VAGINAL HEALTH: EMBARRASSING TALES OF THE PELVIC EXAM | Lee Anne Coetzer

It’s true, we tend to meet everyone’s needs before we look at our own. That’s just our nature. But we need to take a look at our overall health and especially our vaginal health. Vagina/Vulva/female health is and should be a priority. Whether you want children, want to maintain a healthy sex life or just want to be healthy overall, having an annual  check-up should be a priority. Now, I am sure you are all capable of Googling the different symptoms or dreaded procedures and the endless lists of things that could go wrong with our downstairs. But, for this article, I want to share my first Pap smear experience with you. This is a safe space , after all. Yes, I said Pap smear. The one test we all dread. And the one test everyone has a dirty joke about. No, I didn’t wash myself with the kid’s glitter cloth. ( I would be mortified if I did have glitter on my cooch). Was I scared? Hell, yes. Was it a bad experience? Actually, it was worse in my head. (OK, it was worse for the lady in that glitter-cooch joke).

So, let us start. It was after my divorce; I got my own medical aid. And the medical aid wanted me to go for preventative screenings and full medicals. So, I booked an appointment with a gynaecologist (a female doctor, that my friends recommended. I prefer a female doctor over a male doctor, but that’s just my personal preference – look it’s uncomfortable for someone to look at your cooch, in my mind, I just felt a little bit more comfortable with a doctor that actually owned a cooch. I know, my mind is wonderfully strange).

At my appointment, the very kind and patient doctor stated that she would ask a few questions and then we would go into the examination room where she would do a pelvic exam, a sonar and then take a smear of my cervix (which is the Pap smear). She asked me about my sexual activity, sexual history, sexual frequency; whether I used sex toys; my menstrual cycle;  whether I am on any contraceptives or other medications; whether  I had birthed children; whether I had experienced any itching or pain; whether I had any  smelly or other colour discharge. After this uncomfortable questioning, she took me to the examination room where she gave me a theatre gown, and asked me to remove the  clothes from my lower half and get on the examination bed. She briefly left me to do as she asked. (Silently waiting, my mind just went on about how uncomfortable I was, and that I was glad I had showered before the appointment, and that this would be the most action I would get for a while…). Then the door opened andthe doctor returned, interrupting my last thought… and there I was red-faced on my back, thinking “Geez Louise, pull yourself together.!”

The doctor put surgical gloves on and narrated everything she did. She started by pressing on my stomach, ovaries and bladder area, asking if I felt any pain or discomfort. All clear. (Oh dear,  “Open wide” is something a dentist would say, and I am sure there are no teeth down there). Then she examined the vulva, and the discharge, and then proceeded to digitally examine the vaginal wall for any abnormalities. She removed her gloves and put on a new pair, walked over to a machine with a screen where she put a condom and some jelly on an ultrasound probe  that looked like a long, plug-in dildo (sorry, my first thoughts were, of course, about sex toys – the gutter brain. I am just glad she uses protection, I don’t want to know how many cooches that probe has entered…). She said she was going to take an internal ultrasound, and that I should relax when she entered the vagina. It was uncomfortable upon entry, but I could only feel dull pressure once inside. She showed me the ovaries and uterus. Everything looked normal and healthy. She slowly removed the probe and reached for a speculum on the surgical side table (I nervously asked for the smallest one as I am tight upon entry). She then visually inspected the vaginal wall (yes, I was blushing fifty shades of crimson, she was staring up my vagina, where the light of day doesn’t even venture); and then she took something from the surgical tray that looked like a COVID swab (that long earbud they put up your nose), and took a scrape of the cervix, painless. She transferred the smear to a plate, sealed it up, labelled it and sent it off to the laboratory (very CSI). She then wiped the excess jelly off me with some tissue paper and asked me to get dressed. (We survived. Phew!)

Back in her office, she gave me overall feedback, healthy and all clear. She then mentioned that she would give me a call when the test gets back as it usually takes 3-7 days to process – depending on how backlogged the laboratory was. I thanked her and went to reception to make the dreaded payment, where the kind receptionist informed me that most medical aids, including hospital plans, pay for this check-up as part of prevention screenings. Bonus! God blessed that mess for sure.

In short, was it a little embarrassing? Yes. More than a little. Did it hurt? Not at all.

So why should we get this check-up?  

Well, this check-up screens for any pelvic abnormalities and  bacterial or viral infections. It can test for sexually transmitted illnesses such as HPV, chlamydia, candida, etc. A Pap smear (or cervical smear) is a way to check on the health of your cervix and can test for abnormal cells that may lead to cervical cancer. Cervical cancer shows no symptoms until the condition is at an advanced stage. If abnormal cells are noticed at screening, they can be closely observed and/or treated to prevent cancer from developing. Regular screening has been proven to reduce the risk of cancer by 90%.

When and how often should we get checked out?

Once you are sexually active, you should go for a check-up once a year. If you are not sexually active yet, doctors recommend that you go when you experience any abnormalities in or around the pelvic area, this may include vaginal discharge, irregular menstrual cycle, painful intercourse/pain when using tampons, lower abdominal pain or discomfort. It is recommended that you get this test done by the age of 30. If you have previously diagnosed abnormalities of the pelvic area, you should go more regularly.

Must I go to Gynaecologist?

No, you can go to your local clinic where a specialised nurse can take the test, or your GP (General Practitioner) will also be able to do this exam and take a Pap smear.

What to expect?

Well, it will be similar to my experience. However, I cannot talk about bedside manners. But overall you will give consent and the nurse/doctor will describe the procedure. Your vulva will be inspected for abnormalities such as rashes or infections. They may do an internal digital exam of the vagina wall to inspect it for any growths or abnormalities. You may get an ultrasound of the pelvic area, and this could be a transabdominal/intravaginal ultrasound that will check your ovaries, uterus, and pelvis area for abnormalities. You will get a speculum examination where they will inspect the vaginal wall. For the Pap smear, they will take a smear of the cervix using different swab tools (made of plastic/wood). If you are at your GP and it’s part of your medical check-up, they might do a breast examination, where they will feel for any abnormalities around the nipple area, breast area and under the armpit.  

In conclusion, there is no reason not to do this preventative check-up. Yes, it can be embarrassing, but that is the worst part. These are trained professionals, and they have seen so many vaginas that they really don’t even care how it looks. So let’s get out of our heads, and make it a priority to have our check-ups. Prevention is always better than treatment. Take care of your health, it is the most valuable commodity that you own. Remember that you are worthy, you matter and you are loved.