A pelvic exam is a doctor's visual and physical examination of a woman's sexual and reproductive organs. Public and private health care providers routinely perform pelvic exams at their offices or clinics.
There are no specific guidelines for how often a woman should have a pelvic exam, but many women have them once a year. Depending on your medical history, a doctor may suggest that you have them more frequently.
Reasons for having a pelvic exam include:
- unusual vaginal bleeding or discharge
- a family history of cancer
- concern about ovarian cancer, cysts, sexually transmitted diseases, and other gynecological problems
Sometimes a doctor performs the exam before prescribing birth control.
Women should have their first pelvic exam at age 21 unless other health issues require it earlier, according to Planned Parenthood.
During the exam, the doctor inspects the vagina, cervix, fallopian tubes, vulva, ovaries, and uterus.
Many women find pelvic exams physically and mentally uncomfortable. Doctors try to make them as painless as possible and offer reassurance and feedback during the process.
Research shows that some ethnic and sexual minorities, sexual assault victims, disabled people, and adolescents find pelvic exams particularly disturbing. Doctors can take special care during pelvic exams by using lubrication during instrument insertion and educating women about the process before getting started. Some women prefer a female doctor to do these exams (Bates, C., et al., 2011).
Your doctor will have you undress and put on a robe. You may be given something to put around your waist for added privacy. You will lie on an exam table with a place to rest your feet. Sometimes these footrests are called stirrups.
First, your doctor will visually inspect your vagina and vulva. Your doctor may be looking for redness, irritation, discharge, cysts, or something that indicates a sexually transmitted disease, such as sores.
Next, the doctor will insert an instrument known as a speculum into the vagina. The speculum is a stainless steel device that resembles a duckbill. Women should breathe deeply and try to relax their vaginal, rectal, and abdominal muscles during insertion. Sometimes doctors will warm the speculum up before insertion.
The doctor may swipe the cervix, before removing the speculum, with something that looks like a small spatula. The spatula gathers cells for later examination. This procedure is known as a Pap smear. By looking at the cells, the doctor can diagnose conditions such as cancer and sexually transmitted diseases.
The doctor will physically inspect your internal reproductive and sexual organs. The doctor will insert two gloved, lubricated fingers into the vagina while using the other hand to feel your abdomen for irregularities in the uterus or ovaries.
The doctor will be able to determine the size of your uterus, possibly checking for pregnancy, as well as any abnormalities of the fallopian tubes.
Finally, there may be a rectal examination. Sometimes, the doctor inserts their fingers into both the rectum and vagina simultaneously to check for abnormalities in the tissue between the two organs.
After the Exam
Your doctor will be able to tell you right away if he or she found any abnormalities. Results of a Pap smear may take a few days. Your doctor may prescribe medications or require a follow-up visit.
Pelvic exams are essential for determining a woman's sexual and reproductive health. They also can detect life-threatening conditions, such as cancer or infections.
Pelvic exams are routine, but there may be some discomfort during the procedure and spotting afterward.
Try to schedule a pelvic exam when you're not on your period. Do not douche beforehand, as it may alter the results of a Pap smear. Abstain from sexual intercourse for a day or two before your exam.
If you're feeling uncomfortable about the procedure, talk to your doctor about your concerns. You may want to ask if a loved one can come to your appointment with you.