Health checks for women

A routine part of a woman’s health maintenance plan should be a gynaecological examination or ‘gyne exam’ as it is referred to.

Guidelines vary from country to country on the frequency of the check-up but a good rule of thumb is to have this check every two years or more regularly if recommended by your doctor.

Ideally a woman should begin having these checks as soon as she becomes sexually active or by the age of 18, whichever occurs first.

During a gyne exam you will be asked to undress from your waist down and lie down. There are two parts to the exam – a Pap smear and a pelvic exam. A Pap smear is an exam that checks for abnormalities of the cells of the cervix. The cervix is a part of your uterus (womb) that widens during childbirth to allow for the passage of the baby. Cells on the surface can become abnormal long before they become cancerous and regular screening can detect and treat these pre-cancerous changes.

During the procedure the doctor or nurse will place an instrument called a speculum into the vagina to widen it and allow for a better view of the cervix. You may experience some discomfort when it is inserted. The doctor will then use a swab like a giant Q-tip and a small, soft brush to collect a sample of cells from the cervix.

These cells are placed on a slide or in a special liquid solution and sent to a lab for examination under a microscope. It is important to remember that a Pap smear only checks for abnormalities of the cervix.

Pap tests which are placed on a slide have been the conventional way of testing for cervical cancer. The liquid based Pap test has the advantage that the sample can also be used to check for HPV, the virus that is responsible for almost all cases of cervical cancer.

This is a separate test and a woman must request it at the time of her Pap smear if she wishes to be tested.

Pelvic exam

The second part of a gyne exam is the pelvic examination. During this stage of the exam the doctor or nurse will place gloved fingers in through the vagina and feel your ovaries and uterus for possible abnormalities. His/her other hand will be placed on your abdomen during the procedure.

A pelvic examination does not identify abnormalities with your cervix and will not detect all abnormalities of the ovaries and uterus.

For this reason, many doctors are now including a trans-vaginal ultrasound in a gyne exam. This procedure involves the insertion of an ultrasound probe through the vagina. The doctor can then see an image of the ovaries, uterus and other organs on a monitor and look for possible abnormalities.

Women often ask about a CA-125 blood test and why is it not a routine part of a gyne exam. This test is widely touted on the Internet as a test for ovarian cancer, however medical and scientific organizations report that there is insufficient scientific evidence as to the effectiveness of this test in the detection of ovarian cancer to utilize it as a routine screening tool.

If a doctor suspects ovarian cancer then he/she will order it as a part of the diagnostic work-up.

A free educational session on cervical cancer will be held Monday, 27 November at Chrissie Tomlinson Memorial Hospital at 7.30pm.

The session will be led by women’s health expert Dr. Verna Brooks-McKenzie.

For more information contact the Cayman Islands Cancer Society at 949-7618.

FYI

The Cayman Islands Cancer Society in conjunction with the medical community and the Health Services Authority is offering free Pap smears during the month of November for women who are eligible for a voucher. Contact the Cayman Islands Cancer Society at 949-7618 for more information.

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