What is a gynecological examination?
A gynecological check-up is an important check-up. Among other things, it is used for the early detection of breast cancer and cervical cancer, but also offers advice on issues such as pregnancy, menstruation, sexuality, contraception and experiences of abuse.
When is a gynecological examination carried out?
Apart from this, women should also go for a gynecological examination if they have symptoms. The following symptoms are often the reason for a gynecological examination:
- Pain, burning or itching in the genital area, for example during urination or sexual intercourse
- Discharge from the vagina
- menstrual cramps, for example pain, very heavy or very prolonged bleeding
- noticeable changes in the breast, for example lumps or hardening
The gynecologist is also the right contact person for questions about sexuality, the desire to have children, pregnancy and contraception.
Women between the ages of 20 and 64 receive a written reminder from their health insurance company every five years to have a check-up at the gynecologist. However, there is a legal entitlement to such a free examination more often:
Women between the ages of 50 and 69 are also invited to a free breast X-ray (mammogram) every two years for early detection of breast cancer.
For the early detection of cervical cancer, the gynecologist can take a Pap smear from the cervix as part of a gynecological examination and have it examined in the laboratory for suspicious cell changes. Women between the ages of 20 and 34 are entitled to this Pap test once a year.
How often a woman should go to the gynecologist naturally also depends on the individual risk of disease. For example, if you have a family history of breast cancer, you should inform your gynecologist. He or she can tell you exactly how often a gynecological examination with breast examination and possibly mammography would be advisable in your case.
Gynecological examination for children
In the following cases, a gynecological examination is already necessary for young girls:
- Pain, burning, discharge or itching in the genital area
- Suspicion of malformations, developmental disorders
- Suspicion of sexual abuse
In most cases, an external examination of the genitals is sufficient to clarify these complaints, so that no palpation of the vagina is necessary.
Gynecological examination: procedure
Consultation and taking a medical history
At the beginning of the examination by the gynecologist, the doctor will ask the patient about any current complaints or unusual occurrences. He will also want to know whether there is a history of breast or cervical cancer in the immediate family – this can be an important indication of a family history. Other topics that the gynecologist addresses and advises the patient on are
- Regularity, strength and duration of menstruation
- Occurrence of intermenstrual bleeding or vaginal discharge
- Taking medication
- Metabolic diseases
- Sexuality and partnership
Gynecological examination of the genital region
Vaginal gynecological examination
To examine the vagina and cervix, the gynecologist uses a so-called speculum. He coats it with a little lubricant and then carefully inserts it into the patient’s vagina. By opening the speculum, the vaginal wall is spread slightly so that the doctor has a clear view of the vaginal vault and the cervix.
For a more detailed examination, the doctor can also examine the vaginal canal from the outside using a colposcope, a type of magnifying glass with a small light source.
After the doctor has withdrawn the instruments, the vagina is palpated with both hands (bimanual examination): First, the gynecologist carefully inserts his index finger and checks the stretchability of the tissue as well as the presence of lumps, protrusions or hardening.
Gynecological examination: Ultrasound
An ultrasound examination with a special transducer is often carried out during a visit to the gynecologist. This is shaped in such a way that it can be easily inserted into the vagina. This allows the gynecologist to assess the wall and mucous membrane of the uterus, the menstrual phase, the ovaries and the spaces in the small pelvis.
Gynecological examination of the breast
Breast x-rays – known as mammograms – are also used for the early detection of breast cancer. Women between the ages of 50 and 69 are entitled to this examination every two years as part of mammography screening.