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Gynecology
Gynecology
is
the branch of medical science that deals with the care of women,
especially with reference to reproduction and the reproductive organs. A
physician who practices gynecology is called a gynecologist and can be a
man or a woman.
Some women make their
gynecologist their primary medical practitioner, whereas others may have
a general or family practitioner and see a gynecologist only for care
relating to reproductive issues and concerns. Regardless of whether a
gynecologist serves as a primary or specialty doctor, it is recommended
that females have their first gynecological exam approximately 2 years
after beginning menstruation
(also called menses) . A typical first gynecological examination
begins with a careful medical history. Along with establishing a record
of important information, a history-taking gives women the opportunity
to become more comfortable with their doctor before the physical portion
of the examination begins.
In the first and
subsequent annual examinations, the nurse or doctor does a routine
physical examination. Generally it consists of measuring height and
weight, taking the blood pressure, listening to the heart and lungs,
examining the thyroid gland, breasts and abdomen, and possibly taking
specimens for routine blood and urine laboratory tests, including
screening for sexually transmitted diseases (STD's).
The pelvic examination follows and is conducted with the woman on the
examination table with her legs spread to either side of the table and
her feet supported in metal stirrups so that her knees are bent as she
lies back on the table. The doctor begins the pelvic examination by
looking at the vulva
and the area surrounding the entrance to the vagina,
looking for any redness, swelling, irritation or soreness. Women who
want to be able to observe what the doctor is doing may request that a
mirror be placed so they can see their genitals more clearly. This
examination is an excellent opportunity for women to ask questions and
for the gynecologist to teach them about their reproductive organs and
how their bodies work. Next the doctor will put on thin plastic gloves
and conduct an internal examination to feel the size, shape, location
and consistency of the uterus, checking also for pain or tenderness.
Both sides of the abdomen are felt to locate the Fallopian tubes and to
check for masses or tender areas. Next the doctor inserts a speculum (a
metal or plastic device gently inserted into the vagina which can be
adjusted to widen the opening for examination) to allow for closer
examination of the walls of the vagina and the cervix where any redness,
irritation, discharge or abnormalities can be noted. The doctor also may
perform a routine Pap
smear at this time. The visit may also include a rectal examination
in which the doctor inserts a gloved, lubricated finger into the woman's
rectum to feel for the presence of any abnormalities. The entire
physical examination, after taking the medical history, takes about 15
minutes.
Some women find
gynecological exams to be unpleasant, uncomfortable or anxiety
producing. They may find it difficult or embarrassing to have their
genitals examined and to discuss their bodies or their concerns about
sexuality. Asking the doctor to explain each portion of the examination
before it is performed is one strategy that may help women feel less
frightened and anxious during the examination. Being informed of what is
about to take place on vulnerable areas of the body can allow women to
prepare themselves physically and emotionally for the experience. Some
women find it helpful to think about something pleasant (a beach scene
or a hot bath, for example) or to focus on something in the room (such
as a picture or poster) to help distract themselves during the
procedure. Focusing on breathing slowly and deeply can enhance relaxing
and help the time pass more quickly and comfortably.
With regard to discussing
sexuality or bodily functioning, it may help to remember that it is a
gynecologist's job every day to examine women and respond to all kinds
of questions, concerns and worries. In all likelihood, they have
probably already been asked every question imaginable on topics such as
sexually transmitted diseases, birth control, menstruation, sexual
functions and dysfunctions, and many other seemingly sensitive topics.
As anyone who has been to
a doctor knows, the brief amount of time spent with the doctor may at
times feel rushed and even impersonal. Writing down a list of concerns
or questions before going to the appointment and informing the doctor of
the desire to discuss them is a good way to avoid feeling hurried or
dismissed. This alerts the physician to the concerns and allows the
doctor to plan the visit to complete the necessary medical procedures as
quickly as possible so there will be time to hear and respond to the
concerns and questions. As with any professional, it is important to
feel comfortable with one's gynecologist. Lingering feelings of
uneasiness, more than just discomfort with the procedures themselves,
may be an indication that it is time to look for a new gynecologist.
Establishing a comfortable relationship with one's gynecologist makes it
easier to seek help and ask questions, should a problem ever arise.
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Sex
