|Where Women Have No Doctor - A Health Guide for Women (Hesperian Foundation, 1997, 600 p.)|
|Chapter 10: Staying Healthy|
|Special Needs of Women|
If possible, a woman should see a trained health worker to check her reproductive system every 3 to 5 years, even if she feels fine. This exam should include a pelvic exam, a breast exam, a test for weak blood (anemia), and an exam for sexually transmitted diseases (STDs) if she is at risk. It may also include a Pop test (explained below) or other test for cervical cancer. This is especially important for women over 35, because women are more likely to get cancer of the cervix (the opening of the womb) as they get older.
¨ Many STDs and cancers do not show signs until the illness is very serious. By then it may be too late to treat the problem.
These are the steps in the pelvic exam:
1. The health worker will look at your outer genitals for any swelling, bumps, sores, or changes in color.
2. Usually, the health worker will put a speculum into your vagina. A speculum is a small metal or plastic tool that holds the inside of the vagina open. He or she can then examine the walls of the vagina and the cervix for swelling, bumps, sores, or discharge. You may feel slight pressure or discomfort with the speculum inside, but it should not hurt. The exam is more comfortable if your muscles are relaxed and your bladder is empty.
3. If the clinic has laboratory services, the health worker will do a Pap test for cancer and, if needed, tests for STDs. To do a Pap test, the health worker scrapes a few cells from the cervix. This is not painful. You should only feel a little pressure. The cells are sent to a laboratory where they are checked for signs of cancer. If the cancer is found and treated early, it can almost always be cured.
4. After the health worker removes the speculum, she will put on a clean plastic glove and put two fingers of one hand into your vagina. She will press her other hand on your lower belly. In this way she can feel the size, shape, and location of your womb, tubes, and ovaries. This part of the exam should not be painful. If it is, tell her. It may mean something is wrong.
5. For some problems, the health worker may need to do a rectal exam. One finger is put into your rectum and one finger into your vagina. This can give the health worker more information about possible problems of the vagina, and of the womb, tubes, and ovaries.