What to expect on a trip to the gynaecologist

There’s nothing to fear here.

It’s hardly a surprise that as I start typing “What to expect…” into Google, one of the top results is “from a visit to the gynaecologist”. (“…when you’re expecting” is, of course, the search engine’s favourite response). Does it say more about my search history or society at large? Who knows but it is a red hot topic. 

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To be honest, I’ve only been a couple of times in my life, and each experience was barely memorable. All the North American podcasts I listen to discuss their “annual medical”, which always involves an added gynaecological check, it seems. Have I been missing these important yearly appointments? And what can I expect? I spoke to Dr Latika Cilly, a Melbourne-based obstetrician and gynaecologist, to get the answers.

How often should we visit the gynaecologist? 

“There’s no real fixed duration that you have to see one,” Dr Cilly tells me. (My podcast-related fears are instantly alleviated.) Instead, it depends on whether you are experiencing any issues. “If you’re not getting answers, if you’re suffering and you have tried multiple avenues, and you think you need to see a specialist, then you need to see a specialist.”

If you have a strong family history of gynaecological cancers (ovarian, uterine, cervical, vulval or vaginal), Dr Cilly suggests a checkup every two to three years, however. “Otherwise, overall, if you’re fit and healthy, usually most of the stuff can be done at your GP level.”

What are the common reasons to see a gynaecologist?  

The most common reasons, she tells me, are related to abnormal period bleeding. “Usually, we find that we as women are, obviously, tough creatures getting on with things and putting up with struggles when we may be iron deficient or anemic.

“We still don’t put it down to our period, [the] amount of blood that we’re losing,” according to Dr Cilly. A key indicator of excessive blood loss is passing large clots. “Your body’s trying to stop you from losing that much blood,” she explains. These sorts of symptoms may be reasons to see a specialist.

Other issues include abnormal cervical screening tests (the updated term for ye olde pap smear), post-childbirth prolapse and cell fertility options. 

What can one expect on their first visit?

“Don’t be anxious,” says Dr Cilly. “It’s like visiting any other doctors.” In her calming presence, the thought of a visit isn’t so bad. As she puts it, “It’s a part of your body [and] it’s a system which also needs looking after like any other part of your body. That’s all you’re doing. You’re seeing a doctor for a problem.”

Before making an appointment, Dr Cilly reminds me that a referral is needed from a GP. It’s also helpful to have prior health information available, including any investigations that have been done with your GP (or at least knowing who and where your GP is). Be aware of both your own and your family’s medical history to help give further background. 

Dr Cilly says that most gynaecologists will try to put you at ease before getting into the nitty-gritty, talking about life and pets and more pleasant things. Delving into the issue at hand, expect to answer questions like, when did you have your last pap smear? Was it okay? What is your sexual frequency? Have you had any sexually transmitted diseases in the past? What are your periods doing – how often do you get them, and how heavy are they?

“A gynecological checkup should not be a painful affair,” she assures me. If there is the need for an internal check, we shouldn’t leave the appointment feeling traumatised or in excessive pain. “Yes, it’s uncomfortable. It never gets comfortable. It’s not an examination that is nice to have. But it is not painful, and it shouldn’t be. If it is, then it’s done wrong.”

Dispelling the myths

Do you need to be utterly hair-free and shave before your appointment? “You really don’t have to… that’s not something that is a prerequisite for your examination with a gynecologist.”

Another common question Dr Cilly gets asked is ‘What if you are on your period? Can you really undergo an examination at that time?’. “That probably is actually the best time to examine a patient because most of the pathologies are quite evident,” she says. Endometriosis, in particular, is more detectable while you’re having your period, so don’t hesitate. “We do this all the time. And we don’t mind.”  

Something abundantly clear from our chat is that nothing phases a good gynaecologist. They’ve seen it all before. There’s nothing shameful or embarrassing about making an appointment, either. 

Before we end the conversation, Dr Cilly puts out a reminder on the cervical screening test changes – they’re every five years if you’re sexually active or 25 years and older. “Australia is one of the countries leading towards the eradication of cervical cancer. So if we are up with the program, we won’t see cervical cancer very soon at all.” It’s as easy as visiting your GP (and not that scary, really). 

Thankfully, I’m excused from making a yearly appointment, but when the time comes, I know there’s nothing to fear. Find a gynaecologist you feel comfortable with and entrust your issues to the professionals. 

For more on when to see a gynaecologist, try this.