For gynecologic care, a woman should choose a health care practitioner with whom she can comfortably discuss sensitive topics, such as sex, birth control, pregnancy, and problems related to menopause. The practitioner may be a doctor, a nurse-midwife, a nurse practitioner, or a physician assistant.
A gynecologic evaluation includes the gynecologic history and gynecologic examination Gynecologic Examination For gynecologic care, a woman should choose a health care practitioner with whom she can comfortably discuss sensitive topics, such as sex, birth control, pregnancy, and problems related to... read more .
For the gynecologic history, doctors ask about the problem prompting the visit, past and present menstrual periods, past pregnancies, sexual activities, and gynecologic symptoms, disorders, and treatments that the woman has had in the past.
Questions about menstrual periods include the following:
How old the woman was when menstrual bleeding began (menarche)
How often, regular, and long menstrual periods are
How heavy menstrual bleeding is
When did the last menstrual period begin and end
Whether the woman has symptoms (such as pain Pelvic Pain in Women Pelvic pain is discomfort that occurs in the lowest part of the abdomen. Pain that occurs externally in the genital area (vulva, or labia) is called vulvar pain. Many women have pelvic pain... read more , cramps Menstrual Cramps Menstrual cramps are pains in the lowest part of the torso (pelvis), a few days before, during, or after a menstrual period. The pain tends to be most intense about 24 hours after periods begin... read more , headaches, or loose stools) during menstrual periods
Whether the woman has or has had abnormal bleeding Vaginal Bleeding Abnormal vaginal bleeding includes any vaginal bleeding that occurs Before puberty Between menstrual periods During pregnancy After menopause (12 months or more after the last menstrual period) read more —too much, too little, or between menstrual periods
Questions about past pregnancies include the following:
How many pregnancies a woman has had
What the dates of those pregnancies were
How those pregnancies ended (such as in a live birth or a miscarriage)
Whether complications (such as bleeding, high blood pressure, nausea, or vomiting) occurred
The doctor usually asks about sexual activities to assess the risk of gynecologic infections Overview of Vaginal Infections In the United States, vaginal infections are one of the most common reasons women see their doctor, accounting for millions of visits each year. Vaginal infections are caused by microorganisms... read more , injuries, and pregnancy and to determine whether a woman has any sexual problems. A woman is asked whether she uses or wants to use birth control and whether she is interested in counseling or other information. Doctors may ask about sexual identity and gender identity issues to give adolescent girls and women an opportunity to talk about such issues.
The doctor asks whether the woman has pain during intercourse, in the middle of the menstrual cycle (which may indicate that the pain coincides with ovulation), or under other circumstances. If she has pain, she is asked how severe the pain is and what provides relief.
The doctor also asks about breast problems, such as pain Breast Pain Many women experience breast pain. Breast pain may occur in one or both breasts. (See also Overview of Breast Disorders.) Likely causes of breast pain depend on whether the pain is felt in a... read more , lumps Breast Lumps A breast lump (mass) is a thickening or bump that feels different from surrounding breast tissue. A lump may be discovered in a breast incidentally, during a breast self-examination, or during... read more , areas of tenderness or redness, and discharge from the nipples Nipple Discharge Fluid that leaks from one or both nipples is called a nipple discharge. Each breast has several (15 to 20) milk ducts. A discharge can come from one or more of these ducts. (See also Overview... read more . The woman is asked whether she examines her breasts, how often, and whether she needs any instruction on breast examination technique Gynecologic History .
The doctor reviews the woman's history of past gynecologic disorders and usually obtains a general medical and surgical history that includes previous health problems.
The doctor reviews all the drugs a woman is taking, including prescription and nonprescription drugs Overview of Substance-Related Disorders Drugs are an integral part of everyday life for many people, whether the drugs are used for legitimate medical purposes or recreationally (see table Drugs with Medical and Recreational Uses)... read more , tobacco Smoking Smoking tobacco is harmful to almost every organ in the body. Smoking increases the risk of heart attack, lung cancer, chronic obstructive pulmonary disease (COPD), and other disorders. Nicotine... read more , and alcohol Alcohol Alcohol (ethanol) is a depressant. Consuming large amounts rapidly or regularly can cause health problems, including organ damage, coma, and death. Genetics and personal characteristics may... read more , because many of them affect gynecologic function.
The woman is asked about mental, physical, or sexual abuse Domestic Violence Domestic violence is physical, sexual, or psychologic abuse between people who live together. It includes intimate partner violence, which refers to physical, sexual, or psychologic abuse by... read more —whether she or other members of her household are being or have been abused.
Some questions about urination are asked to find out whether the woman has a urinary tract infection Overview of Urinary Tract Infections (UTIs) In healthy people, urine in the bladder is sterile—no bacteria or other infectious organisms are present. The tube that carries urine from the bladder out of the body (urethra) contains no bacteria... read more or has problems with leakage of urine (incontinence Urinary Incontinence in Adults Urinary incontinence is involuntary loss of urine. Incontinence can occur in both men and women at any age, but it is more common among women and older people, affecting about 30% of older women... read more ).