Patient education: Pelvic exam (The Basics)

What is a pelvic exam? — This is when a doctor checks the vulva and reproductive organs. It is also called a "gynecologic exam."

A pelvic exam involves 2 main parts:

●Questions and discussion

●Physical exam

You might get a pelvic exam when you see your regular doctor. Or you might see a gynecologist or other specialist in women's health. A nurse practitioner or midwife can also do a pelvic exam.

When might I need a pelvic exam? — Doctors recommend getting a pelvic exam at different times. These include:

●As part of a regular check-up – Your doctor will talk to you about whether you should get regular pelvic exams, and how often. This will depend on your age, health, and preferences.

●To find the cause of symptoms – Examples include changes in vaginal discharge, very heavy periods or bleeding between periods, pelvic pain, or leaking urine.

●For cervical cancer screening – This involves looking for cancer cells in the cervix. It can be done with a "Pap test," an "HPV test," or both.

●To check for some sexually transmitted infections, or "STIs"

●Before or during placement an IUD – An IUD is a type of birth control.

●At your first "prenatal" visit if you are pregnant

What questions will the doctor ask? — Before the exam, the doctor will talk with you and ask you questions. Your answers will help them give you the best care possible.

They will probably ask about:

●Your period – This includes when you first started getting your period, how often you get your period, and how long it usually lasts. If you have been through menopause, the doctor will also ask when you stopped having periods and whether you take hormone therapy.

●Past pregnancies and births – This includes whether you have ever been pregnant or given birth, how many times, and how old you were. It also includes whether you have had any pregnancy losses (miscarriages) or abortions.

●Sexual health – The doctor will ask if you are having any type of sex and whether you have any new partners. They will also talk to you about birth control, if needed, and protecting yourself from STIs. If you are having any problems related to sex, they can also give you advice.

●Past health problems or procedures – For example, the doctor will ask about past Pap tests or other tests. They will also discuss any other health conditions, infections, or surgeries you have had.

●Whether you want to get pregnant – If you want to try to get pregnant, the doctor can help you prepare for a healthy pregnancy. If you have been trying for some time but have not gotten pregnant, they can give advice on when to consider tests.

●Any symptoms that are bothering you – If you have any pelvic symptoms, tell the doctor. This will make it easier for them to figure out the cause. If you do have a health problem, there are often treatments that can help.

Your doctor might ask you other questions, too. For example, they might ask about your emotional health and whether you feel safe at home.

For some people, it can feel awkward or embarrassing to talk about sex or their bodies. But it's important to be honest so you can get the care you need.

What happens during a pelvic exam? — For the exam, you will be asked to undress from the waist down or put on a hospital gown. You will lie on an exam table with your feet raised. Often, your feet will be placed in footrests.

There are several parts to the physical exam:

●External exam – This means looking at your vulva from the outside (figure 1). The vulva is the area around the opening of the vagina. The doctor will look for any problems, like signs of irritation or infection.

●Speculum exam – A "speculum" is a device the doctor uses to see inside your vagina. They will use lubricant to help insert it gently. This lets them look at the inside of your vagina and at your cervix (figure 2). They can also use small tools to gently collect cells from your cervix. These can be tested to check for signs of cervical cancer.

●Internal exam – The doctor will put 1 hand on your belly. With their other hand, they will put 1 or 2 gloved fingers into your vagina. This lets them feel your cervix, uterus, and ovaries.

The doctor might also look at and feel your belly and breasts. They will check for any changes, problems, or pain.

Does a pelvic exam hurt? — A pelvic exam should not be painful. But for some people, it can be uncomfortable. The doctor will tell you what they are doing at each step so you know what to expect.

If you have discomfort or are nervous, there are things that can help:

●The doctor might be able to use a smaller speculum. Or they can use 1 finger to feel inside your vagina instead of 2.

●Tell your doctor ahead of time if you have a lot of pain or anxiety related to pelvic exams. They can talk to you about your options. If needed, they can give you medicine to help you relax before the exam.

●You can choose to have someone else in the room, if this makes you feel more comfortable. This might be a partner, family member, or nurse.

More on this topic

Patient education: Chronic pelvic pain in females (The Basics)
Patient education: Cervical cancer screening tests (The Basics)
Patient education: Sexually transmitted infections (The Basics)
Patient education: IUD insertion (The Basics)

Patient education: Chronic pelvic pain in females (Beyond the Basics)
Patient education: Cervical cancer screening (Beyond the Basics)