Visiting the doctor, for a routine check-up or due to a worry can lead to anyone feeling awkward, uncomfortable and frightened. Unless, you are someone who practically lives at the hospital, consulting a doctor or any other healthcare professional is generally something not many people want to do. Therefore, when it comes to seeing a doctor that is going to enquire about the most private of places and topics such as: your vulva, vagina, periods or sex-life, is it any wonder many might postpone going, making up excuses or approach the appointment with extra anxiety?
Let’s briefly go through what a visit to a gynaecologist might look like. After reading this, I hope you will feel less worried if you ever need to visit a gynaecologist.
What is a gynaecologist?
A gynaecologist is a doctor (usually also a practising surgeon) who looks after people born with female reproductive organs, throughout their lives. The conditions managed range from infertility, menopause, heavy and painful periods, pelvic infections to pelvic pain.
Why might you go and see a gynaecologist?
Patients might come for a routine check-up, depending on the way your health service is arranged. What is more common is a referral from your General Practitioner/family doctor or self-referral to a gynaecologist when you present with symptoms that might be due to the female reproductive organs or sexual health. These symptoms can include: heavy and/or painful periods, unusual vaginal bleeding, pelvic pain, and pain during sexual intercourse, a change in your vaginal discharge or a new rash or lump on your vulva.
Where would you go to see one?
Gynaecologists hold clinics. These clinics can be held either in hospital or in the community within a health center or through online platforms like provided by OITARY.
What to expect at a gynaecology appointment?
The start of the appointment will be similar to any other with introductions made. The doctor will start by finding out what’s brought you to the clinic. They would usually have read your referral letter but would always want to get more detail from you. They will take a history and then examine you if necessary. The examination part is probably what you are most worried about. An examination might involve an abdominal examination; insertion of a speculum – a plastic or metal device to enable the doctor to inspect your vagina, cervix, take note of any discharge/bleeding and to take sample(s) and an internal examination. The internal examination means gloved fingers are inserted into the vagina and the clinician will be checking for the site of any pain, potential masses (lumps) and the size of the womb in the pelvis.
Verbal consent should always be obtained and a chaperone for the examination should be offered. It is important to remember that you are in control and should not be afraid to ask any questions you might have and can change your mind even after agreeing to the examination or after the examination has started.
At some gynaecology “one-stop” clinics an abdominal or transvaginal (internal) ultrasound scan might be offered during that appointment or later, to look at the anatomy of the pelvic organs and guide further decision making. In some instances, an outpatient hysteroscopy is offered to investigate and manage concerns usually around vaginal bleeding. A hysteroscopy is where a thin camera is inserted through the neck of the womb (cervix), so that a direct look via a camera can be taken, possibly followed by treatment such as removing an endometrial polyp. If it is done in the outpatient setting, there is no general anaesthetic and the patient is awake having had some simple painkillers and local anaesthetic.
You should leave your appointment knowing:
if and when you will be seeing a doctor at the clinic again for follow-up or treatment such as surgery,
if you have been referred for investigations or to another clinician if the concerns are not (purely) gynaecological in nature, and,
That your condition is being monitored, changes in lifestyle are needed or the treatment which you have been started on.
* This description is trying to encompass a standard gynaecology appointment. What takes place in terms of examination and investigations offered are dependent on the reason you are seeing your doctor and what is needed and agreed between the clinician and their patient, in the best interest of the patient. Not everything described above will happen, all of the time.*