A regular gynecological check up is not something most of us look forward to. Frankly, I detest it and try to put it off for as long as possible. But deep down I know it is something I need to do, and the discomfort is worth the peace of mind it gives me.
The first time I visited a gynecologist for a routine check up was, when I was 27. The only reason I did it then was, because I wanted to get pregnant, and I thought I should get the green light from the doctor before I started trying. That’s when my gynecologist told me, I should have started getting regular check ups since I was 20, or at least once I was sexually active.
Don’t want to see a gynecologist? You are not alone.
Most of us would rather avoid a trip to the gynecologist. Some of us don’t consider going to a gynecologist, unless something is actually wrong, and even then, we do so reluctantly. There are many reasons for this. We may be busy. A visit to the gynecologist can be down right scary for some of us, and is, at the very least, unpleasant for most of us. Some of us may be frightened of what we may find out, if we got a check up and prefer not to know. Some of us could be embarrassed by the idea of an internal pelvic exam or breast exam.
Why are regular gynecological exams important?
Regular gynecological exams help detect a number of serious problems at the early stages, when they can still be cured or managed. We are all terrified of the word cancer. Personally, I try my best not to think about it. But over the last decade many of us have had a friend, relative, or acquaintance suffering from this deadly disease. A report shows, that in recent times, for women in Mumbai, the most common cancers are breast cancer, cervical cancer and ovarian cancer. According to the report breast cancer accounts for over 30% of all cancers for women in Mumbai.
However, breast cancer, if detected very early, has a high 5 year survival rate, and if the cancer does not return in 5 years, it is considered to be cured. Early detection is also to key to preventing and treating cervical cancer.
So there is absolutely no good in being an ostrich about it. Awareness and regular check ups are the only way to combat these cancers. A routine check up with your gynecologist involves a number of tests that help detect these cancers early and significantly improves your chances of survival.
What should you expect at a regular check up?
If you don’t already get regular check ups, you can always start now. The following are some tests done you can expect during a routine check up.
Breast exam and mammograms
A regular breast exam is very important for the early detection of breast cancer. While this is done by your gynecologist during your regular routine checkup, ideally you should be doing a self breast exam every month. There are several youtube videos explaining and demonstrating how to do a thorough breast exam. Some contraceptive and period tracking apps alert you, as to what day in your cycle, is best suited to do a self breast exam.
A regular, thorough, self breast exam is, not only the key to early detection of breast cancer, but also helps you to know your breasts, so you can be certain of any sudden changes.
Earlier regular mammograms were also recommended for women over the age of 40. However, there is some concern about the harm done by mammograms, due to large number of false positives, requiring women to get unnecessary invasive treatment, in addition to causing stress. So the recommended age for regular mammograms has been increased to 50, with two year intervals. Some countries are even considering abolishing regular mammograms all together because the benefits do not clearly outweigh the harms.
However if your doctor detects an abnormality in a breast exam, then you may require a mammogram even if you are younger than 40. If you have a family history of breast cancer, or are at a higher risk for breast cancer for some other reason, your doctor may recommend more frequent mammograms at an earlier age too.
For women between the age of 20 and 30, a Pap smear test is recommended every year, and women between ages of 30 and 65 can get tested every other year. Women over the age of 65 do not require Pap tests unless they have a history of irregular Pap smears. A new test which directly checks for the Human Papillomavirus (HPV), rather than for abnormal cervical cells, is available in a few countries. This particular test needs to be done, only once every 5 years. However, as far as I know, it is not yet available in India.
The Pap test can help detect cervical cancer, through abnormal cell changes, long before it develops. By treating those abnormal cell changes, cervical cancer can be treated. That is why regular Pap testing is recommended for all women between the ages of 20 and 65, who have ever been sexually active, including ones that have only one sexual partner, or are no longer sexually active, or have had the HPV vaccine.
Sometimes a pelvic bimanual exam is a part of a routine check up. The doctor inserts two fingers in to the vagina and places the other hand on the stomach to examine the cervix, the uterus, and the abdomen in the vicinity of the ovaries and the fallopian tubes. However, there is some debate about the benefits of such exams in asymptomatic healthy women. Studies have found, that such exams are not very effective in detecting ovarian cancer or bacterial vaginosis . However, they may be required, when a women experiences any symptoms that indicate a problem with the vagina, uterus, cervix, Fallopian tubes or ovaries.
If you are worried about your first internal pelvic exam, here is an article, I wrote on the subject a while ago.
Other issues you can address at a routine check up
If you are experiencing any symptoms like pelvic pain, or unusual vaginal discharge, or rashes, or itchiness, or pain during sex, it’s best to let your doctor know. You can also ask any questions about birth control, pregnancy or urinary tract infections. If you are concerned, that you may have contracted a sexually transmitted infection (STI), it is best to get checked up. Left untreated, some STIs can cause a lot of complications.
Finally, try to be open and honest with your gynecologist about any symptoms, that concern you, and feel free to ask questions. Try to find a gynecologist who you trust and are comfortable with. Many health problems, if detected and treated early, can save you a lot of time, money, pain and misery.