What Is a Pelvic Exam?
Whether you are straight, lesbian, bisexual, married, single,
sexually active or not, your pelvic exam is a normal and important part of
taking care of your body. During a pelvic exam, a health care provider examines
your pelvic area. It includes your vulva and your internal reproductive organs —
your cervix, ovaries, fallopian tubes, uterus, and vagina.
During your pelvic exam, your provider will look for signs of
infection and other conditions. It will most likely include taking a few cells
from your cervix for a Pap test. This is to protect you from cervical cancer.
Detecting problems early can help you get the treatment you need to keep
When Should I Have My First Pelvic Exam?
Unless you have a medical problem, you should have your first
pelvic exam when you turn 21.
Before needing pelvic exams, young women are encouraged to have
periodic gyn visits with their health care providers. During these visits, a
young woman can ask questions and talk with her health care provider about
growing up, changes in her body, and any concerns she has. These checkups help
make sure that she is healthy and developing as she should. Most often, these
early visits do not include a pelvic exam.
After your first pelvic exam, your health care provider will
tell you how often you should have gynecological care, including pelvic exams.
How often you need exams will depend on your medical history and personal health
needs. You may need more frequent pelvic exams if you have
a history of abnormal Pap test results
a history of sexual health problems
a family history of certain kinds of cancer
a sexually transmitted infection or a sex partner with an
In some cases, a pelvic exam is needed in order to prescribe
hormonal birth control — the pill, the patch, the ring, or the shot. A pelvic
exam is always needed for inserting an IUD or fitting a diaphragm.
There are some simple steps you can take to prepare for your
Plan your pelvic exam for a day you when you will not have your
period — unless you have a bleeding problem your health care provider wants to
see. Menstrual fluid can affect the results of some lab tests.
Don't have vaginal intercourse or insert anything in your vagina
for a day or two before your visit.
Women shouldn't douche. But if you do, don't douche for at least
24 hours before your visit. For more accurate test results, don't use any other
vaginal products, either. They can hide many vaginal conditions.
Make a list of the questions you want to ask your health care
provider. Some women write them down so that it is easier to remember them
during the appointment.
Ask if you can have a friend in the room with you if you think
you would feel more comfortable.
How Will My Pelvic Exam Feel?
The pelvic exam part of your gyn exam should only take a few
minutes. Some parts of the exam may be uncomfortable, but it shouldn't be
painful. If it hurts, be sure to tell your health care provider, who may be able
to adjust things to help you be more comfortable. This exam is for you, so don't
be afraid to speak up.
You'll feel less tense during your pelvic exam if you
Breathe slowly and deeply with your mouth open.
Let your stomach muscles go soft.
Relax your shoulders.
Relax the muscles between your legs.
Ask your health care provider to describe what is happening.
What Does the Health Care Provider Do During My Pelvic Exam?
Your health care provider will ask you to undress and put on a
paper or cloth gown. Next, you will be asked to lie down on the exam table and
put your feet on footrests at the end of the table. (Some tables have knee rests
Slide your hips down to the edge of the table. Let your knees
spread out wide. Relax as much as possible. Relax your buttocks and your stomach
and vaginal muscles. This will make you more comfortable. The exam will be more
complete, too. You can cover your lower abdomen and thighs with a sheet to feel
There are usually four parts to the pelvic exam:
1. The External Exam — Your health care provider will look at
the folds of your vulva and the opening of your vagina. This part of the pelvic
exam checks for signs of cysts, discharge, genital warts, irritation, or other
2. The Speculum Exam — Your health care provider will gently
insert a lubricated speculum into your vagina. Made of metal or plastic, the
speculum separates the walls of the vagina when it opens. This may feel
uncomfortable but not painful. Let your health care provider know if it is. She
may be able to adjust the size or position of the speculum. If you would like to
see your cervix, just say so. You may be able to see it using a mirror.
The provider will then use a tiny spatula or small brush to take
a small sample of cells from your cervix. This sample will be given a Pap test
to see if there is any precancer or cancer in the cervix.
If you think you may be at risk of having a sexually transmitted
infection, tell your health care provider. Your health care provider can use a
cotton swab to take a sample of the discharge from your cervix. This sample will
be tested for sexually transmitted infections.
3. The Bimanual Exam — During this part of the exam, your health
care provider will insert one or two gloved and lubricated fingers into your
vagina while gently pressing on your lower abdomen with the other hand. This is
a way to check for
the size, shape, and position of the uterus — which could affect
your fertility and birth control choices
an enlarged uterus — which could mean pregnancy or fibroids
tenderness or pain — which might mean infection or other
swelling of the fallopian tubes — which might mean an ectopic
enlarged ovaries, cysts, or tumors
4. The Rectovaginal Exam — Your health care provider may put a
gloved finger into your rectum. This checks the muscles between your vagina and
your anus. This also checks to see if there are tumors behind the uterus, on the
lower wall of the vagina, or in the rectum. Some health care providers put
another finger in the vagina, too. This lets them examine the tissue in between
You may feel like you need to have a bowel movement during this
part of the exam. This is normal and only lasts a few seconds.