Goin’ to the gyno, annual exam, well woman check, pap smear? (why is it called a pap? why did they have to include the word smear?), breast exams, speculums, exam tables, stirrups, HPV, lab work, vaccines, bone density, blood draws, birth control…Whoa! Hold it right there hunny! It’s no wonder women feel overwhelmed when it’s time for their annual check up. What does it all mean? How do I answer these questions? Am I normal? There’s a lot of big medical language and oftentimes women feel like they’re being tested on something they don’t understand. But, your annual gyno appointment shouldn’t be scary – it’s all about checking in on you to be sure you’re thriving and give you what you need– simple as that!
Lauren Zielinski is a Certified Nurse-Midwife, and the founder of a grassroots women’s health movement called New Moon Rising Events. New Moon Rising works in cities across the US to hold free, day-long workshops that foster discussion about reproductive health, political advocacy, natural medicine options, and community connections.
You should see a women’s health provider every single year to have an annual exam.
The annual exam is meant to accomplish a few big picture items:
1. What does your overall health look like?
2. Are your reproductive organs (uterus, cervix, vagina and vulva) and breasts healthy?
3. Are you physically, emotionally and mentally safe?
4. Do you need anything from your provider like birth control, help managing funky periods, painful sex or any other women’s health concerns?
Knowledge and understanding around the exam and its components equals power. Fear relative to gynecological issues is often bred from not knowing what is going on and letting your mind wander to what if’s. So here we go:
What to expect during your visit?
The exam portion includes a handful of different pieces. Providers will typically be asking questions and interacting with different parts of your body to be sure all is healthy. If you feel anxious during any part of your visit or remember feeling anxious in the past: ask your provider to slow down and explain what they are doing as they do it. Luckily most providers are good at talking you through this piece. You absolutely can and should ask questions!
1. History & Intake: this is when the nurse or medical assistant asks you about your past medical & sexual history. Answer as honestly as possible so you get what you need – this segment should feel non-judgmental– if not – ditch your doc and get a new one.
2. Vital Signs & Weight: This is when they take your weight, blood pressure, heart rate, oxygen levels and temperature. Ask them to explain what’s normal and what’s not if you’re curious! For example: “How does my blood pressure look compared to a normal blood pressure?”
3. Physical Exam: this is the part of the visit where the provider does a head to toe assessment of your overall health. It is supposed to be very hands on so they can gather as many clues as possible to how you’re doing so knowing that can help you prepare! Our hands are our tools as providers. It should be pretty quick though! Before the provider touches you it is absolutely fine to: ask them to explain what they are looking for as they go and tell you what they are doing. If you ever feel extremely uncomfortable or are in pain you are absolutely entitled to ask them to stop the exam completely and that is fine!
4. Breast Exam: This should be happening once a year! It usually takes no longer than 5 minutes and most providers are good at talking you through this piece – if you’re feeling nervous or there is an awkward silence (it happens) ask the provider about current guidelines for breast health and what you should be doing at home. Consider watching how the provider checks your breasts so you know how to assess your own in the future.
5. Internal Exam & Pap: Pap guidelines have changed in recent years and are no longer required every single year! Whoo hoo! Your provider will talk you through how often you need one depending on any history of abnormal cervical cells or positive HPV tests. It’s closer to every 3-5 years now depending on your age.
Many providers will still perform an internal exam to check your ovaries, uterus, vagina and vulva for overall health even if you don’t need a pap. They also may still use a speculum in order to visualize your cervix, perform STD testing or look for signs of anything wrong if you have any specific complaints.
You can also ALWAYS so no to an internal exam if you don’t want one. If any piece of an exam feels out of control, painful or difficult for you, say stop. Take some deep breaths and tell your provider what is going on in your head and ask for what you need. You are the boss.
*Tip: I offer all of my clients a hand mirror to watch what is going on and learn about their body and health – this really empowers women to understand rather than close their eyes and flinch. If this idea feels helpful – put the control back in your hands and ask if your provider has one available (most do).
Good questions for the end of your visit:
1. What tests will be run after this visit and how long until they come back?
2. How will you inform me of my test results?
3. Do I have any family history that poses risk for me?
4. Overall do you have any concerns about my health?
5. When am I due to come back again?
6. Are there any side effects from new medications prescribed I should look out for?
7. Am I due for any bone density scans? HPV testing? Mammograms? Lab Work?
The hope is that when you’re done reading this article that you feel like a gynecological super woman. Take that paper drape off your lap and let it fly in the wind behind you when you leave your next visit, you have got this! By going once a year you are taking great care of yourself and deserve a pat on the back and a glass of champagne. Stat!