Dear Just Wondering,

The current recommendation is for most women to see a gynecologist or health care provider within three years of the onset of sexual activity or when they turn 21, whichever comes first.  After a woman has had sex with a partner, it is important for her to have a full gynecological exam at least every three years. Depending on your personal health history, your health care provider may recommend having an exam every year.

Your visit includes a general examination, as well as some or all of these specific procedures:

• Questions about full family and personal medical history
• A breast examination, with instructions on breast self-exam
• Listening to your heart and lungs with a stethoscope
• A blood pressure and pulse check
• A weight check
• An abdominal exam
• A pelvic exam
• A Pap smear
• Sexually transmitted infection (STI) screening tests (Note! A Pap smear does not automatically test for STIs. You may need to specifically ask your provider to test for STIs, including HIV.)
• Evaluation for contraception, if desired

You can use this experience to learn more about your body as well as yourself. Let your provider know that this is your first exam and ask her/him to explain each procedure. Routine pelvic examinations include both an external and an internal exam. The health care provider will examine your vulva (inner and outer lips), clitoris, and vaginal opening. After that, s/he will look inside your vagina using a speculum, which may be the most unfamiliar part of the exam. A speculum is an instrument used to hold your vaginal walls apart. It may be a bit uncomfortable — even though this may seem impossible, relax, it does get easier with practice.

The provider will examine your vaginal walls for lesions, inflammation, or unusual discharge, and will also check your cervix for the same. S/he will collect a sample of cells from your cervix using a swab. This part of the internal exam is called a Pap smear. Some women feel a slight cramping when the cells are being gathered. The collected cervical cells are then sent to a lab to check for abnormal cell growth and to screen for cervical cancer. Abnormal cell growth is often caused by human papillomavirus (HPV). If the results of the Pap are inconclusive or abnormal, a follow up test for HPV itself may be done. The Pap smear does not test for pregnancy, STIs, vaginal infections, or other types of gynecological problems.

Young women need routine gynecological exams because they may be particularly vulnerable to cervical infection since the surface of their cervixes contains relatively immature, less resistant cells. Early detection and treatment can reduce future complications. The HPV vaccine released in 2006 is recommended for young women ages 9-26 to protect against cervical cancer. It's most effective if administered before you're sexually active, but it can be helpful if you haven't been exposed to the strains of HPV against which it protects.

So if you think it's time, Columbia students can call Primary Care Medical Services at x4-2284 or log-in through Open Communicator to make an appointment for an exam.  If you are not a student at Columbia, contact your health care provider or school's health service for an appointment.

Alice

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