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How do I get an appointment?
If you have a gynecological issue or questions concerning contraception
or prevention of sexually transmitted illnesses, call 044 233 30
30 or send an email for an appointment with one of our gynecologists.
If you want to see a particular gynecologist, let us know and the
next available appointment with her will be yours. Even if you need
to see a doctor the same day, we will try to have “your” doctor
see you. It is possible, however, that no appointment with her is
available. Our gynecologists represent each other during absences.
You are therefore free to consult the stand-in doctor. If you consent,
she can look into your medical files in order to have access to all
necessary medical data for your consultation.
Does ZiSMed accept new gynecological
patients?
Yes.
What happens in a gynecological consultation?
In the consultation, we talk about your requests and possible treatments.
If necessary, we perform a gynecological or obstetrical exam, sometimes
also an ultrasound exam. Your blood or urine may need to be examined,
therefore it is better not to empty your bladder right before visiting
us.
What happens during a gynecological exam?
The gynecological exam is done on a special reclining chair, for
young girls on a bed. Usually, your doctor will visually check your
outer genitals (the vulva with the clitoris and its foreskin, the
outer and the inner lips, the urethral opening, the entrance of your
vagina and the hymen or its remnants, the perineum and the anus).
The colposcope, a magnifying lens, may be helpful in this. You can
follow the exam with a mirror.
Then a warm and lubricated speculum is introduced into your vagina.
If you want, you can do this yourself. Once opened, the speculum
enables a view onto the vaginal walls and the cervix (the lowest
part of the uterus or womb). You can also see this with the mirror.
With a cotton swab, your doctor will sample your vaginal fluids and
check them in the microscope for microbes. She will also take a cervical
sample for the PAP-smear. Diluted vinegar or iodine is used to dye
the surface of your cervix – this may burn a little. Some women
experience the PAP-smear as a brief, unpleasant sensation. Aside
from that, the whole exam should cause no pain.
After removal of the speculum, your doctor will examine your uterus
and ovaries manually with one or two fingers in your vagina and her
other hand on your lower abdomen. Sometimes a rectal exam is performed.
If the exam yields no clear result, an ultrasound is performed with
a thin vaginal probe. This exam can cause pressure at various places
in your vagina, but it should not be painful.
A preventive exam also includes visual and manual examination of
your breasts and armpits.
How much time should I plan for a preventive examination?
The physical exam will take 10-15 minutes, history taking and discussion
of results take about 30 minutes. You should therefore plan about
an hour for the consultation, including the preceding laboratory
examination.
Will the gynecological exam hurt?
The gynecological exam should not hurt. In general, it can be performed
so gently that it will cause no more than slight discomfort, but
no pains. If you are in pain prior to the exam, it may not be possible
to avoid pain during the exam – at any rate, the exam can be
interrupted any time you wish.
Why is the preventive gynecological exam (PAP-smear) necessary?
The PAP-smear is performed to detect signs of a “HP-virus” (human
papilloma virus) infection. This infection doesn’t cause symptoms
and often heals sponaneously. It may, however, if not treated, eventually
lead to cervical cancer. Once discovered in the preventive exam,
the infection can be monitored and treated, if necessary, so no cancer
will develop. Thus, the PAP-smear is a true preventive exam that
prevents the onset of cervical cancer.
I’ve never had a gynecological exam before and want
to consult for the first time.
At your first gynecological consultation, we generally don’t
perform a physical exam (unless you have complaints that warrant
an examination). Issues at a first consultation often concern contraception
or menstruation – these we can talk about without a physical
exam. Likewise, generally you can get your first prescription for
the birth control pill, ring, or patch without a physical exam. This
way you can first get to know your gynecologist a little. Furthermore,
she can explain to you what exactly happens during an exam, and you
can take a look at the examination chair and instruments. As long
as you haven’t started sexual intercourse, preventive exams
(PAP-smears) are not necessary. In general, they will begin about
a year after the onset of intercourse. The PAP-smear serves to detect
HP viruses that are only contracted through sexual intercourse, therefore
screening makes no sense in women who have not yet had intercourse.
I’ve never had intercourse, but I have a physical
complaint. Can I have a gynecological examination?
In case of physical complaints, a gynecological exam may be necessary
even if your hymen is still intact. In that case, special smaller
instruments will be used in order not to hurt your hymen. Young girls
who haven’t had started their menstruation
will be treated by specialized children’s gynecologists.
How can I prepare for the first examination?
You may want to prepare yourself by getting used to touch inside
your vagina. E.g. you may want to touch the entrance and inner walls
of your vagina with your fingers every now and then, apply some gentle
pressure or massage them using a lubricant, such as a good salad
oil or saliva.
That way, you will be used to the sensations inside your vagina
and will feel at home in this inner space before something foreign
such as an examination instrument visits you there. Relaxing your
pelvic floor muscles can also help to make you more comfortable during
the exam. These are the muscles you use to stop the flow of your
urine. They sometimes have a life of their own and may involuntarily
contract in self-defense, which will make the exam more difficult.
If you train these muscles by repeatedly contracting and letting
go, you can learn to relax them voluntarily. Your gynecologist will
give you sufficient time to relax and arrange yourself comfortably
on the examination chair. She may perhaps advise you to exhale deeply
with your abdomen, as this also helps.
What should I bring along to consultation?
Your health insurance information (if you visit us for the first
time), possibly your vaccination records, and a full bladder. It
may also be helpful to have old medical records, which you can demand
from your previous doctors.
I have my menstruation, can I still come to the examination?
Gynecological examinations can be performed even when you bleed.
For the annual check-up (PAP-smear), however, we recommend to wait
until the bleeding is weak or has stopped. If necessary, please call
and reschedule your appointment.
How long will I have to wait?
For check-ups and pregnancy controls, we schedule you so that urine
and blood laboratory exams can be performed before you see the doctor.
That way, some of the results may already be available during the
consultation, but this may entail a short period of waiting.
Unfortunately, unexpected examinations mean we can’t always
keep to our schedule. We thank you for your understanding and for
being on time, as this greatly helps us with the schedule!
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