Preventive gynaecological check-up and the ZORA programme

A preventive gynaecological check-up is short and predictable. It begins with a conversation about your cycle, bleeding, contraception, medicines and any problems, followed by a speculum examination with a cervical smear, and then a manual examination. If the doctor considers it necessary, the examination is supplemented with an ultrasound. The whole visit takes a few minutes, and taking the smear itself takes seconds.

The cervical smear, known as the Pap smear, is not a general test for gynaecological diseases. It is meant for one thing only: finding cell changes on the cervix that are a precursor of cancer. That is exactly its point. As a rule, several years pass between HPV infection and developed cancer, and during this time the changes are visible in the smear and can be removed before they become dangerous.

ZORA is the national screening programme that invites women between the ages of 20 and 64 for regular smears. After two consecutive normal results one year apart, the interval to the next smear is three years. If no smear is recorded in the registry during this period, you will receive an invitation by post. Intervals depend on age and previous results, so the most reliable person to tell you when you are next due is your gynaecologist at the check-up. If you have received an invitation, respond to it even if you have no problems.

An abnormal smear result does not mean cancer. Most changes are mild and clear up on their own. A result most often means that a repeat smear is needed in a few months, additional testing, or referral for colposcopy, in which the gynaecologist looks at the cervix under magnification. Your gynaecologist will explain what applies to you when the result arrives.

A smear tells you about the cervix and nothing else. It says nothing about the ovaries, the lining of the womb or the breasts. So report any problems regardless of when your next smear is due. Bleeding between periods, bleeding after sex or after the menopause, a changed or unpleasant-smelling discharge, lower abdominal pain and pain during sex are reasons for an examination when they occur.

The right time for an examination and smear is outside menstrual bleeding, usually a few days after it. For the last day or two before the smear, do not use vaginal creams or pessaries, and avoid vaginal douching and sex, as this can reduce the quality of the sample. With acute problems such as pain, fever or unusual discharge, do not wait for your cycle.

The gynaecology clinic at Medicinski center Ljubljana works under the public health insurance scheme of the Health Insurance Institute of Slovenia (ZZZS) and on a self-pay basis. You do not need a referral for a self-pay examination; in both cases bring an identity document and your health insurance card. Check what applies to your examination when you book; booking is managed by the provider that runs the clinic. Also bring the results of previous examinations and smears, a list of medicines and the date of your last period.