The clinicians at Wellesley Health Services are here to help you with any health problem you may encounter. Clinical visits are free, and you are only billed for laboratory tests. You can make an appointment for a gynecological exam, or just to talk to a physician or nurse practitioner about your sexual health. Call X2810 if you would like to make an appointment. The Gynecological Exam (from the Health Services website) Whether you've never had a pelvic exam before, or if you've had 20, it can be an embarrassing and uncomfortable experience for some women. By becoming more involved with your health care, you can change this situation. If you know what's going to happen during the exam, and if you talk with your health care provider about your concerns, you can turn an anxiety-provoking situation into a positive experience. The thing to remember is that there is nothing to be embarrassed about. Your clinician performs these same exams on hundreds of women and does them because she cares about your health. These exams help detect medical conditions that could be serious if they are left untreated.
	Are you scared? Many women have had negative experiences with pelvic exams, and they are scared to have another one. It's important to remember that not all clinicians are the same, so not all exams will be the same. If you explain to the person who is going to perform your exam that the last one you had was really uncomfortable, or you were really scared, or anything that that occurred that bothered you, she can respond to that and work with you accordingly. About 48 hours before your exam, do not douche, have intercourse, use tampons or any vaginal medication. It is best to have a GYN exam when you are not menstruating. What will happen? Step by step: First, you will be asked to fill out a questionnaire that reviews your medical and sexual health history. This document is not placed in your medical record, but you do review it with your clinician. This is done, not to be nosy, but to be on the alert for medical or personal issues that may impact on your care. Please answer these questions truthfully. Remember: we care about your health! Then the clinician may ask you for your weight and height. She will take your blood pressure. You may be asked for a urine specimen, particularly if you think you might have a bladder infection. You need to remember when your last period started - that is THE perennial gyn question - which will be recorded in your chart. The next stop is the exam room, where you will remove your clothes (socks are ok). No one will be in the room with you while you undress. You get to wear this stylish paper gown-open in the front so you can have a breast exam. A routine physical is usually part of the gyn exam. The clinician will listen to your heart & lungs, palpate your abdomen etc. The Speculum Exam When it's time to do the pelvic exam and PAP smear, you will be asked to move down to the end of the examining table and put your heels in holders, called stirrups. This position makes many women feel vulnerable, embarrassed and exposed, which is very understandable. Remember: try to relax your muscles and breathe slowly & deeply. The first sensation with the pelvic exam is heat. The clinician uses a strong light so she can see. It won't touch you and you won't be burned. Next she will touch the outside of your vagina and check for any signs of infection like sores, warts or a tumor. Then comes the speculum, a slim metal or plastic instrument that allows the clinician to dilate the vaginal walls, which normally lay flat and relaxed, but can expand easily (to deliver a baby, for instance) to observe your secretions and stabilize the cervix so she can do the PAP test. Named after George N. Papanicolaou, the American scientist who developed the test, it screens for pre-cancerous or cancerous conditions, as well as some infections like monilia (yeast), bacterial vaginosis and the Human Papilloma Virus (HPV). In order to test for these medical conditions, the clinician must remove some of the cells from your cervix. This is done with either a small flat wooden or plastic spatula and a tiny tapered brush. The cells are collected either spread on a slide or mixed into a liquid medium. This process does not hurt, but can be uncomfortable. If it hurts, make sure you tell your clinician. Many women have a small amount of spotting or bleeding after the exam. This is quite common and nothing is wrong. REMEMBER: Most PAPs are normal, but early treatment of abnormal PAP tests can usually prevent serious conditions like cancer. The Bi-Manual Exam In order to check other organs like your ovaries, the fallopian tubes and the rest of your uterus, your clinician will place one or two gloved fingers into your vagina. She will put lubricating jelly on the glove so that her finger(s) will slide in easily. With one hand on your abdomen, the clinician will apply gentle pressure. By using both hands this way, she can feel the size, shape and position of you reproductive organs. This is an important way to locate any masses or tender areas. You will feel pressure, but it shouldn't hurt. Again, if you feel pain, say something. And that's it! A first step in a lifetime of participating in and maintaining your health. Costs of Tests and Services Pregnancy Test...15.75 Pap smear (taken at GYN exam)... $22 Thinprep Pap smear...$50 (slightly different test) Chlamydia/Gonorrhea test...$50 HIV test...$25 Herpes culture...$48 Syphilis test...$16 * For detailed information about Wellesley College Health Services, please visit the official website at www.wellesley.edu/Health/homepage.html

  Created by: Keaty Gross and Cassie Magalhaes-McGurk
  Date Created: April 28, 2008