2. Do you know how to protect your sexual
and reproductive health?
Do you know what you can do for yourself?
Do you know when to see a health care provider?
Do you know what to expect at a gynecological visit
and exam?
3. Vulvar and Vaginal Self-Care
Basics: eat well, get adequate sleep, exercise regularly
Smart sex: learn the sexual history of your partner
Clothing: tight fitting clothing can trap heat and moisture and
cause irritation
o Sleeping without underwear allows air to get to the vulvar
area to keep the tissues healthy
Douching: can create unhealthy changes in the pH
Cleaning: always wipe from front to back
Tampons: choose the right absorbency and change every 28 hours
Irritants: skip the scented soaps and perfumes – they can
cause irritation
4. Shaving
It is not necessary from a health perspective
It can cause irritation and skin infections
If you do, proceed cautiously
5. When to See a Provider
Basics: need birth control, are pregnant, unusual vaginal
discharge
Other: missed periods, bumps or swelling, pelvic pain,
unusual periods
It’s important to have periodic visits once you are
sexually active
STI tests should be done before and after you have sex
with someone, if you are sexually active with more than
one person, and if you think/know your partner has had
sex with someone else
You should have a gynecological exam by 21 even if you
are not sexually active
6. Where to Get Care?
Private medical offices
Health care clinics
Family planning clinics such as planned parenthood
7. Preparing For a Gynecological Exam
Schedule on a period free day - menstrual fluid can affect
the results of some tests
If you have any symptoms, avoid sex, tampons, and
medications
Write down any questions you may have for the provider
Bring support - bringing a friend, partner, or parent may
help you to feel more comfortable
o If a parent comes with you, it is your decision whether to
have them in the room or not
8. When You Arrive for Your Exam
Fill out forms about your health
o In the US, your health information is protected and private according to
the HIPAA law
You may be asked to urinate in a cup so it can be analyzed for a
UTI or pregnancy
Even if you don’t need to do a urine sample, gynecological exams
are more comfortable if your bladder is empty
Height, weight, heart rate, blood pressure are tested
You will be given a robe to put on while the medical assistant is
out of the room
The provider will come in and review your health history and ask
follow up questions
The provider will wash his/her hands or use antibacterial gel and
wear gloves
Remember: this may be uncomfortable for you but the provider
does these over and over again so if you are feeling anxious, let
them know
9. Breast Exam
The provider will examine the breasts
Feel all parts of the breast looking for lumps or
unusual textures
Check your armpits for swollen lymph nodes
10. Pelvic Exam
Lie back on the table and place your feet in the stirrups
Try to relax
If you feel uncomfortable, you can ask to sit up
The provider will exam the vulva visually to make sure
the tissues are healthy
The provider will examine the distribution of public hair,
size and condition of the clitoris, and the architecture of
your vulvar lips and opening to the vagina
The provider will look for irritation, discoloration,
swelling, bumps, lesions, lice, and unusual discharge
Sometimes a Q tip is used to evaluate the entry to the
vagina for pain or tenderness
11. Pelvic Exam Continued
The provider will insert a metal or plastic speculum in your
vagina
The speculum is shaped like duck bills and comes in
different sizes and lengths
It holds the walls of the vagina apart so your provider can
examine the vagina walls and cervix
The provider should explain the process step by step
The provider will examine the vagina walls for lesions,
inflammation, or unusual discharge
The provider will look at the cervix for unusual discharge,
signs of infection, discoloration, damage, or growths
A pap test may be done to check for abnormal cervical cells
Sometimes a smear of vaginal discharge is taken to test for
infections or STI’s
The speculum is removed
12. Bimanual Exam
The provider will insert one or two gloved fingers into
your vagina while pressing down on your abdomen with
the other hand
This is done to locate and determine the size, shape,
and consistency of the uterus and ovaries
The provider will feel for any unusual growths or tender
areas
13. Rectovaginal Exam
The provider will insert one finger into your rectum and
one finger in your vagina to assess your internal pelvic
organs from a different angle
The provider will look for rectal lesions, test the rectal
sphincter muscles, and look for any blood
This is usually the last part of the exam
14. Staying Calm
Take deep breaths
Relax your stomach muscles, shoulders, muscles
between your legs
If you feel any pain, make sure to tell the provider
You can ask for a mirror to watch exactly what the
provider is doing
You can ask the provider to adjust the table and pillows
15. Talking With Your Provider
The provider will address any issues regarding birth
control and general health advice
Findings from the exam will be discussed
Pap and STI tests do not yield immediate results so the
provider will ask for an appropriate number or email to
contact you when the results come in
16. Specific Concerns
You should ask any questions as needed
If you’re not sure about a providers willingness or ability
to accommodate you, ask questions when calling to
make an appointment
Ask for referrals from friends and look online for
reviews to make sure you pick an appropriate provider
17. Sexual Abuse
Many people who have experienced sexual abuse find
that pelvic exams can be difficult
You don’t have to tell your health care provider that
you have been abused but disclosing it may help your
provider to understand your fears and take extra
measures to make you feel comfortable and safe
18. Disability and Chronic Illness
Your health care provider may not initiate discussions
around sexuality, contraception, and STI unless you
bring up those topics
If navigating a medical office or getting ready for the
exam will require extra time, call the office or clinic and
request a long appointment
Adaptation should be provided to meet your needs and
if a provider cannot meet your needs, a referral should
be made
19. Additional Concerns: Size
If you weight more than 250-300 lbs, let the staff know
as not all providers have tables, scales, and gowns or
equipment to accommodate women of size
Subtle and explicit fat biases are common
Lookout for providers who blame every symptom and
problem on your being women of size
20. Additional Concerns: Lesbian,
Gay, Bisexual, Transgender
Some providers make assumptions about risk of STI
to whether they need birth control
Some providers don’t commonly work with LGBT
community
Remind the provider who you are and what issues
are relevant and appropriate for you
21. “According to Mavi Kalem, there are no comprehensive
health resources in Turkish. Health information, when
available, is shaped by conservative cultural ideas on
fertility and childbearing, and focuses on pregnancy,
birth control, and sexually transmitted infections. It is
difficult to find a resource that analyzes the health and
rights of women and girls from their points of view. This
forces many to seek information through unofficial
channels- friends, older relatives, and mothers- that is
not always accurate (32).”
22. Discussion Questions
Where do you go to get information on your health?
Is that a reputable source?
How do you know?
