Speculum, vaginal examination, smear: these terms are known to women but not always understood.

Juju la Gygy, gynecologist-obstetrician for ten years, lifts the veil on the taboos around female anatomy, gynecology or even intimate pathologies.

On Europe 1, she returns to the gynecological consultations, often dreaded. 

INTERVIEW

It's a medical appointment that women often go to reluctantly.

But Juju la Gygy intends to take the complexity out of the gynecological consultation.

In her book

The joyful and uninhibited gynecological guide

, published by First editions, and on her Instagram account which has more than 53,000 subscribers, the obstetrician-gynecologist evokes pell-mell, in drawings with humor and pedagogy, the anatomy of women, the pathologies or contraception.

In short, what touches the intimate and which still too often remains a source of shame or anguish for women.

On Europe 1, in the program Sans Rendez-vous, the caregiver looks back on the progress of the gynecological consultations and the received ideas around this appointment.

>> Find all of Sans rendez-vous every day from 3 p.m. to 4 p.m. on Europe 1 as well as in replay and podcast here

An internal examination is not mandatory the first time

First of all, a gynecological consultation is not compulsory from the age of 16 for young girls.

"There are different situations: either there is a real demand, symptoms, and you have to go there to find out what is going on, answer questions and be taken care of," explains Juju la Gygy.

"Either we feel the need, we want to discuss sexuality, contraception and there, it is also a good answer."

Other professionals trained in women's health can also take care of patients, such as midwives or general practitioners, recalls the gynecologist.

And an internal examination is not obligatory at the first consultation either.

"Usually when I receive a young girl the first time, I reassure her and tell her that unless she has a request, a need, I will not examine her inside, but that if she wants , we can look in a mirror at his anatomy together ", explains the gynecologist.

The opportunity to discover her body, which is still too often overlooked by women themselves.

Several sizes of speculum

During a gynecological consultation, professionals can carry out various examinations.

Vaginal examination, for example, which involves feeling the organs using two fingers inserted into the vagina and one hand placed on the stomach.

"This will allow us to feel what is happening around: the contours of the uterus, if it has increased in size or if there is a cyst on the ovaries", explains Juju la Gygy.

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Other exams may require the use of tools, such as the speculum, which can sometimes be impressive.

"It allows, when it is removed, to see inside the vagina and in particular to see the cervix, to observe if there are particular losses, the appearance of the cervix ...", explains the healthcare professional, who ensures that several sizes of speculum are available, to best suit the patient.

Thanks to the speculum, gynecologists can place intrauterine devices or take samples, such as a smear. 

The smear, an important screening but not (necessarily) before 25 years

Behind this widespread name hides a test that can detect cervical cancer.

"The smear consists, with a small instrument, in recovering cells from the cervix, to analyze them and find out if everything is normal or if we are in a pre-cancer, or even an established cancer", explains Juju la Gygy.

Cervical cancer is a pathology linked to HPV (Human Papillomavirus), a very large family of viruses, some of which, called oncogenic, can cause cancer.

"The 'good news' is that it is a cancer that grows very slowly, that we can detect at various stages and that we can treat," reassures the gynecologist.

Another test now exists under the name of "HPV test", which makes it possible to search directly for the viruses responsible for cancer.

"The examination is the same, but either we send it to cytology to analyze the cells, or we send it to recover the virus," explains the nurse.

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If the age of the first smear is now 25, this has not always been the case, explains Juju la Gygy.

"Medicine is evolving. At one point, we thought we had to do it early, quickly after the first sexual intercourse. Then we realized that we were overdiagnosing," she continues, recalling that 50 to 70% of women will be affected by HPV during their lifetime, but will eliminate it naturally.

"By doing smears too early, we introduced anxiety," adds the caregiver. 

"Today is 25 years for the first smear, we renew it a year later, at 26 years old, then every three years until 30 years old. From 30 years old, and these are the new recommendations since 2019, we look for HPV every five years, up to age 65, "summarizes the gynecologist.  

Palpation and question 

The gynecological consultation, as well as all consultations with a professional trained in women's health, is also an opportunity for patients to have their breasts examined via palpation, in order to detect possible cancers.

Self-examination is also recommended. 

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During these meetings, it is also a question of obtaining answers to certain questions about your period, about pathologies such as endometriosis or advice on hygienic protection.

So many subjects mentioned by Juju la Gygy in his guide for a "joyful and uninhibited" gynecology.