Genital Self-Examination (GSE)

What Is A GSE?
GSE stands for genital self-examination. It’s a simple examination that you can give yourself to see if you have any of the signs or symptoms that might indicate the presence of a sexually transmitted infection (STI). This GSE Guide will explain how to give yourself a genital examination, including the parts of your body to look at, and the signs and symptoms to look for. Your self-examination may reveal no signs or symptoms at all. However, if you discover anything suspicious, you should see a health care provider. Do not try to make a diagnosis on your own. What you find may or may not be a sign of a sexually transmitted disease. Many conditions have similar appearances. Only a health care provider can make a proper diagnosis.

Anyone who is sexually active is potentially at risk for contracting a sexually transmitted disease. The more sexual partners you have, the greater your risk. If you’re sexually active, read this GSE Guide carefully. If you are currently monogamous (having sex with only one person), but were not monogamous in the past, you may want to give yourself a GSE because some STIs remain undetected for years. For the same reason, if you are presently not involved in a sexual relationship, but had several sexual partners in the past, you should also consider giving yourself a GSE.

Why Is A GSE Important?
A genital self-examination is important because it may help you discover if you have any of the signs or symptoms that might indicate the presence of a sexually transmitted infection. More than 10 million men and women, from all walks of life, are affected by STIs each year. And many people who have a sexually transmitted infection don’t know they have one.

It may not be possible to know if you have a sexually transmitted infection even if you know the telltale signs. Many STIs have symptoms that may be confused with one another and with other diseases. Some STIs have symptoms that appear and then disappear. However, just because the signs and symptoms disappear doesn’t mean the disease has disappeared. You could still be passing on a sexually transmitted infection to someone you care about without realizing it. While self-examination can provide useful information, lab testing is necessary to rule out/screen for infections.

Additionally, by helping you find out if you have a sexually transmitted infection, a GSE may help prevent further complications. Left untreated, some STIs can cause serious health problems, including infertility, heart disease, or brain damage. Some STIs may also be passed from a mother to her babe before or during birth.

STIs are serious… but fortunately treatment programs are available for STIs. The earlier you detect the symptoms, seek diagnosis, and begin a treatment program, the less likely that the disease will cause you physical harm, or be spread to others.

The following section will describe how to give yourself a genital self-examination. Please note that there are separate sections for men and women.

How Do I Give Myself a GSE (for men)

Before you begin a genital self-examination, it is important to understand the words that describe the genital portion of your body. The top or head of your penis contains the urinary opening (urethra). The head may be covered with foreskin if you are not circumcised. Moving down past the head is the shaft of your penis. The very bottom of the shaft is called the base. The base of the penis is the area where your pubic hair begins. The underside of the penis refers to the side you can’t see when looking down. Underneath your penis is the scrotum, a sac enclosing the testicles, which hangs slightly away from your body.

Now that we’ve described your genital area, let’s begin your genital self-examination.

Once undressed, hold your penis in your hand. Start by examining the head of the penis from the urinary opening down to where it extends out a little just above the shaft. If you are not circumcised, pull down the foreskin to examine the head.
Look over the entire head of the penis in a clockwise motion. Carefully look for any bumps, sores, or blisters on the skin. Sometimes the bumps or blisters may be red; at other times they may be light-colored. They may even look like pimples. Bumps and blisters sometimes develop into open sores. If you see anything that resembles a sore, blisters, or bump, see a health care provider. In addition, look for warts. Genital warts may look like warts you may have seen on other parts of your body. They may first appear as very small, bumpy spots. Left untreated, they could develop a fleshy, cauliflower-like appearance. Some warts are hard to detect with the naked eye. If you feel any bumpy growth, no matter how slight, have it checked by a physician.
Once you’ve examined the head of the penis, move down the shaft and look for the same signs or symptoms. Then go on to the base. At the base, try to separate your pubic hair with your fingers so you can get a good look at the skin underneath.
After careful examination here, move on to the underside of the penis. This area is often difficult to see, and sometimes gets overlooked. It is very important that you check this part of your body. You may want to use a mirror to be sure that you’ve seen the entire underside. The mirror may also be helpful as you move on to the scrotum. Handling each testicle gently, examine the scrotum for the same signs or symptoms. Also, be alert to any lump, swelling, or soreness in the testicle.
Once you’ve examined your entire genital area for redness, sores, bumps, and warts, be aware of these other symptoms often associated with sexually transmitted infections. STIs may cause burning or pain when you urinate. Some STIs cause a drip or discharge from the penis. This drip may vary in both color and consistency. The drip could be thick and yellow, or it could be watery or very slight. Any drip or discharge from the penis should be brought to the attention of a provider.

If you notice any of the signs or symptoms described – no matter how slight – see your provider. In addition, if you feel you may have come in contact with someone who has a sexually transmitted infection, consult your provider even if you discover no signs or symptoms during your genital self-examination. You may or may not have a sexually transmitted infection. The only way to know for sure is to see your provider for a diagnosis.

Please be aware that the symptoms of some STIs are sometimes so mild you might not notice them, or the symptoms might seem to disappear; however, you are still infected and could spread disease to others. Symptoms of STIs may not appear for weeks, even months, after the sexual encounter. So if you’re sexually active, be sure to see a provider and get an examination on a regular basis. Between provider check-ups, use the GSE periodically to check yourself for early warning signs. If you suspect anything, don’t wait. See a provider.

How Do I Give Myself a GSE (for women)

Before starting your genital self-examination, it is important to understand the words that describe the genital portion of your body. Let’s start where your pubic hair begins and move down. Your pubic hair above your vagina grows from soft fatty tissue called the mons. Your pubic hair continues down between your legs in a fleshy area that forms flaps called the outer lips or labia. The outer lips surround soft flaps of skin that are hairless. These are the inner lips. At the top of your inner lips (right below the mons), you’ll find your clitoris. The clitoris is covered by a soft fold of skin called the hood of the clitoris. If you pull the hood up, you will see the clitoris. Notice that the inner lips are attached to the underside of the clitoris. Right below this attachment you will see the urinary opening. Below that is a larger opening called the vaginal opening.

Now that we’ve described your genital area, let’s begin your genital self-examination.

Once undressed, start by examining the area that your pubic hair covers from the mons down to the area between your legs. You may want to use a mirror and position it so that you can see your entire genital area. Even with a mirror, you may find it difficult to see the area from your urinary opening down. Do the best you can without putting yourself in an uncomfortable position.
Start by spreading your pubic hair apart with your fingers. Carefully look for any bumps, sores, or blisters on the skin. Sometimes the bumps or blisters may be red, at other times they may be light-colored. They may even look like pimples. Bumps and blisters sometimes develop into open sores. If you see anything that resembles a sore, blister or bump, see a health care provider. In addition, look for warts. Genital warts may look like warts you may have seen on other parts of your body. They may first appear as very small bumpy spots. Left untreated, they could develop a fleshy, cauliflower-like appearance. Some warts are hard to detect with the naked eye. If you feel any bumpy growth, no matter how slight, have it checked by a provider.
Once you’ve examined the area covered by pubic hair (the mons and the outer lips), spread your outer vaginal lips apart and take a close look at the hood of your clitoris. Then gently pull the hood up to reveal your clitoris. Once again, look for any bumps, blisters, sores, or warts.
Next look at both sides of your inner lips for the same signs. Then move on to examine the area around your urinary opening and your vaginal opening. This is as far as we recommend that you look. Some signs of STIs may appear up in your vagina, near your cervix, and out of view. Therefore, if you feel you may have come in contact with someone who has a sexually transmitted infection, see your provider even if you discover no signs or symptoms during your genital self-examination.

In addition to examining your entire genital area for redness, sores, blisters, bumps, or warts, be alert to other symptoms that are often associated with STIs. Some STIs may cause a vaginal discharge. Because most women have a vaginal discharge from time to time, try to be more aware of what your “normal” discharge looks like. Discharge caused by a sexually transmitted infection will appear more unusual – it may be thicker, possibly yellow. It may also have an odor. Other symptoms or signs to be aware of include a painful or burning sensation when urinating, pain in your pelvic area, bleeding between menstrual periods, or an itchy rash around the vagina.

If you notice any of the signs or symptoms described – no matter how slight – see a health care provider. You may or may not have a sexually transmitted infection. The only way to know for sure is to see your physician for a diagnosis. Please be aware that the symptoms of STIs are sometimes so mild that you might not notice them, or the symptoms might seem to disappear; however, you are still infected and could spread the disease to others. Symptoms of STIs may not appear for weeks, or even months, after the sexual encounter. So if you’re sexually active, be sure to see a provider and get an examination on a regular basis. Between provider check-ups, use the GSE periodically to check yourself for early warning signs. If you suspect anything, don’t wait. See a provider.

The information provided above is for educational purposes only. Please do not use this information to diagnose yourself. If you have further questions or concerns about this topic or any others, please contact a Campus Health Service provider at (520) 621-9202.