Friday, April 18, 2008

Check-Up Down Below

This is a guest post by KaeLyn that originally appeared in the Empty Closet. Thanks KaeLyn!

May is here and it’s time to open the windows, plant the vegetable garden, and store winter clothes away. May is about checking up, cleaning up, and preparing for the future, so it is the perfect time to celebrate National Women’s Check-Up Day on May 12th. On Check-Up Day, women are encouraged to get annual check-ups and preventative screenings. Today, let's focus on one of the most important routine check-ups for women, the gynecological exam.

There is a lot of fear surrounding the pelvic exam itself—the stirrups, the cold hands, the specula—it sounds like a really, really bad date! So here’s the truth: getting a gynecological exam is one of the easiest, shortest medical appointments you’ll ever have. No needles, no drills, no eye drops, no recovery time—just some questions and an exam that takes a few minutes. We’re going to go through a typical exam step-by-step so you can be empowered and prepared to make that appointment!

You should do a little homework before you get your exam. Call around and get recommendations from friends to find a gynecologist that is sensitive to your gender identity and/or sexual orientation. You may also want to consider if you have a preference about the gender of your gynecologist. Think of any problems or questions you might have for your doctor and write them down. If birth control is a need for you, ask your practitioner about options.

At the beginning of the appointment, your doctor will conduct a medical history. You will be asked questions about your last period, sexual activity, medications you are on, your smoking/drinking/drug use, and your family’s medical history. It’s important to answer honestly. In New York, all people have the right to confidential sexual health care, including teens. Everything you say will be private.

The exam itself is quick and simple. You will be asked to undress, change into a gown, and cover with a drape sheet. After talking with the doctor, you will lie back on the table and the exam will begin. The clinician will check your breasts for lumps, thickening, or irregularities. You may be shown how to do a breast self-exam. If you don’t know how, this is a great time to ask about it.

Next, the pelvic exam will start. You will be asked to put your feet in the footrests and spread your knees for the exam. If it is your first time, it can feel really weird. So take a deep breath and relax. Nobody really likes having a bright light shined onto their private parts while a stranger pokes around their vagina, but the exam will be more comfortable – both mentally and physically – if you are calm. You can ask the gynecologist to explain to you what they’re doing before or while the exam is going on. If your gyno is a man and that makes you feel a little uncomfortable, you can ask a woman to stay with you in the room during your exam.

The entire pelvic exam will only last a few minutes. Your clinician will visually check out your vaginal area for signs of irritation or irregularities. Next, the clinician will insert a speculum to hold your vagina open to see your cervix. Now before you panic, you should know the vagina is really stretchy so this won’t hurt, but you will feel a slight pressure. The clinician will look to see if the cervix is healthy. A Pap test will be done to collect cervical cells to test for pre-cancerous growths or abnormalities. If you and your doctor feel you are at risk for certain sexually transmitted infections, a culture may be taken for testing. A small spatula or tiny brush is used to collect cells for the tests. The speculum will then be removed.

Wearing gloves, the gynecologist will put one or two lubricated fingers in your vagina and use the other hand to press lightly on your abdomen. This is to check for enlarged ovaries, cysts, or tenderness. You'll feel some pressure during this part of the exam, but if you feel tenderness or pain, say something — it could indicate infection. Finally, 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 it should only last a few seconds.

So now you know exactly what to expect when you go in for your check-up “down there”! To be honest, the exam is uncomfortable, but a few minutes of discomfort once a year could save your life by preventing cervical, uterine, ovarian, and breast cancer, or an untreated STI infection. I hope you will celebrate National Women’s Check-Up Day on May 12th by making an appointment for your annual gyno exam, whether you’re a first-timer or an old pro! And tell your friends and family to “check-up down below,” too!

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