Women's Health

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No matter if a person 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 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 under 21, nor is it recommended annually over 21.

  • 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.
  • 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.
  • 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.

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

Contraceptive methods come in many different forms including hormonal, barrier, and natural family planning methods. All of these methods work to accomplish one goal: prevention of pregnancy. Some of the methods also provide the added benefit of protection from sexually transmitted infections (STIs). When choosing a method, be sure and pick one you are likely to use consistently and correctly for the best protection rates. Student Health providers are happy to discuss options available for contraception.
Contraceptive methods available at ECU SHS:

  • Oral Contraceptives
  • Ortho-Evra and NuvaRing
  • Depo-Provera
  • Condoms
  • Diaphragms
  • Emergency Contraception*
  • Implanon/Nexplanon
  • Intrauterine Device (IUD)

* Emergency Contraception
A woman who feels at risk for pregnancy (ex: condom breaks, missed pills without a backup method, sexual assault) can take a high dose of hormones which decreases the likelihood of implantation of a fertilized egg. This must be done within 120 hours of the unprotected intercourse and is available at most pharmacies. No prescription is needed for individuals age 17 and older. A valid ECU 1Card is required for purchase. Student Health will not sell emergency contraception to non students.

Not sure what type of contraceptive would be best for you? Check out www.bedsider.org for information on various methods available, pros/cons, etc.

Obtaining contraceptives at Student Health Services
Condoms may be purchased over-the-counter in the Student Health Service Pharmacy.

To obtain oral contraceptives (birth control pills), Ortho-Evra®, NuvaRing®, Depo-Provera®, Implanon/Nexplanon, an IUD, or to be fitted for a diaphragm, women must have an up to date annual exam (please see the above section entitled "Annual Exams and Pap Testing". SHS provides these exams at a reduced cost to students. Call (252) 328-6841 or stop in to the appointment office inside Student Health to schedule your exam.  

If you have had a recent exam at an outside provider but wish to have SHS prescribe you contraception, please have your medical records sent to us prior to scheduling your appointment for a “contraceptive consultation”.

Student Health can also make referrals for anyone interested in other methods of contraception.
Have a general question about contraceptives? E-mail us at gotquestions@ecu.edu.

The best way to notice changes in your breasts is to do a regular self exam—if you do not know what is normal for you, you will not be able to notice changes in your breasts that could signal a problem. If you find a change, see your health care provider right away.

Most breast changes or lumps are NOT cancer. However, when breast cancer is found early, you have more treatment choices and a better chance of recovery. Regular breast self exams are an important screening test you can perform to help with early detection of breast problems.

Breast self-exams should not take the place of regular screening mammograms or clinical breast exams, which are done by a healthcare provider.

What exactly are you looking for when you are doing a self exam?
It is hard to know what is “right” or “wrong” for your body, unless you have a basic idea of what is normal for you. Breast Self Exam (BSE) is a great way to establish a healthy level of self awareness about your breast. Breast tissue is made up of glands and other tissue that can feel lumpy to the touch. The amount of lumpiness varies for each person.
You are looking for lumps that:
• Stand out
• Are 1/2 inch in size
• Are persistent and unchanging
• Represent any difference from normal breast tissue

Also note any changes in the skin around your breasts, any pain or discharge from your nipples, or any other finding that seems different than normal. It is important to know that the consistency of breast tissue changes throughout the life cycle and the monthly menstrual cycle. To learn how to perform a BSE, visit "The Five Steps of a Breast Self Exam".  

If you notice any changes in your breasts, feel any lumps, or want to talk to a provider about breast health, please schedule an appointment. 

If you have just found out that your Pap test is not normal, you are probably wondering “What now?” First, realize that an abnormal Pap test does not indicate that you have cervical cancer. But, depending on your age and your medical history, you may be asked to have Pap tests more frequently or you may be referred for a special test (colposcopy) that will help evaluate what was not normal about your Pap test. For more information on abnormal Pap tests, visit WebMD. 

The Pap test can show when cells are abnormal on the cervix. It could be an area of atypia or dysplasia, which could be related to things like normal hormonal changes, or possibly to HPV (Human Papilloma Virus). In rare cases it may be early cancer. Atypia, dysplasia, and early cancer do not cause pain, itching, or discharge. It is important to obtain treatment for atypia or dysplasia if recommended by your health care provider.


An abnormal Pap test suggests that there was a chance some of the cells on your cervix were abnormal. Depending on your age and medical history, you may be advised to then have a colposcopy, which is a procedure that allows providers to better see your cervical cells. 

Your visit will be similar to your exam for your Pap smear. You will lie on the exam table, undressed from the waist down, and your feet will be placed in the stirrups. The colposcope does not touch your body; it is a special camera that helps the provider see your cervix in detail. The health care provider will look closely at your cervix for any cells that are abnormal, and if an area of abnormality is found, a tiny sample of tissue will be taken from the cervix. This sample of tissue is called a biopsy. It will be sent to a lab to be studied. When the biopsy is taken you may feel a pinch and afterwards, you may notice light vaginal bleeding for several days. The results of the colposcopy and biopsy will help determine what treatment will be best for you.

Colposcopy procedure

 For more in depth information on colposcopy, including what to expect during the appointment, visit WebMD.

Student Health does perform colposcopy, by appointment only. If you have had your Pap test at an outside provider's office and the procedure has been advised, please make sure to have your Pap records sent to SHS prior to scheduling your colposcopy. To schedule an appointment, or to find out pricing information, please call (252) 328-6841. Have a general question about abnormal Pap tests, colposcopy, or cervical cancer prevention? E-mail us at gotquestions@ecu.edu.

Preparing for your colposcopy exam

1. The colposcopy cannot be done during your period. 

2. Do not douche during the three days before your appointment. 

3. Do not have sex for twenty-four hours before your appointment. 

4. Always let the ECU Student Health Service know if you cannot keep your appointment or if you decide to have your colposcopy performed at an outside office.

After the colposcopy exam...

Do not douche, use a tampon or have sex for seven days after the biopsy so that the area can heal. Results are normally available about a week after the procedure. When you return to learn about the results of your biopsy, the health care provider will talk with you about the treatment or follow up that is best for you.

For the next year to year and a half, you may need to have Pap tests more frequently.

Student Health provides services for sexually transmitted infection (STI) testing and/or evaluation for gynecological problems.

• Want STI testing but not currently having any symptoms? If you are symptom-free, you can schedule a visit with the Fast Track nurse to test for chlamydia, gonorrhea, HIV, and/or syphilis. Make sure not to urinate within 1 hour of your appointment time (if you want oral screening for chlamydia/gonorrhea, do not eat/drink/chew for 1 hour prior to your appointment).

• Having STI symptoms, need testing for warts or herpes, or need to see a provider for a gynecological problem? Make a clinic appointment with one of our providers.

Unsure what the symptoms of an STI might be for a woman? If you have any of these symptoms, you must schedule an appointment with a provider.

• Unusual vaginal discharge, odor, burning, or itching
• Pelvic pain or lower abdominal discomfort
• Irregular vaginal bleeding that is not your period
• Pain with intercourse
• Sores, bumps, or blisters around your genital or anal area
• Burning with urination
• Throat pain
• Rectal bleeding, discharge, itching, or bumps/sores

The staff at Student Health Service recognizes that talking frankly and honestly about sexuality issues is uncomfortable for some people. It is important to remember that the more information you share with the health care provider, the better they can help to meet your needs. Quality health care begins with good communication between patients and health care providers. Be prepared to address topics concerning your sexual history, current sexual behavior, methods of contraception and STI risk reduction, and any current symptoms that you may be experiencing. These questions are asked for medical reasons and will ensure the best care possible. All information is confidential. Based on the shared information, your provider will determine appropriate tests for you.

You should consider getting tested for STIs if you have ever:
- Had unprotected (no barrier device was used) oral, vaginal, or anal sex with someone of an unknown STI status.
 -Had intercourse under the influence of alcohol or other drugs and cannot remember what happened.
- Shared IV drug needles with an infected person or someone whose STI status was unknown.
- Had a past or current sex partner that told you of their infection with an STI.
Want to learn more about the types of STIs, treatment, and prevention? Visit our self care guides.

Have a general question about STIs? E-mail us at gotquestions@ecu.edu. ••