Posted on 1 September 2022

“We as women are often busy with caring for others first and ourselves last,” explains Dr Oburota Onwuagbu, Obstetrician and Gynaecologist at Mediclinic Potchefstroom. She explains that gynaecological evaluations constitute part of self-care which is fast becoming a priority for the present-day woman.


This evaluation is applicable to all women from the adolescent to the elderly. Dr Onwuagbu believes that this becomes an opportunity for preventative health screening and education and depending on the age group, various topics or issues are covered. Topics that may be discussed includes but not limited to contraception, STI’s, vaginal infections, menstrual issues, pelvic pain, preconception counselling, fertility, menopausal symptoms, breast symptoms and GBV.


During the well woman check-up, the gynaecologist will go through a full medical history, menstrual and pregnancy history, previous operations, allergies, previous or current medications, a family medical history as well as one’s social history. This information helps for risk stratification as well as to direct further investigations and safe prescription of medicines if needed.


Dr Onwuagbu explains what to expect. A complete physical examination is then carried out starting with the head and neck assessing the thyroid gland and then on to the chest listening for the breath and heart sounds and most importantly examining both breasts. The breasts are checked for skin changes, nipple discharge or any lumps within the breast tissue. The abdomen is then examined looking for any swelling or growths. The main focus of the physical examination is on the pelvic area, where the genital and reproductive organs are evaluated by inspection of the vulva, vagina, cervix, uterus and ovaries. This is usually done by means of an endocavity (internal) ultrasound and a speculum examination with the aim of looking for growths or lesions which are often hidden. It is at this point that a pap smear (cervical cytology) sample is collected and sent to the lab to screen for cervical cancer.


“According to the South African national cervical screening guidelines, a woman should start having routine pap smears from the age of 25 years and depending on previous results, it should be repeated every 3-5 years if she is HIV negative or yearly if HIV positive,” explains Dr Onwuagbu. However, the age of initial pap smear could be earlier depending on a woman’s medical history.


Yearly mammogram evaluations are routinely carried out from the age of 40 years to assess the inner structures of the breast tissue but ultrasound breast imaging is recommended for women younger than 40 years of age if any abnormality is detected on the physical examination or if the medical history suggestive of breast issues.


Certain gynaecological conditions go undetected for many years and only become apparent at advanced stages. At the annual well woman check-up, any such conditions can be detected at an early stage and can be treated more effectively with preservation of the reproductive system.

Published in Gynaecology

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