You may be worried about taking a pelvic exam. It is normal to feel
anxious or embarrassed about it. But there’s no need to be once you
know that it is a simple procedure that usually doesn't hurt and
takes only a few minutes.
A “pelvic exam,” also called “gynecological exam,” is a way for your
health care provider to examine your female organs and check for any
gynaecological problems. Pelvic exams are useful as a screening tool
for sexually transmitted diseases and some forms of cancer that may
affect the genitalia.
There are no definite rules as to when you should have your first
pelvic exam. But the American Cancer Society and the American
College of Obstetricians and Gynaecologists recommend pelvic exams
for women who are 18 years old or older, sexually active or plan to
be, have vaginal discharge, or have menstrual problems.
Before you go, you should not have sex, use vaginal creams,
lubricants, or douche for at least 24 hours before the exam. Make
sure to schedule your appointment about a week before your period
starts, or the week after your period ends.
What happens during a pelvic exam?
You may be asked to complete a detailed form about your medical
history. Then a nurse or medical assistant will weigh you, take your
blood pressure and may be asked to provide a urine sample.
Before the internal exam, the doctor may check your heart, lungs,
liver or spleen, and the breasts. You will then be asked to lie down
on the exam table, place your feet in the stirrups or footrests, and
slide your hips to the edge of the table.
There are usually four parts to the exam.
The External Exam
The doctor will first examine the external parts of the genitals to
check for irritation, sores, discharge, cysts, warts, or other
The Speculum Exam
Then the doctor will insert an instrument called a speculum into the
vagina. This is either a metal or plastic device shaped like a
duckbill that holds the vagina open. The doctor checks for any
irritation, growth, or abnormal discharge from the cervix. Usually a
small spatula of tiny brush is used to gently collect cells from the
cervix for a Pap test, a test for cervical cancer or precancerous
The Bimanual Exam
The doctor will then insert two fingers into the vagina while
pressing the abdomen with the other hand. The doctor checks the
size, shape and position of the uterus, cervix, fallopian tubes and
ovaries; fibroid growths in the uterus or cysts in the ovaries;
signs of infection such as tenderness or pain.
The Rectovaginal Exam
Finally, the doctor inserts a finger into the rectum to check the
condition of muscles that separate the vagina and rectum. The doctor
will also check for possible tumors located behind the uterus, on
the lower wall of the vagina, and in the rectum.
When the exam is over, your health care provider will answer any
questions you have and tell you when and how to get the results of
your exam. Even with the invasiveness of the procedure, you should
be able to immediately resume normal daily activities.