Preventive check-ups by a gynecologist: unpleasant for many, but important

For many women, the thought of a gynecological examination is rather unpleasant. Yet regular check-ups at the gynecologist are a routine procedure – they are done quickly and usually absolutely pain-free. And as so often in life, the following applies: “Preventive care is better than aftercare.” 

A preventive gynecological examination is essential to detect diseases at an early stage. In recent years, systematic checkups have reduced cervical cancer mortality by about 40 percent. From the age of 20, all women should have a check-up at least once a year. 

Doctors examine their patients for cervical, breast, ovarian and uterine body cancer, as well as for vulva and vaginal cancers. But other diseases, such as sexually transmitted diseases, can also be detected. Find out here which preventive examinations are available for women and which ones make sense. We also answer the question of who bears the costs of the gynecological check-up.

Preventive gynecological examination: What happens there?

Do you always feel a little uneasy when the next appointment for the next gynecologist is due? You’re not alone in that. On the positive side: The routine examination with ultrasound, smear, and palpation of the breast is usually done within a few minutes – and you feel good afterwards. In addition, the appointment with the gynecologist is an opportunity to ask questions and discuss gynecological problems.

The following points are included in the annual gynecological check-up:

• Preliminary discussion: At the beginning of the appointment, the gynecologist asks about any symptoms and abnormalities. Are there any irregularities in the cycle, pain during sexual intercourse or problems with family planning? There’s room for questions.
• Advice: Women can seek advice on issues such as sexuality, contraception and pregnancy as part of the check-up.
• Investigations by palpation: By means of palpation, the doctor can detect changes in the female body and thus also, for example, growing breast nodules as an indication of breast cancer.
• Instrumental examinations: Check-ups are carried out with medical aids. The gynecologist takes swabs and, if necessary, performs ultrasound examinations and a mammogram.

Preventive check-ups by a gynecologist: Which ones are there?

During a preventive gynecological examination, the abdomen is thoroughly examined. The most important studies include:

• PAP test
• HPV test
• palpation of the chest and abdomen
• Ultrasound examination of the uterus and ovaries
• Mammography

The PAP and HPV smear is particularly important. They are essential tools in gynecological screening. They can be used to detect cervical cancer at an early stage.

PAP test

The PAP smear (also: cervical smear) helps to identify cell changes on the cervix that are not yet cancerous but pose an increased risk. These precursors can often be treated before they become cancerous.

When a cancer swab is taken by a gynecologist, some mucous membrane is removed from the cervix with a brush or cotton swab. This can tug a little and cause minimal bleeding in the short term. This sample is then tested for malignant cells in a cytological laboratory.

If the smear is negative, the patient can wait two to three years, according to the recommendations of the Society of Gynecology and Obstetrics, before having the next smear performed. However, if the PAP test is positive, more frequent check-ups are initiated to specifically observe degenerated cells.

HPV smear

Human papillomavirus (HPV) is the leading cause of cervical cancer. The HPV smear can detect infection with HPV types that increase the risk of developing cancer in the cervix. The test can also be positive if the PAP smear does not show any cell changes. It thus provides an additional layer of safety in the early detection of cancer. 

Palpation

Changes can also be detected by palpation. In addition to the breast examination, during which the gynecologist feels for lumps in the area of the breast, the size, shape and mobility of the uterus are assessed by palpation of the abdomen, among other things. In addition, changes in the area of the ovaries can be detected. To do this, the doctor inserts two fingers into the vagina and palpates the abdominal wall with the other hand for abnormalities.

Ultrasound

Finally, the wall and mucous membrane of the uterus as well as the cycle phase, the ovaries and the spaces of the small pelvis can be examined more closely by means of a vaginal examination.

To do this, the gynecologist uses a rod-shaped transducer rubbed with gel and inserts it into the vagina. This may be uncomfortable for a patient, but it is not painful.

Mammography

Are you 50 years of age or older? Then you will also be invited to a mammogram as part of screening programs. If you have an increased risk of breast cancer, this x-ray examination of the female breast is recommended in advance for the early detection of breast cancer (breast cancer).

There’s a reason for this: Mammography is still considered to be the most effective method for the early detection of breast cancer precursors and breast cancer tumors. Even the smallest changes in the structure of the breast tissue can be visualized by this method.

When should women have a check-up with their doctor?

It is advisable that women from the age of 20 or from the time they become sexually active consult a gynecologist. If you get regular examinations at a young age, you can detect and treat malignant diseases such as cancer at an early stage. 

Some girls go to the gynecologist for the first time when they get their period. For example, because they have problems with a very heavy period or because they want to know what is going on in their body. It’s best to bring a trusted person to the kick-off meeting.

Costs of gynecologist examinations: Who pays for this?

In Switzerland, the your basic health insurance covers the cost of preventive gynecological examinations in the first two examinations every one year, in which the cancer swabs are included. Subsequently, the costs are assumed only for PAP/HPV tests every three years. If smears are taken in the intervening years, the costs incurred are usually covered by supplementary insurance. For the insured, this means: For each invoice received, they must check whether they are entitled under basic insurance or supplementary insurance.

Keep this in mind before your visit to the gynecologist

If the next or perhaps even the first preventive check-up is due, these tips can be helpful:

1. It is best to go to the toilet beforehand to empty your bladder. This makes scanning less unpleasant.
2. As you will have to remove your upper and lower clothing during the check, it is advisable to wear practical clothes that are easy to put on and take off. Longer tops are ideal so that you don’t feel so naked during an abdominal examination.
3. If your period is coming, the appointment should be postponed. Ideally, your period should be over for five days.
4. As of two days before your appointment avoid sexual intercourse, tampons and vaginal suppositories, and ideally also avoid products such as lubricants, vaginal creams and intimate douches.