Pelvic Exam
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Pelvic Exam

What Is a Pelvic Exam?

Highlights

  1. A pelvic exam is a visual and physical examination of a woman's reproductive organs.
  2. Women should have their first pelvic exam at age 21, unless other health issues require it earlier.
  3. Avoid vaginal intercourse, inserting anything into your vagina, and douching, at least 24 hours before your pelvic exam.

A pelvic exam is a doctor's visual and physical examination of a woman's reproductive organs. During the exam, the doctor inspects the vagina, cervix, fallopian tubes, vulva, ovaries, and uterus. Public and private healthcare providers routinely perform pelvic exams at their offices or clinics.

When Should You Have a Pelvic Exam?

In Women

There are no specific guidelines for how often a woman should have a pelvic exam, but it is often recommended to have one once a year. Depending on your medical history, a doctor may suggest that you have them more frequently. Women should have their first pelvic exam at age 21 unless other health issues require it earlier.

Women over the age of 21 should receive regular pelvic exams, similar to general checkups. However, special 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.

Preparing for a Pelvic Exam

Diagnosis

If you have never had a pelvic exam before, let your healthcare provider know when making your appointment. Make sure to set your pelvic exam for a date when you will not be on your period. However, if you have a menstrual issue you are concerned about, your doctor may suggest an examination during your period.

Avoid vaginal intercourse, inserting anything into your vagina, and douching, at least 24 hours before your pelvic exam.

What Happens During a Pelvic Exam?

process

Your doctor will have you undress and put on a robe. Sometimes, a breast exam may be included in the examination and you will be asked to remove your bra. You may be given something to put around your waist for added privacy. You will lie on an exam table with your legs spread and your feet on footrests called stirrups.

Visual Exam

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.

Speculum Exam

Next, the doctor will insert an instrument known as a speculum into the vagina. The speculum is a stainless steel or plastic 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 beforehand.

Pap Smear

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.

Manual Exam

Your internal reproductive and sexual organs will be manually inspected. This means that your doctor will wear lubricated gloves and insert two fingers into your vagina while using the other hand to feel your abdomen. This is to check for irregularities in the uterus or ovaries.

During this procedure, your doctor will be able to determine the size of your uterus. They can possibly check 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

Results/Exams

Your doctor will be able to tell you right away if any abnormalities were found. However, Pap smear results may take a few days. Your doctor may prescribe medications or require a follow-up visit.

Benefits of a Pelvic Exam

Pelvic exams are essential for determining a woman's sexual and reproductive health. They can also detect life-threatening conditions, such as cancer or infections.

Outlook

Outlook

Pelvic exams are routine, but there may be some discomfort during the procedure and spotting afterward. 

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. It might be helpful for you to prepare a set of questions you have for your doctor. You may asked a friend or family to stay with you during your appointment.

Research shows that some groups of women are more inclined to feel physical and emotional discomfort during a pelvic exam. This includes adolescents, minorities, people with disabilities, and people who have been sexually assaulted. Doctors can take special care during pelvic exams by using lubrication during instrument insertion and educating women about the process before getting started. If you feel uncomfortable at any point during your exam, make sure to tell your doctor.

You Asked, We Answered

  • If a woman is younger than 21, doesn’t experience any unusual symptoms, but is sexually active, should she have a pelvic exam? What if she is older than 21 but is not sexually active?
  • Routine pelvic exams are an important procedure for all women to have regularly. A woman who is younger than 21 should begin getting pelvic exams at least once a year once she is sexually active. She can discuss safe sex behaviors, birth control options, and her risk for contracting sexually transmitted infections. Even if a woman is over the age of 21 and not sexually active, she should still see her gynecologist yearly to discuss other women’s health issues.

    - Nicole Galan, R.N.

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