Gynecological Exam

General Description

A gynecological exam consists of a series of physical tests performed to assess the general health of the female reproductive system and to detect certain conditions early. This check-up, recommended annually, involves observation, inspection, and palpation of the external and internal genitalia, abdomen, and breasts.

Among the most common tests included in a complete gynecological exam are:

• Medical history and anamnesis: Particularly important during the first visit, this step establishes the patient’s personal and family medical history, as well as her lifestyle, risk factors, or any symptoms of disease if present.
• Breast examination: The appearance of the breasts is inspected to detect possible changes in the skin or nipples, as well as asymmetry between the breasts. Then, the doctor palpates the area to check for lumps, swollen axillary lymph nodes, or abnormal nipple discharge.
• Pelvic exam: The abdomen, uterus, and ovaries are palpated. The appearance of the vulva and cervix is also examined.
• Abdominal or vaginal ultrasound: The condition of the internal genitalia is assessed using an ultrasound device.
• Pap smear: A sample of cervical tissue is collected for laboratory analysis to detect signs of disease such as cancer or human papillomavirus (HPV).

In addition to the gynecological exam, it is common for the specialist to request a blood test to assess the patient’s overall health. In special cases, additional tests such as colposcopy, hysterosalpingography, or mammography may be requested for further evaluation.

When is it recommended?

It is recommended to begin gynecological exams around age 13, when the first menstrual period occurs. After that, the exam should be repeated annually, even in the absence of symptoms.

If symptoms such as breast lumps, pelvic pain, abnormal discharge, bleeding between periods, or discomfort during intercourse appear, a visit should be scheduled so that the specialist can address the specific issue.

How is it performed?

After the initial consultation in the office for medical history collection, the patient proceeds to the examination area for the rest of the tests:

• Breast examination: The patient lies on her back with her upper body slightly elevated and removes her top. The doctor palpates the armpits and breasts with the palms of the hands. The nipple is also gently pressed to check for any discharge.
• Pelvic exam: On the gynecological examination table, the patient places her legs in stirrups to keep them open. The gynecologist palpates the lower abdomen with the hands. Then, wearing gloves and applying lubricant, the doctor inserts the index and middle fingers into the vagina to assess the condition of the uterus, fallopian tubes, and ovaries.
• Abdominal or vaginal ultrasound: A gel is applied to the abdomen, and the ultrasound device is moved over the area to visualize the reproductive organs. For a transvaginal ultrasound, a protective cover is placed over a smaller probe, which is then inserted into the vagina.
• Pap smear: With the patient in the gynecological position, a speculum is inserted to keep the vaginal walls open. Using a swab or spatula, a sample of cervical tissue is collected and sent to the laboratory for analysis.

Risks

A gynecological exam poses no health risks and has no side effects.

In rare cases, slight bleeding may occur after the exam, usually due to the Pap smear procedure.

What to expect during a gynecological exam

During the first part of the exam, the specialist collects information about the patient’s personal and family medical history to assess her health and any risk factors for certain diseases. It is essential to trust the doctor and be completely honest, setting aside any concerns or embarrassment.

Some women report mild discomfort during the gynecological exam, particularly during the pelvic exam and Pap smear. The more relaxed the patient is during the procedure, the less discomfort is felt. Additionally, different sizes of speculums are available to accommodate individual needs and minimize discomfort.

To maintain privacy during the examination, a sheet is placed over the patient’s thighs and lower abdomen while she is in the gynecological position.

Patients are encouraged to ask any questions they may have so that the specialist can clarify doubts and explain each step of the process.

The results of the palpation and ultrasound are available immediately during the consultation. However, the results of the Pap smear take several days, as the sample must be analyzed in the laboratory.

Medical specialties that require a gynecological exam

A gynecological exam is performed in the specialties of gynecology, obstetrics, and assisted reproduction. In some cases, it may also be conducted in family medicine, pediatrics, or oncology.