Pelvic exam

During a pelvic exam, a doctor visually and manually assesses a woman’s reproductive organs. You might have a pelvic exam as part of your regular checkup, or your doctor may recommend a pelvic exam if you have symptoms such as unusual vaginal discharge or pelvic pain.

A pelvic exam is a relatively short procedure, during which your doctor checks your vulva, vagina, cervix, uterus, rectum and pelvis, including your ovaries, for masses, growths or other abnormalities. A Pap test, which screens for cervical cancer, may be performed during a pelvic exam.

You may need a pelvic exam:

  • To assess your gynecologic health. A pelvic exam often is part of a routine physical exam for women to find possible signs of a variety of disorders, such as ovarian cysts, sexually transmitted infections, uterine fibroids or early-stage cancer. Your doctor can recommend how frequently you need to be examined, but many women have a pelvic exam once a year.
  • To diagnose a medical condition. Your doctor may suggest a pelvic exam if you’re experiencing gynecologic symptoms, such as pelvic pain, unusual vaginal bleeding, skin changes, abnormal vaginal discharge or urinary problems. A pelvic exam can help your doctor diagnose possible causes of these symptoms and determine if other diagnostic testing or treatment is needed.

No special preparation is required for a pelvic exam, although your doctor may recommend that you schedule your pelvic exam on a day when you don’t have your period. Also, you may be more comfortable if you empty your bladder before the exam.

If you have questions about the exam or its possible results, write them down and take them with you to the appointment so that you don’t forget to ask about them during the visit with your doctor.

A pelvic exam is performed in your doctor’s office and takes only a few minutes.

You’ll be asked to change out of your clothes and into a gown. You may be given a sheet to wrap around your waist for added privacy. Before performing the pelvic exam, your doctor may listen to your heart and lungs and perform a breast exam.

During the pelvic exam

During the pelvic exam, 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 open.

A pelvic exam generally includes:

  • External visual exam. First, your doctor visually inspects your vulva, looking for irritation, redness, sores, swelling or other abnormalities.
  • Internal visual exam. Next, your doctor uses a speculum — a plastic or metal-hinged instrument shaped like a duck’s bill — to spread open your vaginal walls and view your vagina and cervix. The speculum may be warmed before it’s inserted.

    Inserting and opening the speculum causes pressure that can be uncomfortable for some women. Relax as much as possible to ease discomfort, but tell your doctor if you’re in pain.

  • Pap test. If your pelvic exam includes a Pap test (Pap smear), your doctor collects a sample of your cervical cells before removing the speculum.
  • Bimanual exam. 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 and pelvis for this part 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.

    During this part of the exam, your doctor checks the size and shape of your uterus and ovaries, noting points of tenderness or unusual growths. After the vaginal exam, your doctor inserts a gloved finger into your rectum to check for tenderness, growths or other irregularities.

Usually, at each step, your doctor tells you exactly what he or she is doing, so nothing comes as a surprise to you.

After the pelvic exam

After the pelvic exam is over, you can get dressed and then discuss with your doctor the results of your exam.

When the exam is done, your doctor can usually tell you immediately if the pelvic exam revealed anything unusual. Pap test results may take a few days. Your doctor will discuss with you any next steps, additional tests, follow-up or treatment needed.

If you have questions about the pelvic exam or any other aspect of your health, bring them up while you’re still in the office with your doctor.

May 09, 2014