Dreading your next health check? Insights from a female GP……

Whilst I appreciate that a woman’s health check may not be top of everyone’s list for the

most enjoyable way to spend your free time, please don’t put it off. These opportunities to

check in with your doctor each year are not only invaluable for screening for any serious

issues but also a good time for us to discuss everything from contraception, to period

changes, to hormones and pre-pregnancy/fertility tests. If it is something you desperately

dread, please remember these few dos and don’ts:

1. We really do not care whether you have waxed/shaved/depilated/insert any other

hair removal method. It really saddens me when women apologise or I can sense

their embarrassment because they think they are not appropriately coiffed for the

examination. Having pubic hair is entirely normal. We are doctors accustomed to

seeing normal bodies and there is absolutely no need to be embarrassed or

apologise.

2. This sentiment also applies to labial anatomy….. I promise you, it is all normal.

Sometimes the labia minora protrude outside the majora, sometimes they don’t,

sometimes both sides are symmetrical, sometimes they aren’t. If you look a certain

way, I can assure you that millions of other women will look just the same. Please

don’t let the way you look put you off coming to see us and more importantly,

please don’t let it affect the way you feel about yourself.

3. Please do not douche or use excessively perfumed products; certainly not in

anticipation of your health check and ideally never at all. If you’re not sure about

what that word means, I’m referring to the cleaning of the vagina often with a

forcible jet of water usually from a shower or such like. If you feel you have an

unpleasant smell, then usually that is because you have a bacterial overgrowth,

which will only be made worse by douching and you may need antibiotics. And if

you do it as a matter of routine, it is a really good way to get an infection.

4. If you are worried about the examination side of things, maybe because you’ve

never had one before, find sex painful or have a history of vaginismus, please let us

know. There are lots of things we can do to help. Speculums (the instruments we

use to see the cervix) come in different sizes to suit different bodies, so we can

always start with a smaller one. And we can use proper lubrication for the

examination to make it more comfortable (rather than just water, which we used in

the past and is, perhaps surprisingly, not a very good lubricant).

5. If you really are incredibly apprehensive, perhaps you have experienced trauma in

the past, it’s rare that in this setting, a gynae exam is ever life threateningly urgent.

Your doctor should have time to get to know you and vice versa, build trust over

many appointments, and involve specialised women’s health physiotherapists and

psychologists if needed. And this wouldn’t be just to help you with the examination,

but more importantly to improve your sexual function, relationships and wellbeing

overall.

6. You may not need a pap smear every time you have a woman’s health check-up. For

certain women, if we test for the human papilloma virus (HPV) at the same time as

doing a pap smear, we may be able to extend the interval from annually to 3-5 years.

That doesn’t mean I’d advise skipping your yearly check-up but it might be one less

thing to worry about.

And for those that have had the HPV vaccine already, the same pap smear intervals

also apply (although that may change in the future as we get more evidence). The

HPV vaccine covers most but not all strains of HPV infection and those that received

the vaccine as an adult may have already been infected with certain strains, so a pap

smear at least every 5 years is still recommended. The same is also true even if your

partner has received the vaccine.

7. Being breast aware, having an appreciation for the uniqueness of your own body at

different times of the month, is so much more valuable when it comes to picking up

any abnormal changes in your breasts compared to us performing a breast exam for

you just once a year. Of course, we can show you how to do this if you are unsure

and check anything that you are concerned about but there is no substitute for your

own self-examinations.