Dear Dr Mitchell, 

I am 19 and I have my first gynaecology exam in a couple weeks. What can I expect? I read some articles online but I’m not sure if they’re accurate or complete. I feel a little nervous about the whole examination, especially the speculum. Any advice you can share would be helpful.

It is an excellent idea that you have made an appointment to see a gynaecologist at age 19. This decision should not cause you to become anxious since truthfully there is absolutely nothing to worry about.

The purpose of a visit like this one is to do a complete physical examination which includes examination of the breasts, abdomen and pelvis. Breast examination is important in women especially as you get older, and since breast cancer is the most common cancer in women, followed by cervical cancer. Breast self-examination at home does help, if done monthly at the end of the menstrual period, so that you can pick up abnormal lumps in the breasts even before your gynaecologist sees you for your routine examination.

Most women become a bit concerned that they do not know what to look for. However, if you examine your breasts regularly, you will know what is normal for you and so when an abnormal lump develops you will pick it up easily. The examination of the abdomen and pelvis is important to pick up abnormal growths in the uterus and ovaries such as uterine fibroids and ovarian tumours. In some women, the abdomen becomes distended and this is thought to be just belly fat when there is an abnormal growth in the uterus or ovaries. A routine yearly check-up by your gynaecologist will detect these problems early so that they can be treated early.

The purpose of the vaginal examination is to rule out infections, examine the cervix, vagina and to do a Pap smear. It is important to do regular Pap smears once you reach 21, or two years after becoming sexually active. This is important to detect early changes in the cervix that can lead to cervical cancer. Early detection and treatment is the best way forward in preventing death from both breast and cervical cancer.

I realise that you are anxious about the speculum examination. Most gynaecologists have extremely small speculums that can be used without any discomfort in women who are not sexually active. If you have no significant problems and you have not started being sexually active, then the speculum examination can be deferred until another visit. Once you are comfortable with your gynaecologist then the experience is usually not traumatic and should be interactive and informative.

It is also important for you to discuss the option of getting the vaccine for prevention of genital warts and cervical cancer. This is a three-dose vaccine that is given initially, then the second dose is given two months later, and the third dose given six months from the first dose. All women from age 10 to 65 should get the vaccine. It has been shown to be effective in significantly reducing your risk of cervical cancer.

It sometimes helps if you do a joint visit with a friend, or your mother, so that you can feel a bit more secure.

Best regards.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5 or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.

DISCLAIMER:

The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.