# What Happens at an Annual Gynecological Check-Up? Step by Step > What questions are asked at an annual gynecological check-up, how does the exam go, and when are smear and HPV tests done? Preparation tips and FAQs. Published: 3 October 2026 · Medically reviewed by: Op. Dr. Murat Alpay **What questions are asked at an annual gynecological check-up, how does the exam go, and when are smear and HPV tests done? Preparation tips and FAQs.** An annual gynecological check-up is a preventive visit for women, including those with no complaints, to review general and genital health, carry out cancer and infection screening on time, and get advice on topics such as contraception. International guidelines recommend a general check-up like this once a year for adult women. This article explains what is asked at the visit, the steps of the examination, the timing of screening tests, and how to prepare. For smear and HPV testing, see our [Pap smear and HPV testing](https://www.muratalpay.com.tr/en/tedaviler/pap-smear-ve-hpv/) page. ## What Questions Are Asked at the Appointment? The visit starts with a conversation. The doctor takes a history (your health background) to build a general picture before the examination: - **Menstrual pattern:** Age at first period, date of the last period, how many days between periods, how long bleeding lasts, whether it is heavy or has clots, period pain, and spotting between periods. For women approaching menopause, hot flushes, sleep problems and vaginal dryness are also asked about. - **Sexual health:** Whether you are sexually active, whether there is pain during intercourse or bleeding afterwards, and whether you have ever had a sexually transmitted infection. - **Contraception and pregnancy plans:** The method you use or have used (pill, coil, implant, barrier methods, etc.), how satisfied you are, and any plans for pregnancy. - **General health and medicines:** Past operations, chronic conditions (such as blood pressure, diabetes or thyroid problems), regular medicines and allergies. - **Family history of cancer and illness:** Especially breast, ovarian, womb or bowel cancer and heart and vascular disease in first-degree relatives. - **Lifestyle:** Diet, exercise, smoking and alcohol use, stress, and whether you feel safe at home or at work. ## How Does the Examination Go? The exam starts with a general assessment and finishes with the gynecological examination. **General assessment:** Blood pressure, pulse and temperature are measured; height, weight and body mass index are calculated. The thyroid gland is felt by hand and the abdomen is examined. **Breast examination:** First, while you are seated, the shape and symmetry of the breasts, any skin dimpling or redness, and changes in the nipple are checked by eye. Then, while you lie on your back, the breast tissue is examined with the fingers; the lymph nodes under the arm and above the collarbone are checked too. The most suitable time for a breast exam is the week after your period ends. **Pelvic examination (of the organs inside the pelvis):** This is done lying on your back and usually has four steps: 1. **Looking at the outer genital area:** The skin is checked for redness, sores, warts, cysts or prolapse (sagging of the pelvic organs). 2. **Speculum examination:** A warmed, lubricated, single-use instrument (a speculum) lets the doctor see the vaginal walls and the cervix directly. The doctor looks for discharge, inflammation, polyps or cell changes. If needed, a smear, HPV test or discharge sample is taken at this point. 3. **Two-hand (bimanual) examination:** The doctor places two fingers of one hand inside the vagina and the other hand on the lower abdomen to assess the size and position of the womb and whether it is tender, and to check the ovaries for lumps or tenderness. 4. **Rectovaginal examination, if needed:** This helps assess deeper structures in cases such as pelvic pain; it is not done at every check-up. A routine vaginal examination is not done for women who are not sexually active. ## When Are Smear and HPV Tests Done? Cervical cancer screening looks for changes in cells (a smear, or cell test) and for the presence of high-risk HPV. The general schedule in international guidelines is as follows: - **Under 21:** Routine screening is not recommended; HPV infections at these ages usually clear up on their own. - **Ages 21-29:** A smear (cell test) alone every 3 years. Routine HPV testing is not recommended in this age group because temporary HPV infections are very common. - **Ages 30-65:** There are three options: a smear and an HPV test together every 5 years (the most preferred), an HPV test alone every 5 years, or a smear alone every 3 years. - **After 65:** Screening may stop for women whose tests over the last 10 years have been regular and normal and who have not had a serious cell change (CIN 2 or above). - **After a womb removal for a non-cancer reason**, in women with no history of a serious cell change, screening stops. - **Women with a weakened immune system** (for example, those with HIV) or who have been treated for a serious cell change are followed earlier and more often. Having the HPV vaccine does not change this screening schedule; vaccinated women follow the same schedule. ## When Are Ultrasound and Blood Tests Requested? Ultrasound (imaging of the womb and ovaries) is not a mandatory screening tool in women without complaints. It is used when a hand examination finds an enlarged womb or a lump in the ovary area, or when there are complaints such as abnormal bleeding, pelvic pain, irregular periods or bleeding after menopause, to assess the thickness of the womb lining and the pelvic structures. Some tests that may be requested: - **Urine test:** To look for infection or bacteria without symptoms. - **Screening for sexually transmitted infections:** In all sexually active women aged 24 and under, yearly chlamydia and gonorrhea (two common bacterial sexually transmitted infections) screening is recommended. Over 25, it is done if there is a new partner or a risk factor. A HIV test is recommended at least once in a lifetime. - **Blood tests:** A blood count and iron levels if there is heavy bleeding or fatigue; depending on age and risk, cholesterol, fasting blood sugar and thyroid tests from around age 45-50. ## Vaccines and Other Screening - **HPV vaccine:** Recommended routinely for girls and boys aged 9-26 (target age 11-12). Between ages 27 and 45 it can be given after a joint decision with the doctor. Two doses are given if started before age 15, and three if started later. Starting during pregnancy is not recommended; it can be given safely while breastfeeding. - **Other adult vaccines:** A tetanus-diphtheria booster every 10 years, a yearly flu vaccine, and, depending on age or risk group, measles-mumps-rubella, chickenpox, hepatitis B and pneumonia vaccines are reviewed. - **Mammography (breast X-ray):** For women at average risk it can be offered from age 40 and is recommended every 1-2 years between ages 50 and 75. - **Bowel screening:** For women at average risk it begins at age 50. ## How to Prepare for the Check-Up - **Timing:** For a smear, choose a day without heavy period bleeding. The days just after your period ends are the most suitable time for the exam and breast check. - **The last 24-48 hours:** So that the quality of the sample is not affected, avoid vaginal douching, vaginal suppositories, creams or medicines, tampons and intercourse for 2 days before the exam. - **Bladder:** Empty your bladder just before the pelvic exam; a full bladder is uncomfortable and makes it harder to feel the organs properly by hand. ## Staying Comfortable During the Exam - Taking a deep breath in through your nose, breathing out slowly through your mouth, and letting your abdomen and hip muscles relax noticeably reduces discomfort. - The doctor is expected to explain each step and what you will feel before doing it, and to ask for your consent. - If you are very uncomfortable or feel pain, you may ask for the exam to stop or to pause. - Having another member of staff (for example, a nurse) in the room is standard practice for privacy and safety. - Findings and the plan are explained after you have dressed, in a conversation at the desk. ## Why Go If You Have No Complaints? Pre-cancer changes in the cervix, small fibroids, ovarian cysts, breast lumps, high blood pressure and thyroid problems often give no symptoms at first. A yearly check-up helps catch them early, keeps screening such as smear, HPV and mammography on time, and gives preventive advice on contraception, diet, weight, bone health and missing vaccines. ## Frequently Asked Questions ### Can I go for a gynecological check-up during my period? Heavy bleeding days are not suitable for exams where a sample is taken, such as a smear. The days after bleeding ends are more suitable for both the exam and the breast check. If there is an urgent complaint, you can of course be seen during your period. ### Do I need a smear test every year? No. According to international guidelines, a smear and HPV test are done every 3 or 5 years depending on age. The yearly check-up is a broader assessment that includes the general exam, history, breast exam and other screening. ### Can someone who is not sexually active have a gynecological check-up? Yes. They can attend for a general exam, breast exam, review of menstrual pattern, and advice on contraception and vaccines. A routine vaginal examination is not done for these women; alternative methods are considered if needed. Written and reviewed by **Op. Dr. Murat Alpay** Specialist in Obstetrics and Gynaecology · Istanbul University, Istanbul Faculty of Medicine (Çapa) [Full biography →](https://www.muratalpay.com.tr/en/hakkinda/) [← All posts](https://www.muratalpay.com.tr/en/blog/) --- Original page: https://www.muratalpay.com.tr/en/blog/yillik-jinekolojik-kontrolde-neler-yapilir/ Last updated: 2026-10-03 Op. Dr. Murat Alpay — Specialist in Obstetrics and Gynaecology Op. Dr. Murat Alpay Practice, Tekelioğlu Cd. No:51 B Kat:2, Filo Apt., 07160 Muratpaşa / Antalya 0505 351 77 88 · Monday – Saturday 09:00 – 18:00 · Closed on Sunday *This information is for general guidance only and does not replace examination, diagnosis or treatment.*