THE GYNECOLOGICAL EXAM
The medical procedure performed to check the health of the female sexual-reproductive system is called the gynecological or pelvic examination. For numbers of women, such exams are distasteful or anxiety producing. Lying on one’s back with one’s legs up in stirrups and one’s genitals exposed produces a feeling of vulnerability. If the woman is anxious and tense, a procedure which can otherwise be negligibly uncomfortable can be transformed into a painful and trying event. Since an annual pelvic exam is considered an important part of preventive health care, it is important to demystify the procedure. The medical practitioner first examines the external genitals. He or she then inserts a speculum into the vagina to look at the vaginal walls and cervix and to take cell samples from the cervix for a Pap smear, a laboratory test for the early detection of cancer. After removing the speculum, the examiner performs a bimanual (“internal’) exam. She or he inserts two fingers of a surgically gloved hand into the vagina and places the other hand on the lower abdomen. By applying pressure, she or he can usually locate the pelvic organs between the two hands. In this way, the size, shape, position, and mobility of the uterus and ovaries can be checked. The more knowledgeable a woman is about her anatomy and its functioning, the more she can become an active participant in the exam, with fear and excess anxiety replaced by understanding.
As the women’s movement in the late 1960s focused attention on health-related issues, the concept of self-examination developed. This procedure enables a woman to examine her own cervix with the aid of a plastic speculum, a mirror, and a light source such as a flashlight or high-intensity lamp.
By performing self-examination, a woman can learn to become familiar with the menstrual cycle changes in the appearance of her cervix and in the cervical mucus. She can also learn what constitutes the normal amounts and texture of her vaginal discharge. In this way, she can become aware of unusual changes, detect infections early, and, when necessary, provide a medical practitioner with appropriate information. If the woman has an IUD, she can check the placement of the string. Additionally, in some cases, a woman can detect early pregnancy: the cervix will take on a bluish color that is due to increased venous blood circulation. In general, the value of self-examination resides in the demystification of one’s anatomy and in the heightened comfort level and self-acceptance it can facilitate.
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