Most women visit a gynaecologist only when emergencies arise or when something seems amiss. Regular check-ups by a gynaecologist are important for all adult women, as they keep a tab on a woman’s reproductive health and deal with any issues that may arise in good time. A gynaecologist is a specialist in women’s reproductive health and is trained to keep women’s reproductive organs in good health as well as manage pregnancies and deliveries. Regular check-ups by a gynaecologist can detect diseases such as breast and cervical cancers, sexually transmitted diseases, abnormalities of the genitals and other reproductive organs, as well as offer important advice to women on how to stay sexually healthy. It is recommended that a woman starts getting regular gynaecological checkups from the age of 18, or as soon as she becomes sexually active. Some sexually transmitted diseases as well as cancers of the reproductive organs have no symptoms in their early stages and a woman can easily miss them if she does not go for regular check-ups. Seeing your gynaecologist regularly can, therefore, save your life. Annual check-ups are usually recommended unless a woman has concerns that may require a doctor to keep her on a close check.
If you can afford it, it is best to have a personal gynaecologist as he or she will be dealing with intimate areas of your body and you need to be comfortable with him or her. A visit to your gynaecologist should not be stressful and you therefore need to select your doctor carefully. He or she should be a person who listens to your health concerns, is professional and has time for you. You should be free to discuss sexual concerns with your gynaecologist, as well as family planning issues. It is important that you are aware of the check-ups that your gynaecologist is likely to perform on your visit and why these check-ups are important.
Pap smear: A pap smear is recommended once a year if you are not sexually active or are below 35, and every six months if you are sexually active or are above age 35. It is a simple painless test where the doctor uses a spatula to get a sample of cells from your cervix. The cells are tested in a laboratory for signs of any abnormalities that may be symptoms of cancer or STDs. Because many women do not have regular pap smears,most cervical cancers are detected when it’s too late to contain them. Most hospitals offer pap smear tests so you don’t have to miss one because you don’t have a personal gynaecologist. It will cost between Kshs.1500 and 2,500, depending on the hospital you visit.
Breast examination: A doctor will perform a physical examination on your breasts to detect any changes such as puckering, dimpling, retracted nipples, discharge from nipples not associated with breast feeding, change of breast size or shape or any breast pain. The doctor will also show you how to do this examination at home. Every woman is advised to do self-breast examination regularly as part of her breast health management. If detected early, breast cancer can be cured.
Depending on your age or what the doctor finds from the physical examination, he may recommend a mammogram. Menopausal women are advised to have a mammogram every two to five years. This test involves the use of low-dose x-rays to detect cancerous cells. Another test used to detect breast cancer is ultrasound. This uses sound waves to detect unusual lumps in the breast. The best time to do all breast checks, apart from self-breast examination, is mid-cycle (two weeks after the start of the last period). The breasts are tender during menstruation and normal lumps occurring at this time because of hormonal changes may be confused with cancer lumps.
Reproductive tract examinations: These involve physical examination of the vagina, uterus, ovaries, cervix and bladder. These examinations are particularly important if you suffer from severe menstrual cramps, severe bleeding or bleeding between periods, or have unusual vaginal discharge accompanied by an offensive odour. These symptoms could indicate vaginal infection or the presence of an STD, pelvic inflammatory disease, endometriosis, ovarian cysts, or HIV infection. The gynaecologist looks out for vaginal, cervical and urinary tract infections during these tests. By manipulating his hands inside the vaginal canal, he is able to detect abnormalities such as swellings and pain in the pelvic region.
Other scanning tests can help detect infections in the uterus, cervix and ovaries, and also determine the size and lie of these organs – all-important parameters in detecting abnormalities. Commonly used tools for these tests include ultrasound scan and trans-vaginal scan. An ultrasound is a small handheld probe that is placed around the abdominal area to detect any abnormalities. A trans-vaginal scan is a small thin probe inserted in the vagina to detect any abnormalities. You should visit a doctor when you experience any vaginal discharge, itchiness and burning when passing urine.
Painful sex: If you experience pain during intercourse, it’s important to let the doctor know as there may be underlying factors. Pain during sex is not normal and there may be an infection that requires treatment, or your sexual organs may be malformed or you may be having psychological issues. Your doctor will be able to determine the cause and offer advice and treatment.
Severe cramps: It is normal for women to experience cramps during menstruation, but severe cramps are not normal and require a doctor’s attention. Severe cramps could be a symptom of a serious disease like cervical cancer or fibroids and should therefore not be ignored. Your doctor will determine the cause and offer appropriate treatment.
Hot flashes: Premenopausal, menopausal or postmenopausal women suffer from hot flashes, which can be extremely uncomfortable. Your gynaecologist will be able to diagnose the cause of your hot flashes and offer appropriate treatment, which may include hormone replacement therapy.
Pregnancy chat: If you are planning to have a baby, it is important to discuss this with your gynaecologist who will help you prepare for a healthy pregnancy by giving you appropriate advice. Your gynaecologist will walk you through the pregnancy journey and ensure a safe delivery.
Your gynaecologist will also be able to offer you a general examination to ensure you are in good health generally. If he finds something that needs attention, such as high blood pressure, he will refer you to a specialist.