A pelvic exam should be part of your regular check up. Here's what's involved.
A pelvic exam is a simple procedure — although for many an embarrassing or uncomfortable one — that allows your doctor to examine your vulva, vagina, uterus, rectum and pelvis, including your ovaries, for masses or growths. Often, a Pap test, which screens for cervical cancer, is performed during a pelvic exam, but that's not always the case.
Understanding what your doctor is looking for during a pelvic exam may put your mind at ease. Learn who the test is for, when you should have it done and what exactly happens during a pelvic exam.
Who needs a pelvic exam?
All women benefit from routine gynecologic screening, including a pelvic exam. Most experts agree that the first pelvic exam should take place within three years of the onset of sexual activity or by age 21, whichever comes first. Your doctor can recommend how frequently you need to be examined, but many women have a pelvic exam once a year.
How do you prepare for a pelvic exam?
No special preparation is required for a pelvic exam, though you may be advised to schedule the test on a day when you don't have your period.
How is it done?
A pelvic exam is performed in your doctor's office and takes only a few minutes. The exam involves using an instrument called a speculum and a specialized technique to feel (palpate) your pelvic organs. Your doctor is looking for signs that point to a problem that requires treatment, such as an infection, a sexually transmitted disease or early-stage cancer.
What can you expect during a pelvic exam?
You'll be asked to change out of your clothes and into a gown. Often, you're also given a sheet to wrap around you for added comfort and privacy.
Before performing the pelvic exam, your doctor may listen to your heart and lungs and perform a breast exam. During the pelvic exam itself, you lie on your back on an examining table, with your knees bent and your feet placed on the corners of the table or in supports called stirrups. You'll be asked to slide your body toward the end of the table and let your knees fall apart.
First, your doctor visually inspects your external genitalia, looking for sores, swelling or any other abnormalities. Then the doctor inspects your vagina using a speculum — a plastic or metal-hinged instrument shaped like a duck's bill, which spreads open your vaginal canal. Often, the speculum is warmed before it's inserted. Inserting and opening the speculum can cause pressure or discomfort for some women. Relaxing as much as possible may ease discomfort, but tell your doctor if it's painful. If your pelvic exam includes a Pap test (Pap smear), your doctor collects the sample before removing the speculum.
After the speculum is removed, your doctor will examine your other pelvic organs for any signs of abnormalities. Because your pelvic organs, including your uterus and ovaries, can't be seen from outside your body, your doctor needs to feel (palpate) your abdomen for this portion of the exam. To do this, your doctor inserts two lubricated, gloved fingers into your vagina with one hand, while the other hand presses gently on the outside of your lower abdomen. This is to check the size and shape of your uterus and ovaries and identify any tenderness or unusual growths. Sometimes after the vaginal examination — especially if you're older than 40 — your doctor also inserts a gloved finger into your rectum to check for tenderness, growths or other irregularities.
Usually, at each step along the way, your doctor tells you exactly what he or she is doing next so that nothing comes as a surprise to you.
As part of the pelvic examination, your physician will insert two gloved fingers inside your vagina while simultaneously pressing down on your abdomen. This allows him or her to examine your uterus and ovaries.
During a pelvic exam, your doctor uses a speculum to hold your vaginal walls apart. If your pelvic exam also includes a Pap test, your doctor collects a sample of cells from your cervix, using a small cone-shaped brush and a small plastic spatula (1 and 2). Your doctor then transfers the cells onto a glass slide (3) for examination under a microscope. Or your doctor may rinse the brush in a liquid-filled vial (4) and send the vial to a laboratory for testing.
After the pelvic exam
After the pelvic exam is over, you can get dressed. Your doctor can tell you if he or she discovered anything unusual during the pelvic exam. If you had a Pap test, the results take a few days. You'll discuss any necessary next steps, including your doctor's recommendation on the timing of your next pelvic exam.
If you have any questions about the pelvic exam or any other aspect of your health, now is the time to bring them up. It might help to prepare a list of questions before your appointment so that you don't forget to ask them during this visit with your doctor.
Going in for a pelvic exam on a regular basis can help ensure that you stay healthy — and that any problems detected can be caught at an early, and treatable, stage.
Last Updated: 04/17/2008
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