Gynecology, Obstetrics, Family Planning

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?

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!