Pelvic Exam

Medically reviewed by Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT on November 25, 2017Written by David Heitz

What is a 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?

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. Often the first pelvic exam is when a young woman goes to seek birth control.

Women over the age of 21 should receive regular pelvic exams, similar to general checkups. However, special reasons for having a pelvic exam include:

Sometimes a doctor performs the exam before prescribing birth control.

Preparing for a pelvic exam

If you’ve never had a pelvic exam before, let your healthcare provider know when making your appointment. Schedule 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?

Your doctor will have you undress and put on a robe. A breast exam may be included in the examination in which case you’ll 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 up the speculum 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, your doctor can diagnose conditions such as cancer and sexually transmitted diseases.

Manual exam

Your doctor will also manually inspect your internal reproductive and sexual organs. To do this, your doctor will put on lubricated gloves and insert two fingers into your vagina while using the other hand to feel your abdomen. This manual exam looks 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, your doctor may perform a rectal examination. For this exam, 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 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

Pelvic exams are routine, but you may have 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 also ask 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. Healthcare providers will 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 healthcare provider.

Q:

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?

A:

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.Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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