ScientIST: Women's Health Week - Get Your Lady Parts To The Doctor!


Photo by Rachael Porter via Flickr/used with permission

When was the last time you had someone give your lady parts a good once-over? And by “someone,” I mean an individual with a medical degree from an accredited university. That’s right; it’s time for us ladies of Los Angeles to schedule our yearly gynecological appointment, affectionately known as “the Annual”.

Since we’ve dubbed January “New Year’s Resolution Month”, it’s only fair we take week 2 of our series to focus on women’s health issues. Whether you’re the kind of girl who sends her doctor’s staff a Christmas card or the type that forgot what a Pap smear is, we give you some information to get on track with your body, yourself in 2009.

Like any routine check-up, you’ll most likely be weighed and your blood pressure, temperature, pulse, and respiration will be checked. If you are having any urinary symptoms or want a pregnancy test, inform the nurse that you’d like to give a urine sample. You’ll then be asked to remove all clothing, and likely have two drapes (the entirely immodest paper gown-thingy) - one for your top and one to cover your nether regions. Doctor’s offices are generally cold, so go ahead and keep your socks on while you wait. (FYI, if you want to decrease your office wait time, ask for the first appointment of the day.)

Don’t forget to make a list of discussion topics before you arrive. Most physicians have about 15 minutes with a patient, so use it wisely. Copy down and fill out the following questionnaire to ensure that you can answer quickly and correctly. You have to be your own advocate!

• When was the first day of your last period? (Whether or not you are trying to get pregnant, you should be marking this on your calendar each month!)
• At what age did you start menstruating?
• What is the length of your average cycle (measured from the first day of your period to the next time your period begins again)?
• Are your periods normal? Do you experience heavy bleeding or cramping? Are you spotting between periods?
• Are you having any abnormal vaginal symptoms like a strange odor or discharge? Do you have any pain with urination? Are you experiencing any pain with intercourse?
• What is your current form of birth control? Are you interested in pursuing a new method? If you are using a hormonal method (the pill, the shot, the ring, IUD) have you also been diagnosed with migraines? Are you a smoker?
• When was the last time you had a Pap smear, pelvic exam, and breast exam? What were the results?
• When was the last time you were tested for any sexually transmitted infections and which ones (Gonorrhea, Chlamydia, Syphilis, HIV, etc.)? What were the results?
• Are you planning on getting pregnant in the near future? Do you have any fertility questions?
• Do you have any other questions to discuss at this time? (Mental health referrals, physical or sexual abuse, drugs and alcohol use, safe sex, follow-up to previous test results, cholesterol, thyroid, trouble sleeping, weight loss/gain, etc.?)

After you’ve discussed your concerns and explained your history, the physician will often listen to your heart and lungs, feel for your thyroid gland, your lymph nodes, and your abdomen, and conduct a breast exam. At this point, you’ll normally be asked to shimmy your rear towards the end of the table and put your feet into the dreaded stirrups. The physician will check the exterior genitalia - labia, anus, surrounding tissue - for any abnormalities (redness, tenderness, etc.).

Then it’s on to the interior. If your doctor or nurse practitioner is awesome, she will have already warmed the lubricant with the lamp and use it to coat the speculum before inserting it into the vaginal canal. It’s normal to feel tense/awkward/uncomfortable, so try and concentrate on your breathing in order to relax. You’ll feel pressure (not pain - inform your doctor if it really hurts!) as the speculum is opened, which allows the physician to isolate the cervix and peer into the vagina.

Experienced physicians with great bedside manner will talk you through the exam (if they don’t, feel free to ask them to explain each step in their procedure), which should go rather quickly from here on out. They’ll check the pH of the vagina (which can be an indicator of infection), and take a sample of the vaginal mucosa to look under the microscope. They’ll conduct the Pap smear and any additional swabs for sexually transmitted infections, then carefully remove the speculum.

Breathe a sigh of relief - you’re almost out of the woods! Once the speculum is gone, they’ll insert two fingers into the vagina and press down on your abdomen in order to check your ovaries and uterus. Tell your doctor if any pressing causes pain or severe discomfort. Remember - this is YOUR exam. What you get out of it is directly related to your input.

And that’s it! You’re done. CONGRATULATIONS! Wipe off any lube remains, get dressed, wait for your clinician to report back (blood tests, birth control, referrals, pregnancy tests, etc.), and then schedule a girl’s night out to swap stories (or post yours in the comments section below) and toast to another year’s annual exam in the bag.