Gynaecological Examinations

Annual examinations usually consist of screening, laboratory tests, evaluation, counselling and immunisation.

Ages 13 to 18 years

Establish doctor-patient relationship

Age appropriate education of anatomy, body image, weight management and prevention of sexually transmitted diseases

  • Screening checks for you and your family’s medical history, menstrual and reproductive health, sexual development and history of sexual activities
  • Pelvic examination (includes examining the external genitalia, cervix and vagina), is generally not included unless there is related medical history or presenting symptoms that require further evaluation
  • Regular laboratory tests for sexually transmitted diseases such as chlamydia, gonorrhoea, HIV (human immunodeficiency virus), and Hepatitis B and C virus

Dr Alexander will advise you on your sexual health, sexual behaviour, preventing unintended pregnancies and contraceptive use.

You will be recommended immunization for human papillomavirus (HPV), and Hepatitis A and B vaccine.

Ages 19 to 39 years

Screening checks for your medical history, menstrual and reproductive health including sexual practices

  • Clinical breast examination every 1 to 3 years from the age of 20
  • Pelvic examination from 19 to 20 years if there is any related medical history and periodically if you are above the age of 21
  • Laboratory test such as cervical cytology ( to detect cancerous changes in the cervix) at age 21 to 29, every 3 years
  • Cervical cytology (Pap test) after 20 years of age, every 2 years
  • Pap test + HPV after 20 years of age, every 5 years
  • Laboratory test for sexually transmitted diseases such as chlamydia, gonorrhoea and HIV if you are 25 years of age or younger and sexually active
  • Colorectal cancer screening and mammography tests in high-risk groups

Dr Alexander may discuss sexuality, sexual behaviour, reproductive planning and contraceptives. Your visit will also include genetic counselling, preconception and protection against sexually transmitted infections.

Dr Alexander will also inform you about the importance of breast self-examination. You will be advised to vaccinate yourself against human papilloma virus, and Hepatitis A and B.

Ages 40 to 64 years

Screening checks for your medical history, menstrual, and reproductive history, sexual practices and menopausal symptoms.

  • Annual examination for pelvic prolapse (internal pelvic organ presses against the vagina), clinical breast examination and pelvic examination
  • Cervical cytology, every 2 years
  • Pap test + HPV, every 5 years
  • Colonoscopy (colorectal cancer screening) from age 50, or earlier if strong family history
  • Laboratory tests for HIV
  • Thyroid stimulating hormone test, every 1 years after the age of 45
  • Yearly mammography

Dr Alexander will advise you regarding sexually transmitted diseases, avoiding unwanted pregnancies, genetic counselling, preconception, hormone therapy, breast self-awareness and prophylaxis for breast cancer.

You will be advised to vaccinate yourself against Hepatitis A and B.

Ages 65 years and older

  • Screening checks for your medical history, reproductive health and menopausal symptoms.
  • Bone density scan especially with family history of osteoporosis
  • Annual examination for pelvic prolapse, breast examination and pelvic examination
  • Cervical cytology (can be stopped if prior tests have been negative)
  • Colonoscopy every 5 years or more frequently if family history.
  • Yearly mammography
  • Thyroid stimulating hormone testing every 1 years

You will be advised to perform self-breast examination tests, and can discuss sexual behaviours with Dr Alexander.

Regardless of your age, Dr Alexander will also examine your health with respect to nutrition, tobacco, alcohol and drug usage, physical activity and sexual practices.


What is a Pap test?

The Pap test, also known as Pap smear, checks for changes in the cells of your cervix. The cervix is the lower part of the uterus (womb) that opens into the vagina (birth canal). The Pap test can indicate if you have an infection, abnormal (unhealthy) cervical cells, or cervical cancer.

During a Pap smear, Dr Alexander takes a sample of cells from your cervix to be tested and examined. A Pap test is safe with no known medical risks.

Why is a Pap test Performed?

A Pap test can save your life. Pap tests can

  • find the earliest signs of cervical cancer
  • detect infections and
  • abnormal cervical cells that can turn into cancer cells.

If diagnosed early, the chance of curing cervical cancer is very high as treatments can prevent most cases of cervical cancer from developing.

Getting regular Pap tests is the best thing you can do to prevent cervical cancer. In fact, regular Pap tests have led to a major decline in the number of cervical cancer cases and deaths.

Do all Women need Pap Tests?

It is important for all women to have annual Pap tests, along with pelvic examinations, as part of their routine health care. You need a Pap test if you are:

  • 21 years or older, and
  • Women under 21 years of age who have been sexually active for 3 years or more

There is no age limit for the Pap test. Even women who have gone through menopause need regular Pap tests.

Women aged 65 to 70 can talk to their doctor about stopping after at least 3 normal Pap tests and no abnormal results in the last 10 years.

How to prepare for a Pap test?

Many things can cause wrong test results by washing away or hiding abnormal cells of the cervix. So Dr Alexander suggest that for 2 days before the test you avoid:

  • Douching
  • Using tampons
  • Using vaginal creams, suppositories, and medicines
  • Using vaginal deodorant sprays or powders
  • Having sex

Make sure to empty your bladder just before your examination. Dr Alexander may suggest you schedule a Pap test when you do not have your period. The best time to be tested is 10 to 20 days after the first day of your last period.

How is a Pap test done?

Dr Alexander can do a Pap test during a pelvic examination. It is a simple and quick test. While you lie on an examination table, Dr Alexander puts an instrument called a speculum into your vagina opening to see the cervix.

When Dr Alexander performs the procedure what is being examine is:

  • lumps, sores, inflammation, or other abnormalities of the external genitals..
  • using a metal or plastic instrument called a speculum into the vagina, and
  • a small disposable swab, wooden spatula, brush, or soft-bristled "broom" to remove cells from the entrance to the canal that connects the cervix with the uterus.
  • the cell sample on a glass slide, which is sent to a laboratory for examination under a microscope.

While usually painless, a Pap test is uncomfortable for some women.

What do abnormal Pap test results mean?

Abnormal Pap test results usually do not mean you have cancer. Most often there is a small problem with the cervix. Some abnormal cells will turn into cancer if left untreated for a long period of time, but early cell changes can revert back into normal in most of the cases.

By treating these unhealthy cells, almost all cases of cervical cancer can be prevented. If you have abnormal results, then consult with Dr Alexander about what they mean.

Although every effort is made to educate you on PAP TEST and take control, there will be specific information that will not be discussed. Talk to Dr Alexander about any concerns you have about PAP TEST.