Gynaecological Examination and Annual Check-up

A gynaecological examination is a consultation and examination that can be planned according to age and risk, even without symptoms. An internal examination or cervical smear is not needed at every visit. Its scope depends on the person's history, symptoms and previous screening. The following information is general and does not replace an individual assessment.

Why is a gynaecological examination performed?

A consultation about symptoms aims to understand a particular problem. A preventive visit reviews general reproductive health, discusses screening and vaccination needs, and allows time for questions. Current medical guidance describes this kind of preventive visit as covering screening, assessment, counselling and vaccinations according to age and risk.

Does an annual check-up mean that every test is performed?

No. An annual check-up does not mean that everyone receives the same list of tests. The examinations and tests needed depend on your history. It is therefore unrealistic to expect that everything has been checked; every test has limitations.

How often should you have a gynaecological examination?

Frequency varies between individuals. Age, contraception, pregnancy plans, previous screening results, long-term conditions and family history affect the decision. An annual consultation provides a reasonable framework for many people, but does not mean every test is performed each year. If symptoms develop, there is no need to wait for a scheduled appointment.

How are the consultation and medical history taken?

Much of the visit is a conversation. Questions cover period patterns and the date of the last period, medicines and supplements, previous illnesses and operations, family history, contraception and pregnancy plans. Sexual health questions may also form part of the discussion.

Are general and breast examinations performed at every visit?

If needed, general measurements such as blood pressure, height and weight are taken. Whether and how a breast examination is performed depends on age, history and the doctor's assessment.

When is a pelvic examination performed?

A pelvic examination, using a speculum and a bimanual examination with the hands, is not a routine compulsory step for every woman without symptoms. For someone without symptoms, the decision is shared between the person and doctor. An examination may be considered for abnormal bleeding, discharge, pain or a screening-related reason.

When is ultrasound added?

Ultrasound is not performed at every visit; it is requested according to symptoms and examination findings. The doctor decides which method is appropriate.

How is cervical cancer screening performed?

Cervical cancer screening uses a smear test, an HPV test or both. Starting age, intervals and test type vary by country and individual. Türkiye has a national screening programme run by the Ministry of Health. For current age ranges and arrangements, consult your family doctor or Ministry of Health sources. People who have received the HPV vaccine are also advised to continue screening.

When does breast screening start?

Breast screening generally uses mammography from a particular age. Starting age and intervals vary by country and risk factors such as family history. A breast lump, skin changes or nipple discharge should be assessed without waiting for the next screening date.

Is there a routine screening test for ovarian cancer?

No. Current medical guidance does not recommend transvaginal ultrasound and CA-125 testing to screen women without symptoms for ovarian cancer. There is no evidence that these methods reduce deaths; they may also produce false-positive results leading to unnecessary investigations or surgery. An inherited cancer syndrome or strong family history requires a different assessment; discussing your family history with your doctor is recommended.

Can you discuss contraception, vaccinations and pregnancy plans during the examination?

Yes. The visit also allows time to discuss contraception, prevention of sexually transmitted infections and, if needed, a review of testing and vaccination status. Tell your doctor if you are planning a pregnancy; some tests, medicines and supplements may need adjustment. Details of supplements and preparation before pregnancy are covered in preconception counselling.

How can you prepare for the examination?

• You can attend during your period, but ask when booking if bleeding is heavy or a smear is planned.
• Bring the date of your last period, details of medicines and any previous test results.
• Write down questions beforehand.
• If you have never had sexual intercourse, say so at the start of the consultation so that the method can be chosen accordingly. This does not prevent an examination.
• Consent and privacy are within your control; you can ask for the examination to stop if you feel uncomfortable.

How are privacy and consent protected?

Before the examination, you should be told what will happen, why it is needed and whether there are alternatives. You also have the right to ask about having a person close to you accompany the examination. Sexual orientation, marital status and sexual history are discussed to the extent needed for an appropriate assessment; you have the right not to be judged.

Are check-ups needed before and after menopause?

Yes. Periodic assessment is also appropriate during perimenopause and after menopause. The focus is on age-related changes, screening and symptom management. A normal smear or HPV result does not remove this need.