Self-examination

Self-examination of the vagina is really no more shocking than self-examination of the breasts. A physician hasn't the time and most women haven't the money or inclination, for regular medical examinations that could catch all early signs of breast cancer, or vaginal infection, venereal disease, cervical cysts, or pregnancy. So the M.D.s came up with breast examination for the home. It has received wide publicity and advocacy.

I don't think we can expect the same for vaginal self-examination; the first time I told a doctor that I had examined myself for an infection he would not beleive that I had actually done it. It is, in fact, not nearly as difficult a physical act to perform as might be expected. Any woman can learn to examine herself with a speculum.

The speculum is a device that you use to open the vaginal cavity to allow examination of the vaginal walls and cervix. With the use of a directional lamp and mirror, it becomes simple to examine yourself for irritations, infections, discharges, etc.

A group of five or six women would be optimal for learning. Each woman should have her own speculum to eliminate the transfer of infection and the speculum should be washed with phisohex after each use. Arrange yourself on a table or firm bed on your back with knees bent and feet placed far apart. Insert speculum upside-down (when your doctor inserts it, he has the handle pointing down, you need it pointing up so that you can open it).

After inserting, open speculum (manipulate your speculum extensively before insertion so that you are will acquainted with it, and can use it easily). If you have difficulty, have a friend open it. Point the directional light at vagina, place mirror so that you can see your vagina and cervix.

If you cannot see your cervix, try withdrawing speculum slightly and sucking your stomach in; cervix should pop into view. If not, have a friend try manipulating the speculum.

If you have never had a child, your cervix will be small (1 to 1 1/2 inch in diameter), pink, smooth, and very firm looking. If you have delivered one or more children, your cervix will be larger, perhaps colored differently and the cervical canal will be substantially larger. The vagina should also be pink and firm looking, although ridged, and not terribly sensitive to touch (not sore). The vagina has a normal clear or whitish secretion which varies in quantity with each woman. 

If the vagina is infected or irratated it becomes swollen, tender to the touch, extremely sensitive to touch, extremely sensitive to the pressure of the speculum. Upon viewing, the vaginal walls will be inflamed and red (much the same as a sore throat). There may be an increased secretion, usually of a different color. Discharge from yeast or trichomoniasis will be yellow and mucousy, gonorrhea has a thick yellow-green discharge.

There are some home remedies for yeast infections such as putting yogurt in the vagina to inhibit the growth of yeast fungus. (The vagina has a delicate balance of bacterial and fungal growth which can be easily upset and result in an infection, really an over-growth of one or the other. This is why when antibiotics are taken, a yeast infection often results. The antibiotics kill the natural bacteria and the yeast grow wild.)

Some physicians who are concerned with the comfort of their patients will prescribe Mycostatin (orally or vaginally) along with antibiotics; other physicians concerned with their patients' pocketbooks as well as their comfort will indicate that yogurt will preserve their natural bacteria. And eating yogurt will replace the bacteria in the digestive tract which has been destroyed by the antibiotic.

The vagina and cervix change during the menstrual cycle. Once you are familiar with the changes that occur in your own body, it may be possible to detect an early pregnancy simply by noting the unusual changes, or the lack of the regular one. The only way to give yourself the necessary knowledge of your body is to follow it closely and learn what it looks like at what stage in the cycle.

During the first two weeks following menstruation, a healthy cervix and vagina will be pink and firm and smooth, there may be a clear mucous secreted from the cervical canal. Most women have cyclical changes in their vaginal secretions and you may learn that these secretions increase for you at the time of ovulation or one week before menstruating. When you examine yourself just before menstruation you may be amazed to find the vaginal walls swollen and tender, the cervix swollen and blue veins seeming to pop out on it -- a perfectly normal pre-menstrual condition.

Whatever the changes are in your body, know them. If you suspect you are pregnant, check yourself; if your period is late and your cervix does not appear as it usually does pre-menstrually, you could be pregnant, and can at least make an intelligent and informed decision.

Peggy Grau/everywoman