Women's Health: Gynecological Exam

Women's Health at MTSU is focused primarily on the reproductive health of the female. This focus includes the annual gynecology examination. If requested, the provider can also help in the selection of birth control method(s). During this annual exam a Pap test, gonorrhea/chlamydia screen and breast exam are performed by a physician, physician's assistant or nurse practitioner. The American Cancer Society recommends that women begin having PAP tests at the age of 21 or three years after first becoming sexually active.

Why have the PAP Test?
The PAP test was first used 50 years ago and has lowered the number of deaths from cancer of the cervix by 70% in the US. The Pap test detects changes in the cells of the cervix (the opening of a woman's uterus). These changes can lead to cancer. The Pap test helps find these changes early, so they can be treated before they become serious.

Who should have a Pap Test?
Young, sexually active women may be at an increased risk for pre-cancerous changes in the cervix. Your risk may be higher if you:

1. Have had more than one sexual partner or a male sexual partner who has had more than one partner.
2. Had intercourse for the first time at an early age.
3. Have had an sexually transmitted disease (STD).
4. Have HIV or have a weakened immune system resulting from such things as a transplant.
5. Smoke cigarettes. If you have any of these risk factors, it is important for you to have a Pap test every year.

How can I schedule a gynecological exam?
You can book your appointment in person at Student Health Services or go online. It is best, not to schedule your appointment to coincide with your menstrual period. Appointments are made all day Monday - Friday. Should you not be able to make your appointment, PLEASE call and cancel at least 24 hours in advance. There is a $10 No Show Policy if you do not hold to this policy.

How should I prepare for the test?
For best results:

1. Avoid douching for 2 days before exam.
   
2. Avoid sexual intercourse for 2 days before exam.
   
3. Avoid putting anything into the vagina for 2 days before exam: washcloths, cervical caps, vaginal medications/yeast infection medicine, tampons, sponges, condoms, fingers, penis etc.
   
4. Make your appointment for the Pap test to occur 1-2 weeks after your period.

What will I experience during the pelvic exam?
A physician, physician assistant or nurse practitioner will perform the exam with the assistance of an RN. You will be more comfortable if your bladder is empty, so a bathroom is provided for you, connected to the exam room. You will be asked to remove your clothes. A paper cape and sheet will be provided for you to cover yourself. Let us know if you are cold, as we can turn the heat up in the exam room.

When you are ready, let the staff know and they will then enter the exam room. The nurse will help you to get into the position for the exam. You will be assisted to lie on your back with your feet placed in supports at the end of the table. The provider will insert a device called a speculum into your vagina. This device gently opens the vagina so the cervix can be seen. At this time, screening for gonorrhea and chlamydia can be done by touching a q-tip to the opening in the cervix. Then a tiny brush and paddle are used to collect cells from the inside and outside of the cervix. The speculum is removed after the cells are collected. Next your uterus, tubes, and ovaries will be palpated for size, location and tenderness. This completes the pelvic exam. The collected cell samples are sent to a lab outside of the Women's Center. At the lab, your sample will be evaluated for cells that do not appear normal.

What is involved in a breast examination?
Over her lifetime, an American woman has a 1 in 8 chance of having breast cancer. During the gynecological visit, your provider will inspect and manually examine each of your breasts. This annual, provider-performed exam should be combined with your monthly self breast exam. Together, they should detect any abnormalities that could lead to breast cancer. Doing your self exam monthly lets you learn what is normal for you. During your visit, the provider will review the technique of performing a thorough self breast exam. Between visits, perform the self breast exam monthly, the week after your menstrual period. If you discover any lumps or abnormalities in your breasts, please come to the Student Health Center for evaluation.

At around the age of 40, a baseline mammogram should be done as part of your annual exam.

How will I receive the results of my Pap test and Screening for Chlamydia/Gonorrhea?
While here for your exam, you will be given a phone number to call for your test results. If there is any abnormality (perhaps something as minor as a yeast infection or a more concerning situation), we will contact you by phone, at the number you listed during the examination visit.

If all results are normal, you should schedule your next exam in 1 year.

What are the fees for the gynecological exam?
There is no additional fee for the examination and counseling. There are fees for cytology and lab tests. It is recommended that all females 25 years and younger, who are sexually active, consider having annual screening for gonorrhea/chlamydia. Your provider may recommend adding a lab test for Human Papilloma Virus if the results of the Pap test are abnormal. They will consult with you before doing so.

Pap Test $45
Screening for: Gonorrhea/chlamydia $25
HPV $55

Will the Women's Center file insurance for the above fees?
Yes, but there is a specimen collection fee of $15. Be sure to bring your insurance information with you, so we can complete the filing information for you.