Womens Health

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, 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.

***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.

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

 

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

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.

      

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.

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.

Who can help?

• ECU Police can be reached by calling 911 for emergencies, or (252) 328-6787 for non-emergency calls.
  
• The Center for Counseling and Student Development, (252) 328-6661
• Student Health Services, (252) 328-6841
• Office of the Victims Advocate, (252) 737-1466
• Dean of Students, (252) 328-9297, or by filling out the Person of Concern form
  

Think assaults and relationship violence only happens to women?  It can happen to ANYONE.

SHS has trained forensic nurse examiners on staff that can assist victims of sexual assault.  We can provide information, appropriate testing for health concerns related to the assault, and can also collect evidence kits during our normal business hours.  Sexual assault and abuse is any type of sexual activity that you do not agree to, including:

• Inappropriate touching
• Vaginal, anal, or oral penetration
• Sexual intercourse that you say no to
• Rape
• Attempted rape   
  

• Get to a safe place, call 911 or a trusted family member or friend.  If on campus, remember the blue light emergency stations on campus that link immediately to police.
• Know that rape and sexual assault ARE NEVER THE VICTIM'S FAULT.  No matter where or how it happens.
• Call or suggest calling a rape crisis center.  You can call the ECU Center for Counseling and Student Development at (252) 328-6661 or the REAL Crisis Center at (252) 758-4357.
• Preserve evidence of the rape.  Try to encourage the victim not to eat, drink, or smoke.  The victim should also not bathe or shower.  Evidence of the rape would literally be washed away.  Keep all clothing from the rape.  SHS can collect rape kits during normal business hours, or the victim can go to Vidant Medical Center's Emergency Department.
• Bruises, cuts, and sexually transmitted infections may all be of medical concern.  Seek treatment with a medical provider, even if you do not want evidence collected.
• If you friend has been raped, help him/her organize his/her thoughts about how to proceed.  Do not take control or make decisions for him/her.  Present options, but let your friend make the final choices.

Ways to reduce your chance of being a victim (from www.womenshealth.gov):

• Be aware of your surroundings — who’s out there and what’s going on.
• Walk with confidence. The more confident you look, the stronger you appear.
• Know your limits when it comes to using alcohol and other mind altering substances.
• Be assertive — don’t let anyone violate your space.
• Trust your instincts. If you feel uncomfortable in your surroundings, leave.
• Don’t prop open self-locking doors.
• Lock your door and your windows, even if you leave for just a few minutes.
• Watch your keys. Don’t lend them. Don’t leave them. Don’t lose them. And don’t put your name and address on the key ring.
• Watch out for unwanted visitors. Know who’s on the other side of the door before you open it.
• Be wary of isolated spots, like underground garages, offices after business hours, and apartment laundry rooms.
• Avoid walking or jogging alone, especially at night. Vary your route. Stay in well-traveled, well-lit areas.
• Have your key ready to use before you reach the door — home, car, or work.
• ark in well-lit areas and lock the car, even if you’ll only be gone a few minutes.
• Drive on well-traveled streets, with doors and windows locked.
• Never hitchhike or pick up a hitchhiker.
• Keep your car in good shape with plenty of gas in the tank.