Gynecologist

Pick one date in the year that you will reserve for visiting your gynaecologist every year, for the annual examination.

Visiting the gynaecologist every year is one of the ways to take care of your health. These regular visits (even when you do not have any negative symptoms) are of indispensable value in preserving your reproductive and overall health.

Regular gynaecological examinations are tremendously important because they help register the smallest of changes that can indicate the ailments in your reproductive systems, which then can be treated timely and successfully.

When to visit a gynaecologist?

Deciding on when to go for the first examination sometimes can be difficult, but the more information you have about how the examination looks and what to expect, the easier it will be to decide. It would be good to visit a gynaecologist in the following cases:

If you have turned 16 and still haven’t had the first period

If you have turned 18 and have never visited a gynaecologist

If you are sexually active or are planning to soon become sexually active

If you have prolonged menstrual bleeding (longer than eight days) or if your menstrual bleeding is missing

If you have pains in your lower belly

If you have intensified vaginal secretion, especially if it has strong odour

If you feel any kind of discomfort in the genital region (itch, pricking, pain)

If you notice any changes with your breasts

If you are planning to stay pregnant

If you need protection from unwanted pregnancy

If you need protection from sexually transmitted infections

If you need any other information related to reproductive health and sexuality

 

Who makes better gynaecologists – men or women?

It makes no difference whether your gynaecologist is man or woman. What is important is that they are sufficiently trained and experienced to do their work well and that you trust them. However, if you prefer to pick one gender (women often prefer female gynaecologists) you are within your rights to ask for it. Our country’s laws allow patients to pick their chosen physicians and gynaecologists – be it in public or private health institutions.

 

Scheduling examination

You will schedule the examination in your local health centre at the department for the medical protection for women, which includes gynaecology. Usually it is not too difficult to find the telephone number of this department online.

Before you schedule the examination, check your calendar for days when you will not be having your menstrual period, because these days are the best for examination and you will be ready when the scheduling nurse offers you dates.

Inform yourself about when your chosen physician is in the office – the dates and times – and when does she or he work with pregnant and non-pregnant women. Check whether your health insurance card is verified.

If you have an urgent matter that can not wait weeks or days, you are within your rights to go and see your chosen gynaecologist without a scheduled examination. Likewise, if the doctor or the nurse assess that the matter after all is not that urgent, they can offer you another date.

In private medical institutions, you use telephone to schedule examinations, picking date and time that fits you. You don’t need your health card/ insurance, but you need to pay on the spot. When scheduling the examination, make sure you ask about the price so that you can being sufficient amount of money with you.

 

Before going to the examination

Avoid having sex 24 hours before the examination. Have a shower, wash genital region with mild soap and warm water. In case you usually use different intimate hygiene products (creams, powders, vaginal suppositories, spray etc.), do not use them prior to the examination because they can affect the results of analyses and tests.  Wear clothes and footwear that are easy taken off and put on. Most women wear skirts or dresses that they can just lift above their hips immediately before the examination. The ones wearing trousers usually wear something longer on the upper body that also can be lifted up. It really is a matter of personal choice.

If you have any particular questions for the doctor, it might be a good idea to write up a list and take the list with you.

 

In the health institution

When you arrive to the institution, hand in your health card at the counter/ window. The nurse will either fetch your health record, or if you do not already have one, open up a new one for you. If you did not schedule the examination in advance, the nurse will ask about the reason you came for to establish whether it is an urgent matter. If she or he decides that it is not urgent, she is within her rights to schedule you an examination at another date/ time.

Your health record is a medical document recording your personal medical data, results of examinations and tests, established diagnoses and prescribed treatments. All the registered data is confidential (this data can not be shared without your consent with any other institution, public or private), as guaranteed by the laws of the republic of Serbia. The legal protection of confidentiality also stretched to private medical institutions.

 

In the gynaecologist’s office

At the start of your conversation, the doctor will ask you several standard questions: what was the reason for you scheduling the appointment, do you have any health problems or discomfort, do you take any medication, are you allergic to anything, is there a history of illness in your family and some other questions that she or he deems important. On your first visit, this part will take a little longer to establish the baseline and record the data in your medical record so that on subsequent visits you do not have to go through it again.

The gynaecologist will ask about your menstrual cycle – when did the first menstruation occur, what is the duration of the bleeding, when was the last menstruation and other questions as per need. It is a good idea to put these pieces of data on paper prior to coming so that you do not have to think about it there. For example: My first period occurred when I was 12, my cycle is 29 days, bleeding around six days, the last occurred on 26 January.

In addition, the gynaecologist may ask about your sexual life and other aspects of your health and lifestyle, so that she or he has complete picture.

After the conversation follows the examination containing the following stages (although the extent of the examination can be changed and the doctor adapts to each client):

 

General physical examination: Measuring height, weight and blood pressure. The gynaecologist can also use the stethoscope to listen to your heart and lungs but this is usually a part of the examination for pregnant women, while non-pregnant women do this at a general practitioner’s rather than at gynaecologist’s office.

 

Breast examination: Before starting examination, the doctor will ask whether you have noticed any changes related to your breasts. Then she or he will carefully touch-examine your breasts, touching region after region, using light pressure and circular movements to establish whether there are any lumps beneath the skin. She or he will also apply some pressure to the nipples to see whether there is any secretion there. She or he will also observe the size and shape of your breasts. As it is of crucial importance that you yourself do periodic, frequent examinations of your own breasts, this is a good time to ask the doctor to teach you how to do it.

 

Gynaecological examination in the strict sense: For this part it is needed for you to strip from the waist down, and to allow your gynaecologist access to your genitals and lower abdomen. Every gynaecologist’s office has a large folding screen in one part, behind which you will find clothes hangers for your clothes as well as slippers that you can use as you take off your clothes. After that you lie on the gynaecological table, with special leg holders – the table is designed to offer you maximum comfort while providing the doctor with best possible access to regions of interest.

a. Examination of outer genitalia is a visual examination of genitalia and their surroundings, entrance to the vagina, small and large labia and clitoris, in order to determine whether there are any irregularities visible to the naked eye (e.g. red skin, irritation, secrete, cysts, warts etc.)

b. Vaginal examination: It is important to remember to relax as just focusing on relaxing will make this part of examination less unpleasant. It is important to remember that the examination does not cause any pain. The doctor uses a tool called speculum (akin to duck’s beak), made of metal or plastic, inserts it into your vagina and opens it, which then allows her or him to see into the vagina and the cervix, as well as to take samples for analysis (samples for papa test or a sample of vaginal secrete). If necessary, the gynaecologist will also do colposcopy using a microscope and paint to examine the cervix. Remember to relax. The next part of the examination is bimanual examination which has the doctor inserting her or his index and middle finger of one hand into the vagina and using the other hand to touch and lightly press the outer wall of the lower abdomen. This is to establish the size, consistency, hardness and sensitivity of inner reproductive organs – uterus and ovaries. And this concludes the vaginal examination.

Additional examination: depending on the experienced discomfort and the findings of the initial examination, the doctor may suggest additional examination such as ultrasound scan, mammography (X-ray examination of breasts), laboratory analyses and other diagnostic procedures.

 

After the examination, you will discuss the findings with your doctor, see whether additional examinations or analyses are needed, learn where and when to get the test and examination results, what is the telephone number for information purposes and when to come for the next examination. If you have any additional questions, this is the time to ask them.