Pelvic Exams

What is a Pelvic Exam?

A pelvic exam is a doctor’s visual and physical examination of a woman’s reproductive organs. During the exam, the doctor inspects the vagina, cervix, Fallopian tubes, vulva, ovaries, and uterus. Health care providers, like your doctor or a nurse practitioner, routinely perform pelvic exams at their offices or clinics.

When Should You Have a Pelvic Exam?

There are no specific guidelines for how often you should have a pelvic exam. But it is often recommended to have one once a year.

Depending on your medical history, your doctor may suggest that you have them more frequently. Women should have their first pelvic exam at age 21 unless other health issues require it earlier. Often the first pelvic exam is when a young woman becomes sexually active.

Women over the age of 21 should receive regular pelvic exams, similar to general checkups. However, special reasons for having a pelvic exam include:

  • Unusual vaginal bleeding or discharge
  • A family history of cancer
  • Concern about ovarian cancer, cysts, sexually transmitted diseases, and other gynecological problems

Preparing for a Pelvic Exam

If you’ve never had a pelvic exam before, let your health care provider know when making your appointment. Schedule your pelvic exam for a day when you will not be on your period. However, if you have a menstrual issue you are concerned about, your doctor may suggest an examination during your period.

Avoid vaginal intercourse, inserting anything into your vagina, and douching, at least 24 hours before your pelvic exam.

What Happens During Pelvic Exams?

Your doctor will have you undress and put on a robe. A breast exam may be included in the examination in which case you’ll be asked to remove your bra. You will lie on an exam table with your legs spread and your feet on footrests called stirrups.

Visual exam — First, your doctor will visually inspect your vagina and vulva. Your doctor may be looking for redness, irritation, discharge, cysts, or something that indicates a sexually transmitted disease, such as sores.

Speculum exam — Next, the doctor will insert an instrument known as a speculum into the vagina. The speculum is a stainless steel or plastic device that resembles a duckbill. Women should breathe deeply and try to relax their vaginal, rectal, and abdominal muscles during insertion. Sometimes doctors will warm up the speculum beforehand.

Pap smear — The doctor may take some cells from you cervix, before removing the speculum. He or she will use something that looks like a small spatula. The spatula gathers cells for later examination. This procedure is known as a Pap smear. By looking at the cells, your doctor can diagnose conditions such as cancer and sexually transmitted diseases.

Manual exam — Your doctor will also manually inspect your internal reproductive and sexual organs. To do this, your doctor will put on lubricated gloves and insert two fingers into your vagina while using the other hand to feel your abdomen.

This manual exam looks for irregularities in the uterus or ovaries. During this procedure, your doctor will be able to determine the size of your uterus.

Finally, your doctor may perform a rectal examination. For this exam, the doctor inserts their fingers into both the rectum and vagina simultaneously to check for abnormalities in the tissue between the two organs.

After the Exam

Your doctor will be able to tell you right away if any abnormalities were found. However, Pap smear results may take up to one week to return. Your doctor may prescribe medications or require a follow-up visit.

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