident in your ability to breastfeed.
Remember that you and your baby are learning. So the best, and
probably hardest, breastfeeding advice is to relax! The rewards for not
giving up are great!
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