Gynaecological check-up in Vienna
The gynaecological check-up is an important part of regular preventive healthcare. Its purpose is to detect certain changes at an early stage and to investigate symptoms and risk factors. At my private practice in Vienna's 9th district, I take time for this examination. You receive a thorough assessment, an explanation of every finding in plain language and a clear recommendation as to when you should come back. My experience from more than three decades at the University Department of Obstetrics and Gynaecology at Vienna General Hospital (AKH Wien) goes into every examination, including those that appear entirely unremarkable.
Why is the annual check-up so important?
Many gynaecological conditions can cause few or no symptoms at first. That applies to the precancerous stages of cervical cancer just as it does to ovarian cysts, fibroids (benign muscular growths of the uterus, or womb) or changes in the breast. Depending on the finding, early investigation can make treatment easier and avoid unnecessary procedures. Cervical cancer is the best example. Its precancerous stages can be detected with the cervical smear (Pap smear) for many years before a carcinoma develops. In countries with comprehensive screening, the number of cases has therefore fallen sharply.
The check-up has a second function, however, which is at least as important to me. It is the moment when you can raise, without hurry, everything that is on your mind. Bleeding problems, pain, and questions about contraception, family planning, the menopause or sexuality belong in this conversation just as much as the smear itself. At my practice there is no clock ticking in the background.
What does the check-up with me include?
The examination begins with a conversation. I ask about your menstrual cycle, any symptoms, previous illnesses and operations, your family history and your current circumstances. Please bring earlier reports with you if you have any. This is followed by the gynaecological examination on the examination chair. I assess the vagina and cervix using a speculum, take the smear and then feel the uterus and ovaries.
The smear, also known as a Pap test, is the central examination for the early detection of cervical cancer. Using a small brush, I collect cells from the cervix, which are examined in the laboratory for changes. From the age of 30, a validated HPV test can be used for early detection. It detects the human papillomaviruses that are responsible for almost all cases of cervical cancer. Depending on your individual situation and the recommendation, the Pap test and the HPV test can be used alternately.
I then carry out an ultrasound scan through the vagina. Transvaginal ultrasound shows the uterus, the lining of the uterus and the ovaries. Cysts, fibroids or abnormalities of the lining of the uterus, for example, can be detected and assessed further in this way. Ultrasound diagnosis was one of my main research interests for many years, especially the assessment of changes in the ovaries. This experience helps me to distinguish harmless findings from those that need further investigation and to spare you unnecessary worry.
Finally, I examine the breasts and armpits by hand. If necessary, I add a breast ultrasound to the examination. I looked after and headed the breast ultrasound outpatient clinic at AKH Wien for years and know how valuable this examination is, particularly in the dense breast tissue of younger women, where mammography reaches its limits. I examine palpable lumps, pain or discharge from the nipple clinically and by ultrasound on the same day and, if necessary, arrange further investigation by imaging or histology.
How often should you come for a gynaecological check-up?
In Austria, regular gynaecological check-ups with a Pap smear are recommended for women from the age of 18. From the age of 30, a validated HPV test can also be used for early detection. Which method and which interval between examinations make sense depends on the previous findings and the individual situation. As regards the breast: women between 45 and 74 are invited for a mammogram every two years as part of the Austrian breast cancer screening programme. Women between 40 and 44 and those aged 75 and over can take part voluntarily. A breast ultrasound can supplement mammography where there is a relevant indication, but does not replace it.
I consider regular gynaecological follow-ups, usually once a year, to be worthwhile regardless of the smear interval. Which examinations are indicated depends on age, symptoms, medical history and individual risk factors. We discuss which interval is right for you personally at the end of each examination. If there is a family history, after abnormal smears or where fibroids and cysts are known, shorter intervals can make sense.
When should you come to see me between check-ups?
Do not wait for your next check-up if something changes. Bleeding between periods, after intercourse or after the menopause should always be investigated. The same applies to lower abdominal pain that is new or getting worse, to pain during intercourse and to a discharge whose colour, smell or amount changes. A palpable lump in the breast, a nipple that has newly turned inwards or a change in the skin of the breast should be examined promptly. A new and persistent feeling of pressure in the abdomen, bloating with no identifiable cause or an increase in abdominal girth should also be assessed by a gynaecologist.
At my practice you will be given an appointment at short notice for concerns like these. It often turns out that the cause is harmless. But that reassurance is only worth something if it is based on a thorough examination.
Recurrent symptoms in the vaginal area, caused for instance by fungal infections or changes in the vaginal flora, are a subject in their own right. If you are affected several times a year, there is little point in using the same product again and again on suspicion alone. Unnecessary or repeated treatments can put additional strain on the natural vaginal flora. In such cases I look at your situation as a whole, from your cycle and contraception to your circumstances and stress, and look for possible causes and contributing factors instead of treating only the symptom. For me, that too is part of a check-up.
How does the check-up change at different stages of life?
Gynaecology accompanies you over decades, and the focus of the check-up shifts along the way.
Check-ups for young patients
With young patients, the conversation about contraception, the menstrual cycle and the HPV vaccination comes first. Here, advice is often more important than the examination itself, and I deliberately take time for it.
At this age I take very heavy or painful periods seriously, because they can be a first sign of endometriosis, a condition in which tissue resembling the lining of the uterus settles outside the uterine cavity. Heavy bleeding can also lead to iron deficiency, which causes tiredness and reduced performance. If I suspect this, I have your iron levels checked and start treatment if necessary.
Check-ups when you wish to have children
If you wish to have children, the check-up becomes preparation. I check your vaccination status, check thyroid function and iron levels where necessary, discuss folic acid and investigate cycle irregularities that can make it harder to become pregnant.
If pregnancy does not occur, investigation is usually appropriate after twelve months in women under 35, and after only about six months from the age of 35. Where there are known risk factors, earlier investigation may be indicated. Both partners should be examined.
My training in the hormone outpatient clinic of the university department helps me to recognise hormonal causes. If you become pregnant, the check-up passes seamlessly into pregnancy care.
Check-ups around the menopause
Around the menopause the body changes again. Hot flushes, sleep problems, vaginal dryness and irregular bleeding are frequent topics in the consultation. I advise you on the options for hormone therapy as well as on alternatives. Bleeding after the menopause should always be assessed by a doctor.
For patients with recurrent infections, prolapse symptoms or fibroids that might need surgical treatment, I plan the follow-ups individually. As a gynaecologist with a university background, I can tell you at each of these stages what can safely be observed and what needs treatment.
How do I deal with an abnormal finding?
An abnormal smear does not mean that you have cancer. Many low-grade changes regress on their own. I explain the finding and its classification to you, and together we decide whether a follow-up after a few months is enough or whether a closer examination of the cervix under magnification, known as colposcopy, makes sense. From 1989 I helped to set up the vulva and dysplasia outpatient clinic at the university department, where precisely these changes are investigated. I am therefore very familiar with the procedure.
If the ultrasound shows a cyst or a fibroid, I discuss with you whether observation is enough or treatment is needed. Many functional ovarian cysts in women before the menopause regress on their own within a few cycles. You will find everything else about these findings on the page about the ZEM outpatient clinic. If the breast ultrasound produces an unclear finding, I arrange the further investigation required, for example a mammogram or a targeted tissue sample, and support you through the next steps. You will not be left alone with any finding.
Why should you come to me for your check-up?
I have been a specialist in gynaecology and obstetrics since 1993 and worked at the university department at AKH Wien from 1989 until the end of 2023, from 1994 as senior consultant. During that time I practised in numerous areas of the specialty, from check-ups and ultrasound diagnosis to gynaecological oncology and the treatment of breast cancer.
This broad experience is an advantage in a check-up too. It helps me to assess findings expertly, to recognise abnormalities and to explain to you clearly which further steps make sense.
The private practice setting allows me to do what is often not possible in a busy outpatient clinic. You have a fixed appointment without a long wait, I examine you myself and I explain your findings to you in person. So after the examination you know whether further steps are necessary and when the next follow-up makes sense.
I enjoy medicine, and that enjoyment expressly includes the conversation with you.
What does the check-up cost?
I run a private practice without a health-insurance contract. After the examination you will receive an invoice.
You will find details on billing on the page about the practice.
At what age should I go for my first check-up?
A gynaecological consultation can be worthwhile as soon as you have questions about contraception, problems with your cycle or other gynaecological concerns, and it does not have to involve an examination on the examination chair. In Austria, the Pap smear for the early detection of cervical cancer is recommended from the age of 18.
Can the examination be done during my period?
In principle, yes. The conversation and the ultrasound are also possible during your period. For the smear, an appointment outside a time of heavier bleeding is preferable, because blood can make the cells collected harder to assess. If your appointment coincides with your period, simply give us a call. We will work out with you whether the examination can go ahead as planned or whether it makes sense to postpone it.
How long does it take to get the result of the smear?
The laboratory generally needs about one to two weeks. If the result is normal, we will let you know. If the result is abnormal, I will discuss with you in person what it means and which further steps make sense.
Do I still need gynaecological check-ups after the menopause?
Yes. Gynaecological follow-ups remain important after the menopause too. The risk of several diseases, including cancer of the body of the uterus, ovarian cancer and breast cancer, increases with age. Cervical cancer can also occur after the menopause. It is particularly important not to put off new symptoms until the next routine appointment. Bleeding after the menopause, for example, should always be assessed promptly by a doctor. Which examinations make sense as part of the check-up depends on your age, your medical history, your symptoms and individual risk factors.
Does breast ultrasound replace mammography?
No. Breast ultrasound does not replace mammography. The two methods have different strengths. Mammography is the established examination for the early detection of breast cancer and can show, among other things, fine calcifications that are not visible, or only barely visible, on ultrasound. A breast ultrasound can be useful in particular where breast tissue is dense or for the further investigation of an abnormal or palpable finding.
In the Austrian breast cancer screening programme, women between 45 and 74 are invited for a mammogram every two years. Women between 40 and 44 and those aged 75 and over can also take part in the programme at their own request. I decide on the basis of the individual findings whether a breast ultrasound makes sense in addition.
From 1989 to 2023 at the University Department of Obstetrics and Gynaecology at Vienna General Hospital (AKH Wien), senior consultant from 1994; founder and long-standing head of the ZEM outpatient clinic for cysts, endometriosis and fibroids.
Book your check-up by telephone on +43 1 317 660 0 or by e-mail at ordination@prof-obwegeser.at. I offer appointments by prior arrangement by telephone. My practice is at Hörlgasse 14, Top 11, 1090 Wien. Please note that the entrance is at Liechtensteinstraße 8.