Women should start having "well women exams" or "pap-smears" at the age of 21 or when they become sexually active, whichever comes earlier.
Well Women Exams consist of a physical exam including a breast and pelvic exam. If you are sexually active, we highly recommend being screened for chlamydia and gonorrhea at this visit. Do not have intercourse or place anything (tampons) into your vagina for 48 hours prior to your exam. You will need to arrive 15 minutes early for your appointment, as there is additional paperwork that must be completed.
The Pelvic Exam
On the day of your appointment, you will be escorted to an exam room. Your vital signs and weight will be taken at this time. You will be instructed to take off all of your clothes and you will be given a gown. The gown will be worn with the open side on the front. The provider will do a general exam including auscultation of heart and lungs sounds, palpation of the thyroid and abdomen. A breast exam will be done on this visit. You will also be instructed on how to perform a breast exam.
You will be asked to lie down, slide to the end of the table, and place your feet in a footrest. The provider will exam your external gentilia looking for lumps, bumps, discharge, lesions or any signs of infection. Next, the provider will use a special instrument called a speculum. A speculum is a small plastic "duck-bill" instrument. It should not pinch or cause you pain. The plastic speculum will be inserted into your vagina You may hear a clicking noise as the speculum is opened.
The provider will be able to visualize your vagina and your cervix. Three samples of cells will be obtained, one with a q-tip from the cervix, one with a very small brush from the cervix and one from the vaginal wall. The cells are placed in a fluid filled container called "Thin Prep". The cells are then checked for any changes from normal.
A pap smear can tell you are going thru changes long before cervical cancer occurs. Having a regular pap can greatly reduce your risk of cervical cancer. The speculum is then removed. The provider will then place one finger into your vagina and place there hand on your abdomen. They will gently press on your abdomen to fill the size and shape of your uterus and ovaries. Once this is done, your pelvic exam is complete and you may get dressed.