Womens Health

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Annual exams and Pap testing

No matter if a woman is single, married, straight, lesbian, bisexual, sexually active, asexual, or abstinent, having an annual exam is an important part of health and well-being.  During this type of exam, a health care provider can check for abnormalities, infections, discuss normal findings, explain symptoms or changes in the body, and help educate about birth control and safe sex options that are available.   
   
It is very normal to be nervous about your visit, particularly if you have never had an exam before.  You may feel embarrassed to have a provider examine you, scared the exam will hurt, or you might be worried that something is wrong or you have a problem.  Our goal is to give you information to help you be more prepared for the exam to hopefully ease any anxiety you might be feeling.    

The type of annual exam you have is based upon your age.  Student Health Services follows the 2012 guidelines endorsed by both the American Cancer Society, American College of Obstetricians and Gynecologists, and the United States Preventative Services Task Force, when providing care to women. Pap testing (cervical cancer screening) is no longer routinely recommended for women under 21, nor is it recommended annually for women over 21.

  • Women 20 years of age and younger, who have never had an abnormal Pap test
    Annual exam consists of a breast exam, general physical exam from the waist up, urine testing for chlamydia/gonorrhea, and blood testing for HIV and syphilis.    A pelvic (gynecological) exam is only necessary if there are symptoms of vaginal discharge, abdominal pain, irregular vaginal bleeding, genital sores or bumps, or other reproductive system concerns.
  • Women 21 and over who have never had an abnormal Pap test:  Annual exam consists of a breast exam, general physical exam from the waist up, urine testing for chlamydia/gonorrhea, and blood testing for HIV and syphilis.    Pap testing is performed every 3 years.  A pelvic (gynecological) exam is only necessary when Pap testing is performed, or if there are symptoms of vaginal discharge, abdominal pain, irregular vaginal bleeding, genital sores or bumps, or other reproductive system concerns.

  • Women currently being treated for, or followed, due to an abnormal Pap result:
    Annual exams, as well as repeat Pap testing, will be at the recommendation of your health care provider.


Preparing for your annual appointment

Preparation for your appointment is very important to ensure an accurate exam and lab results.  If you will need a pelvic (gynecological) exam and/or Pap testing, do not have sexual intercourse, use vaginal creams, douches, or tampons for 24 hours prior to your appointment.  If your period begins or you are experiencing vaginal bleeding on the day of your appointment, you should reschedule.

Do not urinate for at least 1 hour prior to your appointment to enable an accurate urine sample to be collected.

It is important for you to understand what type of exam you are having, and what tests are being performed.  Make sure to ask your nurse or provider any questions about your care that you may feel unsure about, and be sure to mention any symptoms you are having, any problems, or any concerns related to your health.  Our goal is for you to have a positive experience, but also to learn about your own personal health care.

What to expect during your annual appointment
After you check in at the front desk or self check in kiosk, you will be called by a member of our nursing staff to a small room where the staff member will take your weight, blood pressure, pulse, and temperature.  The nursing staff member will also ask you a few questions about your health, any problems you are experiencing, what medications you take, and any allergies you have.  Some of the questions about your health may seem very personal, such as the date of your last menstrual period, any birth control use, whether you are sexually active, or if you have ever been pregnant.  While these questions may make you uncomfortable, they are very important to the health care provider who will do your exam.  HIV testing will also be discussed, as we encourage routine HIV testing for all patients during reproductive health visits.  It is important to tell the nursing staff member about any problems you are experiencing, so we may communicate those issues to the provider who will perform your exam.  After the nurse has obtained the necessary information, you will be asked to wait in the lobby while another staff member prepares the exam room for your provider.

The nurse will give you a urine cup for collection of your chlamydia/gonorrhea test and show you to the bathroom.  After you provide your urine sample, a nurse will take you back to the exam room when the provider is ready to see you.  You will be given a paper gown and asked to either completely undress (for a pelvic/gynecological exam) or undress just from the waist up. The provider will come in, talk with you briefly, and then perform a physical examination.  Pelvic exams are performed using a speculum, which is an instrument that opens the vagina and enables the provider to examine the cervix and take any necessary lab samples.  Depending on the type of visit, and what kind of symptoms you are having, the provider may also perform a bimanual exam (the provider inserts 2 fingers into the patient’s vagina while also palpating the abdomen, checking for ovarian irregularities).  A breast exam will also be performed.

The provider will explain your plan of care, instruct you on how to obtain any lab results from tests performed, and may counsel you on preventive health measures such as safe sex, contraception, smoking cessation, weight management, or stress reduction.  If you desire contraceptives, you and the provider will discuss what method would work best for you and then you will obtain a prescription.

***If you have never been on birth control but would like for a SHS provider to prescribe it for you, you must also view the Health Issues Class presentation prior to your appointment and submit your name/Banner ID at the end of the presentation.  This is a one time only requirement, and viewing it is not necessary if you have been on birth control in the past.***


Want more information about the Pap test?  Check out this fact sheet with frequently asked questions.

Have a general question about Pap tests or gynecological exams?  Feel free to ask!  E-mail us at gotquestions@ecu.edu.
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