Some appointments are easy to put off precisely because you feel perfectly well. The annual gynaecological check-up is one of them: it exists to pick up changes that do not yet cause symptoms and to answer questions about periods, contraception, pregnancy or the menopause. It takes twenty to thirty minutes, needs no special preparation and, at Centre Mèdic Palafrugell, can be arranged through your health insurance or privately.
What an annual check-up includes
Every appointment is adapted to your age and history, but the usual structure is this:
- A conversation and medical history: your cycle, contraception, previous pregnancies, surgery, medication and any family history of breast, ovarian or bowel cancer.
- A gynaecological examination with a speculum, to see the cervix and vaginal walls.
- A cervical smear and, depending on your age, an HPV test.
- A pelvic ultrasound, usually transvaginal, to look at the uterus and ovaries.
- A breast examination, and a review of your mammogram if you are within screening age.
- Advice and follow-up: contraception, vaccinations, bone health, pelvic floor or planning a pregnancy.
Our gynaecology and obstetrics page lists the tests we carry out at the centre.
When to start, and how often
A first gynaecological appointment is usually recommended at around 20 to 25 years of age, or earlier if you have become sexually active, have very painful or irregular periods, or want to start contraception. After that, the general guidance in Catalonia is:
- Ages 25 to 29: a cervical smear every three years.
- Ages 30 to 65: an HPV test every five years, which detects pre-cancerous changes more reliably.
- From 50: a mammogram every two years through the breast screening programme.
- Earlier and more often if you have a close family history, previous abnormal results, a weakened immune system or other risk factors.
Smear tests and HPV: what they tell you
The smear collects cells from the cervix to look for abnormal changes. The HPV test looks directly for the virus behind almost all cervical cancers. Finding the virus does not mean you have cancer: HPV infection is very common and in most cases the body clears it within a year or two. Follow-up simply keeps an eye on the few infections that persist, so that any changes can be treated long before they become a problem.
The sample takes seconds and most women describe it as uncomfortable rather than painful. In the 48 hours before your appointment, avoid intercourse, vaginal douching and pessaries, and try not to book on your heaviest bleeding days.
Ultrasound and the breast examination
A pelvic ultrasound is painless and gives a detailed picture of the uterus and ovaries: fibroids, polyps, ovarian cysts, the thickness of the endometrium or the position of a coil. If you have pelvic pain, very heavy periods or difficulty conceiving, it is often the test that points to the diagnosis. When a more detailed image of a pregnancy is needed, the centre also offers 3D ultrasound scans.
The breast examination looks for lumps, skin changes or nipple discharge, and it is a good moment to learn what your breasts normally feel like. From the age of 50, the test that saves lives is the mammogram; the examination complements it rather than replacing it.
Symptoms that should not wait for your next check-up
Book sooner if you notice any of the following:
- Bleeding between periods, after sex or after the menopause.
- Very heavy periods that soak through a pad every hour, or cycles that have become markedly irregular.
- Persistent pelvic pain, or pain during sex.
- A breast lump, a change in shape, dimpled skin or discharge from the nipple.
- Itching, burning or discharge with an unpleasant smell that does not settle.
- Repeated discomfort when passing urine, or leaking that affects your daily life.
None of these automatically means something serious, but all of them deserve to be looked at.
Contraception and the menopause
During your fertile years, the consultation is where you choose the contraception that suits you best — pill, ring, implant, hormonal coil or copper coil — and where you review it from time to time. What worked at 20 may not be the best option at 38, particularly if you smoke or have developed high blood pressure or migraines.
The menopause arrives on average at around 51. It is not an illness, but it does bring new needs: hot flushes, poor sleep, vaginal dryness, mood changes and, importantly, a faster loss of bone density. Your gynaecologist can advise which symptoms are worth treating and whether a bone density scan would be useful.
Frequently asked questions
Do I still need check-ups after the menopause?
Yes. Cervical screening continues until 65, any bleeding after the menopause needs assessing, breast health matters more with age, and vaginal dryness has simple, effective treatments.
Can I come while I have my period?
The examination and ultrasound can go ahead, but a smear gives a better sample away from heavy bleeding days. Call us and we will usually move the appointment by a few days.
Will my insurance cover it?
We work with more than 40 health insurers. Check the list of insurers we work with or ask at reception, and we will tell you whether your policy needs prior authorisation for any of the tests.
Booking an appointment
Call 972 30 65 65, write to us through the contact page or book through our online appointment portal. We are at Plaça de Catalunya, 5 in Palafrugell, open Monday to Friday from 8 am to 8 pm and Saturday from 9 am to 2 pm, and our staff can attend you in English. Please bring any previous reports or test results with you, as they give the gynaecologist the full picture.
