By Amelia Pooser
Counseling, Health, & Wellness Services (CHWS) may be best known for their flu shots or mental health support, but they also provide a variety of other medical services, including gynecology exams. Gynecology exams entail examinations of the vaginal area both externally and internally in order to check for abnormalities and/or screen for diseases. To explain more in-depth, a Nurse Practitioner in the medical care team at CHWS, Amy Andersen, shared more about the process and the ins-and-outs of the appointment.
Gynecology exams — specifically those entailing a pap smear to screen for cervical cancer — should start when a person who owns a vagina turns 21 years old, and these appointments should occur around every three years. According to Andersen, exams should also take place when concerns appear such as “pelvic pain or unusual symptoms in the genital area.” Nurse Andersen gave a list of symptoms to look out for including: signs of infection (rashes, itching, etc.), external abnormalities (bumps, lumps, rashes, etc.), discharge abnormalities (in texture, odor, or color), pain with sex, unusual vaginal bleeding or any general kinds of concerns about your genital region.
So, what should you expect going into a gynecology exam? According to Nurse Andersen, you should wear what makes you comfortable but expect to undress from the waist-down. The appointment will start with a brief conversation. Nurse Anderson explained that a patient “can expect discussion beforehand, talking about what is going on for them, what are their symptoms.” Sometimes the questions can feel “really personal,” but Nurse Anderson notes that “you don’t have to answer them if they feel too intrusive, but it gives me a better sense of what’s going on so that we can do an exam that’s really tailored to the concern of the person.”
After the conversation, the medical professional will step out and allow the patient to dress down and cover themselves with a sheet. The patient will lie on their back and put their feet into stirrups, which is a medical device that helps support a patient’s leg externally during a vaginal or pelvic exam. Then the medical professional will begin with the physical examination which happens in three parts.
Part one is the external exam. This is where the medical professional will observe the external genital area looking “to see if there’s anything going on that would be concerning or would explain the symptoms.” Nurse Anderson explains that “we’re looking for lumps and bumps and things like that, any kind of rash.”
Part two is the internal or speculum exam. A speculum is a tool that spreads open the vagina and often has a light. There are multiple sizes, and it will only be inserted for a maximum of around 30 seconds. This portion is done to look inside the vagina and cervix so swabs can be done. These swabs can be performed by the medical professional or by the patient themselves. These swabs are used to screen for sexually transmitted disease or infections as well as cervical cancer.
Then part three is a bimanual exam. This is an exam where the medical profession will use both hands to look for abnormalities inside and outside the vagina. One to two fingers will be inserted into the vagina so that the medical professional can feel for abnormalities and feel the cervix. Simultaneously, the medical professional’s other hand will be slightly pushing on the patient’s lower abdomen feeling the uterus and ovaries externally checking for abnormalities.
Then the physical exam is done! The medical professional will step out and allow the patient to re-dress and then will discuss the results with the patient. The timeline of results may vary if swabs need to be sent out to external laboratories. The general cost for the appointments are around $40, but additional fees may be added on with additional services (like labs or swabs).
So why CHWS, instead of a different care provider? Nurse Anderson detailed the speed at which CHWS can arrange an appointment, typically on the same day or the next one. She also said that patients are welcome to come into CHWS to get to know the providers and develop a deeper level of comfort before an exam. In general, CHWS offers an amazing and comprehensive gynecology service. Although a gynecology exam might sound scary and mysterious to some, it shouldn’t be anymore. Everyone deserves to receive the medical care they need to stay healthy and live a fulfilling life. So make some appointments at CHWS and take advantage of this amazing campus resource!