Part of caring for health is a regular visit to the gynaecologist, usually once a year, which is part of the care for maintaining your reproductive health. It is often thought that a gynaecological examination is unpleasant. This opinion is associated with discomfort, shame, fear, and ignorance about what a gynaecological examination looks like in general.
Gynaecologists are specialists in genital diseases and reproductive health protection and treat female genitals like all other organs and systems in the human body.
When you go for a gynaecological examination, put on or take with you a skirt that you will put on in the changing room before entering the gynaecological office, because that will make you feel more comfortable, since you have to take off your clothes for the gynaecological examination. Some gynaecological clinics have disposable slippers in the changing room, but since some clinics do not, you can take the slippers with you. When entering the clinic and before the gynaecological examination, the gynaecologist will take your medical history (data) regarding your previous illnesses or diseases in the immediate family, the time of the first menstruation (menarche), your menstrual cycle (the interval between menstruation, so consider this and calculate according to your menstrual calendar), the length, abundance and pain of menstruation, as well as the date of the beginning of the last menstruation. After that, you will say briefly and clearly why you came, but without hesitation you can talk about other problems, if you have them. If you have already had sexual intercourse, the gynaecologist will also ask you about the methods of contraception you use during sexual intercourse.
Gynaecological examination of women and girls who have had sexual intercourse is performed on a gynaecological table, in a supine position. The legs are placed on special holders (legs) to facilitate the examination of the external genitalia. It is important to listen to your doctor’s instructions regarding being relaxed, as this avoids squeezing the muscles that can cause discomfort during the examination. After that, the examination is continued using instruments that are placed in the vagina so that the vagina itself and the cervix can be displayed so that cervical swabs and a PAP test can be taken. The examination ends with bimanual palpation, examination and palpation of the internal genitals, in order to exclude changes in the uterus and ovaries.
PAP test (Papanicolaou swab) is a cytological (cellular) analysis of vaginal and cervical swabs. The test is started during the first year of sexual intercourse, it is painless, and allows early detection of pre-stages and cervical cancer, as well as causes of sexually transmitted diseases associated with cancer. This is important because in the early stages the cancer can be completely cured. Risk factors for cancer are: early onset of sexual intercourse, changing sexual partners and a higher number of sexual partners, sexually transmitted diseases – especially HPV infection, and smoking. If the PAP test is normal, the second is repeated after a year.
As part of the gynaecological examination, the vaginal discharge is examined and the so-called degree of purity of secretions is determined. The vaginal secretion is examined under a microscope where some microorganisms, individual causes of inflammation of the genital tract and sexually transmitted diseases can be detected immediately, and appropriate treatment can be prescribed.
After the gynaecological examination, the doctor will make a diagnosis, explain the results and recommend treatment, and make appointment for a follow-up examination. If additional tests are needed (laboratory examination of blood or urine, ultrasound examination), the doctor will give instructions to follow. If treatment is needed, the drug should be taken exactly as directed regardless of the cessation of the problems.
When to visit a gynaecologist:
- after the first sexual experience
- if you are 16 and have not had your first period
- due to disorders and irregular menstrual cycle
- due to very heavy or painful menstruation
- due to absence of menstruation
- due to the appearance of altered and increased vaginal discharge
- in the event of sores, blisters, warts, or growths on the external genitalia
- if you are referred to a gynaecologist by another doctor
- if there is tenderness, burning and / or itching in the area of the external genitalia
- if you experience pain, tenderness, or bleeding during intercourse
- if a “lump” appears on the breast
- if discharge from the nipple occurs
- immediately after forced sexual intercourse (rape, incest)
- for contraception use
- due to a desired pregnancy or due to an unplanned pregnancy
- for advice and information.
According to the instructions of the Croatian Health Insurance Fund (CHIF) in Croatia, from the age of 12, one can report to the primary gynaecologist at the Health Centre. The exception is the Children’s Clinic in Zagreb, where children and young people, aged 0-18, can come to the Clinic’s gynaecological clinic with a referral from a family doctor, primary paediatrician, school doctor or primary gynaecologist. After the age of 18, a girl chooses and reports to a gynaecologist within primary healthcare.
CHIF instructions: You choose your primary gynaecologist by filling in the form “Statement on the selection / change of the chosen doctor” which you can get in the office of the doctor you have chosen or download it from the CHIF website. The second part of the form is filled in by your doctor and certified by your signature and the stamp of the office of a health institution or a private practice. You can receive health care from the chosen doctor no later than ten days after signing the Statement. The doctor is chosen for one year.
If you have problems finding and reporting to the primary gynaecologist, contact the CHIF for help on this matter.