It is a good idea for every woman to examine and explore her own sexual anatomy. A genital self-exam (see Sex in Real Life, “Female Genital Self-Examination”) can help increase a woman’s comfort with her genitals. In addition, to maintain reproductive health, all women should undergo routine gynecological examinations once they begin menstruating and certainly before they begin having sexual intercourse. Routine gynecological exams include a general medical history and a general checkup, a pelvic examination, and a breast examination. During the pelvic examination, the healthcare provider inspects the genitals, both internally and externally, and manually examines the internal organs.
In a pelvic exam, the health professional will often use a speculum to hold open the vagina to examine the cervix (though there is a sense of stretching, this is not generally painful). Many women report discomfort with speculums, and research is currently being done to find alternatives that would allow healthcare providers access to the cervix. One such product, the FemSpec™, is an inflatable device that comes in three sizes (small, medium, and large). A Papanicolaou (Pap) smear will be taken from the cervix (see the discussion on cervical cancer, following). The practitioner will then insert two fingers in the vagina and press down on the lower abdomen to feel the ovaries and uterus for abnormal lumps or pain. A recto-vaginal exam may also be performed, in which the practitioner inserts one finger into the rectum and one into the vagina to feel the membranes in between.
It is important to choose a gynecologist or nurse practitioner with care, for they should be a resource for sexual and birth control information as well. Referrals from friends or family members, college health services, women’s health centers, and Planned Parenthood Centers can direct you to competent professionals. Do not be afraid to change practitioners if you are not completely comfortable.