BATES The Female Genitalia

1. Know the anatomy and physiology of the female genitalia

a.
2. Know the common or concerning symptoms associated with the female genitalia
a. Menarche, menstruation, menopause, postmenopausal bleeding
b. Pregnancy
c. Vulvovaginal symptoms
d. Sexual health
e. Pelvic pain – acute and chronic
f. Sexually transmitted infections
3. Know about menarche, menstruation, menopause and pregnancy
a. Menarche – age at onset of menses
b. Menstruation – usually begins between ages 9-16 years, flow lasts from 3-7 days
c. Menopause – absence of menses for 12 consecutive months, usually occurring between
ages 48-55 years
d. Pregnancy – gravida (total number of pregnancies); para (outcomes of pregnancies)
4. Know about vulvovaginal symptoms and sexual activity
a. Vaginal discharge (amount, color, consistency, odor) and itching
b. Sores or lumps in the vulvular area
5. Know important topics for health promotion and counseling
a. Cervical cancer screening
b. Ovarian cancer: risk factors and screening
c. Sexually transmitted infections
d. Options for family planning
e. Menopause and hormone replacement therapy
6. Know the techniques of examination of both the external and internal (pelvic exam)
a. Ask the patient’s permission to perform the exam
b. Explain the steps
c. If a pap smear is to be collected using the glass-slide techniques, time the examination
so that it does not occur during menses, because blood can interfere with interpretation
7. Know the tools used and the technique and the procedure for collecting samples
a. Pap smear, speculum, bacteriologic cultures and DNA probes
8. Know about special techniques when examining the female genitalia and pelvic areas
a. Assessing urethritis
 i. Insert index finger into the vagina and milk the urethra gently outward from the
inside
ii. Note any discharge from or about the urethral meatus
1. If present, culture it
9. Know about lesions of the vulva and abnormalities of the cervix
a. Epidermoid cyst, syphilitic chancre, genital herpes, venereal wart, secondary syphilis,
carcinoma of the vulva
b. Mucopulurent cervicitis, carcinoma of the cervix, petal exposure to DES
10. Know about uterine positions and adnexal masses
a. Retroversion – tilting backward of the entire uterus
b. Retroflexion – backward angulation of the body of the uterus in relation to the cervix
c. Adnexal masses – ovarian cysts and ovarian cancer, ectopic pregnancy including rupture,
pelvic inflammatory disease