What is Pelvic Exam

Pelvic exam is an exam of a woman’s outer and inner genitals and reproductive organs. Pelvic exams are done to screen for health problems and to help prevent health problems from developing.

You should start having pelvic exams when you turn 21 years old, unless your health care provider recommends having a pelvic exam earlier. Talk with your health care provider about how often you should have a pelvic exam.

During your pelvic exam, your health care provider may ask you questions about your health, your family’s health, your menstrual periods, immunizations, and your sexual activity. The information shared between you and your health care provider will not be shared with anyone else.

What are some reasons to have a pelvic exam?

There are many possible reasons for having a pelvic exam. A pelvic exam may be recommended to check for:

• Normal development and function of the reproductive organs.
• Cancer of the ovaries, uterus, or vagina.
• Signs of sexually transmitted infections (STIs) or other types of infections.
• Pregnancy. If you are pregnant, a pelvic exam can also help determine how far along you are in your pregnancy.
• Widening (dilation) of the cervix during labor.
• Injury (trauma) to the reproductive organs.

A pelvic exam may be recommended to help explain or diagnose:

• Changes in your body that may be signs of cancer in the reproductive system.
• Inability to get pregnant (infertility).
• Vaginal itching or burning.
• Abnormal vaginal discharge or bleeding.
• Problems with sexual function.
• Problems with urination, such as:
  • Painful urination.
  • Frequent urinary tract infections.
  • Inability to control when you urinate (urinary incontinence).
• Problems with menstrual periods, such as:
  • Severe cramping.
  • Absence of any menstrual flow in a female by the age of 15 years (primary amenorrhea).
  • Stopping of menstrual flow for 3–6 months at a time (secondary amenorrhea).

Depending on the purpose of your pelvic exam, your health care provider may perform:

• A Pap test. This is sometimes called a Pap smear. It is a screening test that is used to check for signs of cancer of the vagina, cervix, and uterus. The test can also identify the presence of infection or precancerous changes.
• A cervical biopsy. This is the removal of a small sample of tissue from the cervix. The cervix is the lowest part of the womb (uterus), which opens into the vagina (birth canal). The tissue will be checked under a microscope.
• Other diagnostic tests that involve taking samples of tissue or fluid (cultures).

If you have tests done, it is your responsibility to get your test results. Ask your health care provider or the department performing the test when your results will be ready.

How is a pelvic exam performed?

Usually, a physical exam is done first. This may include:

• An exam of your breasts. Your health care provider may feel your breasts to check for abnormalities.
• An exam of your abdomen. Your health care provider may press on your abdomen to check for abnormalities.

Pelvic exams may vary among health care providers and hospitals. The following things are usually done during a pelvic exam:

• You will remove your clothes from the waist down. You will put on a gown or a wrap to cover yourself while you get ready for the exam.
• You will lie on your back on a special table. Your feet will be placed into foot rests (stirrups) so that your legs are wide apart and your knees are bent. A drape will be placed over your abdomen and your legs.
• Your health care provider will examine your outer genitals to check for anything unusual. This includes your clitoris, urethra, vaginal opening, labia, and the skin between your vagina and your anus (perineum).
• Your health care provider will examine your inner genitals. To do this, a lubricated instrument (speculum) will be inserted into your vagina. The speculum will be widened to open the walls of your vagina.
  • Your health care provider will examine your vagina and cervix.
  • A Pap test, cervical biopsy, or cultures may be done as needed.
  • After the internal exam is done, the speculum will be removed.
• Your health care provider will put on germ-free (sterile) latex gloves and insert two fingers into your vagina to gently press against various organs.
  • Your health care provider may use his or her other hand to gently press on your lower abdomen while doing this.

A pelvic exam is usually painless, although it can cause mild discomfort. If you experience pain at any time during your pelvic exam, tell your health care provider right away.

When should I seek medical care?

Seek medical care after your pelvic exam if:

• You develop new symptoms.
• You experience pain or discomfort from anything that was done during your pelvic exam.