Sexual health

Staying healthy isn’t just about practicing safer sex and preventing STIs, although that’s an important aspect of healthy sexuality. Regular testing is also important, as well as honest disclosure to (and from) your partner(s). You’ll find information on this on other pages (check out our Sexually Transmitted Infections section for information on testing, Relationships for information on disclosure, and the Safer Sex section for information on preventing the transmission of STIs). Below you’ll find information on pap testing (yes, it’s different than STI testing), breast self examination, testicular self examination, and Toxic Shock Syndrome.

pelvic exams and pap testing

A pelvic exam is an examination that your doctor or a nurse performs to make sure that your reproductive organs are healthy.

Here are a few reasons why a pelvic exam is a good idea:

  • They make sure that your pelvic organs (uterus, fallopian tubes and ovaries) are normal.
  • They can detect infections that can cause vaginal discharge, pelvic pain or infertility.  If you have one of these infections, a regular pelvic exam can help make sure that it’s detected early, so you can get treatment before any serious damage is done.
  • Probably the best reason to get a pelvic exam is that it includes a “Pap” test that can detect early stages of some types of cancers.  Spotting these early signs of cancer could even save your life.

“Pelvic exam”, “Pap test” or “Pap Smear”?
During a Pap smear, the cells from the cervix are “smeared” onto a microscope slide using a q-tip. You may have wondered before if there is a difference between a “pelvic exam”, a “Pap test” and a “Pap smear”.  A “Pap test” and “Pap smear” are the same thing – they are a test that involves collecting cells from your cervix and then looking at them through a microscope to make sure they are normal and healthy.  It is sometimes called a “smear” because the cells from the cervix are “smeared” onto a microscope slide.  A pelvic exam is a little different – it refers to the entire exam of your reproductive organs, part of which is the collection of cells for the Pap test.  Some people think that a Pap test is a screening test for all sexually transmitted diseases, this is not true. You can request to have both a Pap test and STI testing done at the same time, though!

When do I need a pelvic exam?
If you are sexually active and if you’re 21 or older, your family doctor or health care giver will discuss the necessity of a pelvic exam. In Ontario regulations regarding the frequency and qualifications regarding pap smears has recently been changed. Talk to your doctor to find out what’s best for you. Sometimes, a pelvic exam might also be necessary if you have unusual discharge or bleeding from your vagina, or unexplained pain in your pelvic area. A pelvic exam can sometimes help identify the cause of these problems.

It’s very important for anyone with a cervix (including trans men) to have regular pelvic exams.  After your first visit, ask your doctor or nurse when you should schedule your next visit. Typically, you will be asked to schedule your next exam a year later.   After you’ve had two or three yearly exams, your doctor may suggest that you can reduce your exam frequency to once every two or three years. If you are on hormonal birth control, your doctor may require an annual Pap smear before renewing your prescription.

Breast Self-Examination

[Note: breast and testicular self-examination may not be appropriate for everyone. Your doctor can help you determine if you stand to benefit from these techniques.]
A breast self-exam (BSE) includes both looking and feeling over the entire breast and chest area, and as a general rule should be performed once a month. The best time to conduct an exam is about a week after the beginning of your period, when your breasts are at their least swollen and tender. Here’s how to do it:

Manual inspection
  • Stand upright or lie down on your back
  • For each breast: move the pads of your middle three fingers around the breast in a pattern, making sure to cover the entire breast area. Try different patterns, such as vertical, circular, or “spokes of a wheel”
  • Remember that most breast cancers are found in the upper, outer portion of the breast or in the area behind the nipple, so pay particular attention to these areas
  • Also inspect the areas around your breasts, including the region from the armpit to the collarbone, and below the breasts
  • If you began by standing up, lie down and repeat the same procedure; if you began by lying down, stand up and repeat the same procedure
Visual inspection
  • Stand in front of a mirror with your arms by your sides and check your breasts for any changes in size, shape or position, dimpling or puckering of the skin, pushed-in or misshapen nipples, redness, swelling or other irregularities.
  • Repeat the inspection with your hands on your hips
  • Raise your arms over or behind your head, and turn to each side to inspect your breasts in profile.

Testicular Self-examination

[Note: testicular and breast self-examination may not be appropriate for everyone. Your doctor can help you determine if you stand to benefit from these techniques.]
The best time to conduct a monthly testicular self exam (TSE) is after a warm bath or shower, then the skin of the scrotum is relaxed. Here’s how to do it:

  • Standing in front of a mirror, inspect the scrotum visually for swelling
  • For each testicle: hold the testicle between the thumb and fingers of both hands; roll it gently between the fingers, looking out for any hard lumps or nodules or for any change in size, shape, or consistency
  • Feel the epididymis, a cord-like structure on the top and back of each testicle, noting any changes.

Toxic Shock Syndrome (TSS)

The tampon, diaphragm, sponge, and IUD are all associated with Toxic Shock Syndrome, a rare but serious, rapidly-developing illness. If you are using one of these contaceptive methods and you experience two or more of the following symptoms, seek medical attention immediately:

  • a sudden high fever (sudden high body temperature)
  • vomiting
  • a sunburn-like rash
  • diarrhoea
  • fainting or feeling faint
  • muscle aches
  • dizziness
  • confusion
If using a tampon, diaphragm or sponge, remove it immediately. An IUD must be removed by a doctor.The Diva Cup (an alternative menstrual product) is NOT associated with TSS.

If you have any further questions, please contact the Sexual Health Resource Centre by calling (613) 533-2959 or visiting our office in person in Room 223 of the John Deutsch University Centre at Queen’s University.