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Gynaecology - Frequently Asked Questions




1. I am not married. Should I have a pap smear?
It is advisable that women should have Pap smear after they have begun their sexual life or reached the age of 26 years.
2. How often should I have a pap smear?

It is recommended that you have a Pap smear annually until 70 years of age. Those women who have had a hysterectomy done (surgery to remove the uterus and cervix) do not need regular Pap smear, unless the surgery was done as a treatment for precancer or cancer condition.

3. My doctor said that my pap smear is abnormal. Does this mean that I have cancer of cervix?
Abnormal Pap smear means that some of your cervical cells appear abnormal, but usually are not cancerous. You will need medical follow-up if you have an abnormal Pap smear to prevent the abnormal cells becoming cancerous. That's why regular Pap smear is recommended, to detect and treat the abnormalities at the early stage before it is too late. You will be asked to do a cervical biopsy (removal of a sample of the cervical tissue for examination) to confirm whether the abnormal cervical cells will be premalignant.
4. When is the best time to do a pap smear?
It is advisable to have your Pap smear done between Day 7 to Day 10 of your menstrual cycle (first day of  your menses is considered as Day 1). However, if you are busy or unable to have an appointment with your gynaecologist on the particular days, Pap smear can be done at any time as long as you do not have your menses.
I used to have abdominal pain the day before my menses came. Now I have the pain on my first and second day of menses. Why does this happen?
It is normal to have mild abdominal pain on the day before menses come which is due to increase blood flow to the pelvic and fluid congestion. Period pain which is occurs during your menstruation may be due to endometriosis ( the growth of endometrial cells outside the uterus). Endometriosis bleeds in the abdomen during menstruation and cause irritation and pain . Endometriosis in the long run may lead to infertility and so you should consult your gynaecologist if you have period pain during menses.
I have vaginal discharge which is worrying me. Am I having vaginal infection and what should should I do?
If your vaginal discharge is smelly, coloured (green or yellow colour) or itchy, you probably are having vaginal infection. You should consult your doctor and let him have a vaginal examination for you. It is normal if you feel that you have excess discharge, as long as it is not smelly, coloured or itchy, because the vagina is never dry.
7. Why do I have more vaginal discharge on certain days of the menstrual cycle?
You will have more vaginal discharge during the mid of your menstrual cycle (day 14) when ovulation (release of egg from the ovary) occurs. Vaginal discharge becomes more watery and less viscous during ovulation time to facilitate and enable the sperm to swim through the cervix and uterus.
8. My vaginal discharge is panty-stained. Is it normal?
Panty-stained vaginal discharge is abnormal. It could be due to infections, threatened abortion (you are pregnant without you know about it), polyps or early stage of cancer. It is important to consult your gynaecologist and determine the real reason if you are having panty-stained vaginal discharge.
My daughter is now 15 years old and has not had her menarche yet. Is there something wrong with her?
Girls will have their menarche (the first menses in her life) during their age of 12 to 17 years. They will show some secondary sexual characteristics like the growth of pubic hair and breast development 2 years before their menarche. If your daughter has the characteristics mentioned, she can wait for a year or two for her menarche. If she still does not have her menarche after 2 year, she should consult her gynaecologist. Late menarche may be familiar which means it may occur in many of the girls in the same family, and it is normal.
10. I am not pregnant. Why does the lower part of my tummy getting bigger and bigger?
There are a few reasons that can cause your tummy to become bigger. The reasons could be: pregnancy, obesity (increase in fat), fluid in the abdomen or tumour in the uterus or ovaries. It is important to consult your gynaecologist to determine the real reason.
I have severe pain in my vulva. Doctor said that I have herpes simplex and may recur later after treatment. What can I do?
Herpes virus usually stays in the body lifelong. In between, herpes ulcer may recur and cause severe pain in the vulva. Recurrence of the herpes ulcer is associates with stress, illness, fatigue, prolonged exposure under the sun or having menses. There are some medicines available that can shorten the duration of the ulcer and lessen the pain or prevent its recurrence. Ask your doctor for the prescription.
My doctor said that I have gonorrhea and asked my husband to have an investigation, but he is asymtomatic. It is possible to have gonorrhea without symtom?
The common symptoms of gonorrhea in men are white, yellow or green discharge from the penis, pain on passing urine and some men may experience painful or swollen testicles. However, there are some men and women who have gonorrhea and do not show any symptom. So, it is advisable to treat both husband and wife if one of them having the infection.
13. How do I know if I have gonorrhea?
Gonorrhea is associates with yellow pusy vaginal discharge, pain on passing urine and increased frequency of passing urine. If you have these symptoms, see your doctor to confirm the diagnosis. He will do a vaginal examination and swab the vaginal discharge for microscopic analysis and culture for Neisseria gonorrhea.
14. Will gonorrhea affect my future fertility?

Gonorrhea infection can ascend through the cervix into the uterus, Fallopian tubes and the pelvis cavity. The infection will cause damage to these organs, form adhesion, block  the tubes and cause infertility.

15. Can the cancer of the ovary be detected by a blood test?
There is a blood test called CA-125 test, which is used to detect the concentration of CA-125 (a protein which is found at high levels in most ovarian cancer cells). If your CA-125 levels is elevates in blood stream, there is a possibility that you are having cancer of ovary. However, other disorders such as endometriosis, benign (non-cancerous) ovarian cyst, first trimester of pregnancy and inflammatory of pelvis can also produce high levels of CA-125 in blood stream and give a false positive result. Therefore, the CA-125 test should not be used alone to confirm ovarian cancer, but to be used with transvaginal ultrasound scan and laparoscopy.