Peer.Health@gmail.com
Paresky 212, x3140
AIM: HealthyEphs
Women's Health
Infections and menstrual problems
Gynecological exams
Self-exams for women
Female problems with sexual functioning
This section covers issues associated with gynecological services and infections which primarily affect women. For more information on contraception, sexually transmitted diseases, pregnancy, and eating disorders please visit those pages.
Infections and Menstrual Problems
Women should keep track of when their periods start and when they expect their next period; this not only helps determine pregnancy, but also helps women and their health care providers evaluate other reproductive health conditions. A number of symptoms surrounding menstruation can cause a great deal of worry. Most fall within the "normal" range of symptoms, but a woman needs to pay attention to all symptoms to determine what is "normal" for her. If you are uncertain, seek the advice of a health professional.
Amenorrhea
Amenorrhea is an absence or abnormal stoppage of menstruation,. In college women this can be associated with stress, sever dieting including eating disorders, increased levels of excercise, and illness. Or, it could indicate a pregnancy. In any case, if you have kept track of your cycles and know what is normal for you, you can help a health professional evaluate the missed period.
Dysmenorrhea
Dysmenorrhea is painful menstruation. It is normal to experience some pain and cramping as part of the menstrual cycle. If menstrual pain interferes with your normal activities, ask your health care professional for advice. While keeping track of your cycles, you might also want to develop a personal index that measures how uncomfortable you are through your cycle. If pain increases over "normal" for you it would be helpful for the health professional to be able to assess both the length of the cycle, number of days of flow, and intensity of the pain.
Premenstrual Syndrome (PMS)
Premenstrual Syndrome, or PMS, refers to a combination of symptoms experienced by many women during the menstrual cycle, usually just before menstrual bleeding begins. The intensity and range of symptoms vary widely. Symptoms may include temporary (water) weight gain or a bloated feeling, headaches, cramps, tender breasts, tension, skin outbreaks and depression. All of these may occur to some degree when hormonal balances change. Women are encouraged to keep track of their cycle and symptoms to document for themselves their own pattern. Diet (low sodium/salt, increased fluids, high fiber, high complex carbohydrates, low fat and low sugar), exercise, massage, relaxation techniques, and prescription medication may be helpful in alleviating symptoms. Researchers are investigating the relationship of PMS to certain vitamins and minerals. Check with your health care provider about the advisability of taking extra nutrients to relieve PMS.
Toxic Shock Syndrome (TSS)
TSS is a rare bacterial-cause illness occuring mostly in young women during their menstrual periods, especially in women who are using high-absorbency tampons. Symptoms include the sudden onset of a fever over 102 F, vomiting, diarrhea, and a rash on the hands or feet. These symptoms can rapidly lead ot loss of blood pressure and shock. If these symptoms appear, consult a physician or go to an emegency room immediately.
Infections
For information on vaginitis, pelvic inflammatory disease, urinary tract infections, scabies, or crabs, please see our STD page.
An appointment to see a gynecologist can be made by calling the Health Center at 597-2206. All female students are entitled to gynecological services, most of which are free, through the Health Center.
The clinic gynecologists are available to perform routine gynecological exams, discuss menstrual problems, prescribe and provide forms of contraception including the Pill, the diaphragm, and condoms, treat vaginal infections and sexually transmitted diseases, and conduct pregnancy tests.
Peer Health provides a service where women can, prior to their first gynecological exam, talk with a trained peer educator to learn what to expect during the exam. Before your appointment, we suggest you talk with a trained Peer Health educator to learn what to expect during the exam. A GYN Education Session may be a good opportunity to ask questions or relieve anxieties. Appointments for GYN Education Sessions may be made by calling the Health Center at 597-2206 or Peer Health at 597-3140.
A Routine Gynecological Exam
Many young women hesitate to make your first appointment with a gynecologist. Nonetheless, before she becomes sexually active or around the age of 18, every woman should begin to make gynecological check-ups a routine part of her health care. Since most visits to a gynecologist include a routine pelvic and breast examination, it is important to feel comfortable with the procedures and to remember to feel free to ask questions at any point during the examination. Again, taking advantage of the Peer Health GYN Education Sessions to talk one-on-one with another woman about the experience can make the experience of a first GYN exam much less stressful than it could otherwise be.
Breast Exam
The breast exam helps detect abnormalities in the breasts which may indicate cancer or other problems. The doctor will feel each breast, moving in a circular motion to check for lumps or other abnormalities. Feel free to ask the doctor to demonstrate how to do a breast self-exam.
Pelvic Exam
A pelvic exam is an essential part of every woman's health care program. The pelvic exam helps the woman and her doctor evaluate the health of her reproductive organs and check for unusual color, rash, warts, swelling, irritation, or discharge.
You will be asked to position yourself on the table, placing your feet in the foot rests so that the doctor can examine the pelvic area. You may sit up to watch the clinician during the examination. After looking at the external genitalia, the clinician will insert a speculum, a device which enlarges the vaginal opening to provide a clear view of the vaginal walls and the cervix. Feel free to ask for a hand mirror so that you can look at your cervix.
An important part of the examination is a Pap test. The Pap test is a simple procedure which is used to detect pre-cancerous cells. The doctor uses a small round brush to take cells from the mouth of the cervix. For most women this is a painless procedure, although you may feel the brush touch your cervix.
If you feel that you may be at risk for a sexually transmitted disease, you may want to ask for a Chlamydia test. This test, which is free of charge, detects one of the most common sexually transmitted diseases, a disease which often causes no or few symptoms in women but may lead to sterility. Like the Pap test, the Chlamydia test involves taking a few cell samples from the cervix. When necessary, the clinician may take samples to test for other sexually transmitted diseases. Once the tests are performed, the clinician removes the speculum and begins the bimanual exam.
During the bimanual exam, the clinician will place one hand on your lower abdomen and two fingers of the other hand in the vagina. She or he will do this in order to outline the uterus and ovaries. The clinician can then detect pelvic abnormalities and will ask you to describe any tenderness you feel.
Rectal Exam
Lastly, the clinician may perform a rectal exam. She or he will briefly insert one lubricated, gloved finger into your rectum, which will push your uterus, ovaries and fallopian toward the surface of the abdomen. This allows the clinician to feel irregularities which may not be detected otherwise.
After the Visit
Soon after this visit, you will receive results from the Pap test and any other test that may have been done at the time of the examination.
While a clinician at a gynecological exam will look for infections and abnormalities, she or he will recommend that a regimen of self-exams be practiced so that the woman herself can learn to recognize any physical changes which may suggest problems. The ability to examine one’s own breasts and vulva is an important part of personal health care for women.
Breast Self-Examination (BSE)
A BSE should be performed every month during the week after the menstrual period ends. It is important to determine what feels normal initially and then to check for any changes. The examination has both a visual and manual component. During the visual examination, stand in front of a mirror and look for:
- Difference in shape - flattening or bulging in one breast
- Puckering in the skin or nipple
- Changes in the nipple, such as a discharge of fluid, scaly crusts, reddening of the nipple, and/or nipples pointing in different directions
The breasts should then be examined by touch. You should also examine your breasts by feeling them. Using your opposite hand and the flats of your fingers, examine your breasts as illustrated on the next page. If you notice anything unusual, contact the Health Center at 597-2206.
Peer Health has breast models available on which BSEs can be demonstrated and practiced. Also, the American Cancer Society has developed a good brochure on BSE which is available at Health Services and in the Peer Health room.
Vulva Self-examination
A vulva self-examination is a simple exam that can help the woman discover the presence of a sexually transmitted disease. Often early diagnosis can be very important in treating a disease most effectively. For more information on specific diseases, see the pages on Sexually Transmitted Diseases and Urinary Tract and Genital Infections.
The vulva is the entire external portion of the vagina. To perform an exam, first undress, and examine the area of your genitals covered with pubic hair. It may be difficult to see the entire vulva area, and it might help to use a mirror. Spread the hair and check for any of the following:
• Bumps and blisters which may be reddish or flesh-colored. Some may look more like pimples.
• Open sores.
• Warts which may be similar in appearance to warts on other parts of your body, and may be difficult to detect.
Next, spread the outer lips of your vagina and check the hood of your clitoris. Then, look at the clitoris itself by gently pulling up the hood. Again, check for sores, bumps, blisters, or warts. Then look at the inner lips on all sides, and then check the area surrounding the urinary and vaginal openings. Also, try to be aware of any unusual discharge from your vagina. If you see or feel anything suspicious, call the Health Center at 597-2206. Some STDs will not appear in your vulva area, so if you have reason to think you have been exposed, it is important to have a pelvic exam or other tests by a doctor.
Female Problems with Sexual Functioning
Male problems with sexual functioning often receive more attention than do women’s, since, in heterosexual relationships, men are often perceived as the partner who must "perform." But women may also have problems which prevent them from enjoying intercourse fully. When both partners are conscious of each other’s emotional and physical feelings, sexual intimacy--whether it takes the form of sexual intercourse or other activities--may be a more pleasurable experience each.
Dispareunia
Women may experience uncomfortable or painful sexual intercourse, known as dispareunia, for a variety of physical reasons. Vaginal infections or irritations may make penetration of the vagina painful, or penetration may cause the infection to flare up. Women may also develop reactions to contraceptive products, lubricants, or other feminine hygiene products. Lubrication of the vagina is also important in making sexual intercourse fully pleasurable. Insufficient lubrication of the vagina may have physical causes or may be the result of nervousness or lack of arousal. A spermicidal or water-based lubricant is the best method for adding vaginal lubrication, particularly if you are using condoms (oil-based lubricants will break down latex). During the first few times she has intercourse, a woman may feel pain due to an unstretched hymen or nervousness. Waiting until she is most aroused and trying to relax may help reduce this discomfort. Pain deeper in the pelvic area during intercourse may be caused by an infection or other medical problem. If any pain during intercourse persistently recurs, seeing a gynecologist is a good idea.
Vaginismus
Strong involuntary contraction of the vaginal muscles, specifically of the outer third of the vagina, may make penetration sharply painful. This spasm of the vaginal muscles, known as vaginismus may be an unconscious defense against an uncomfortable sexual situation. Previous unwanted sexual experiences, including rape, may also result in vaginismus. Health care professionals or psychotherapists may be able to suggest self-treatment techniques to help alleviate painful penetration.