Pelvic Exam

Pelvic Floor Doctor

Medically Reviewed By Dr. Amanda Olson,DPT, PRPC

What is a Pelvic Exam?

A pelvic exam allows a healthcare provider to assess a woman’s reproductive organs for overall gynecological health and wellness. During the exam, the doctor will check the vagina, uterus, cervix, fallopian tubes, ovaries, and vulva for infections or abnormal cells. 

A pelvic floor muscle examination is different and is performed to assess the pelvic floor muscles in regards to strength, tone, coordination, and overall health as it relates to continence, pelvic pain, and pelvic organ prolapse. Pelvic floor muscle examinations are commonly performed by pelvic physical therapists or doctors specializing in pelvic health. 

When to Have a Pelvic Exam

Unless there have been earlier health issues, gynecological professionals recommend that women should have their first pelvic exam by age of 21. After the age of 21, it is suggested that all women have a pelvic exam at least once a year. 

Additional reasons to schedule a pelvic exam include the following:

  • When seeking birth control options
  • Vaginal bleeding for more than 10 days
  • Extreme menstrual cramping
  • Unexplained pain around the vulva or pelvic area
  • Unusual or foul-smelling vaginal discharge
  • Burning, itching, or pain in the vulva or pelvic area
  • Concern about ovarian cysts or sexually transmitted diseases
  • Menstruation has not begun by the age of 16
  • A family history of ovarian cancer
  • Presence of urinary or fecal incontinence
  • Sensation of pressure or bulging in the vagina
  • Low back and pelvic pain

If You’re a Virgin, Should You Have Regular Pelvic Exams?

Yes. Even if you are not sexually active or have not had vaginal intercourse, regular pelvic exams are suggested for all women over the age of 21. 

Just like using tampons will not alter or damage the hymen, a pelvic exam will not either. Regular check-ups are merely the best way to check for any underlying conditions associated with the female reproductive system. 

Preparing For a Pelvic Exam

If it’s your first time having a pelvic exam, let your doctor know. Doctors will generally explain what the procedure entails to first-timers and do their best to reassure patients. It can help to have any questions or concerns prepared in advance. And it’s also calming to have a friend or family member present if you’re feeling uncomfortable. 

Ideally, try to schedule your pelvic exam when you are not menstruating. Unless there is an issue related to your menstruation that you’d like to discuss with your doctor. In this case, let the doctor know, and they may suggest an exam during menstruation.

Avoid vaginal intercourse, douching, or using vaginal creams at least 24 hours before your pelvic exam. These can alter the vaginal cells that your doctor will check during a pap smear. 

Once checked in for the appointment, try to empty your bladder to avoid any feeling of discomfort during the exam.   

What Happens During a Pelvic Exam?

The following is a guide on what to expect during a pelvic exam, as well as some tips that will allow you to feel more empowered and in control during the procedure.  

Pre-Exam

Before a pelvic exam, the healthcare provider will discuss with you your medical history. Then they will then ask you to change into a hospital gown and remove your undergarments.  

A pelvic exam usually includes a breast exam if performed by a gynecologist, so don’t be surprised when you are asked to remove your bra too. 

Visual Exam

Next, you will be asked to lie on the exam table and place your feet in the footrests called stirrups. The doctor will visually inspect the vulva and vagina looking for any signs of irritation, redness, infection, or sexually transmitted diseases. 

Speculum Exam

After the visual exam, the doctor will use a medical instrument called a speculum to gently open and inspect the inner vagina. A speculum is made from stainless steel or medically approved plastic and resembles a duck beak. 

Do your best to breathe gently and relax the vagina and abdominal muscles as the speculum is inserted. It does not hurt, but it can feel strange for some women. The doctor will usually warm the speculum before insertion and be as gentle as possible. 

Pap Smear

Before removing the speculum, the doctor will normally use an instrument that looks like a tiny spatula to swipe the cervix. Also known as a pap smear, this is where vaginal cells are collected for later examination under a microscope. 

The vaginal cells taken during a pap smear help doctors to check for abnormalities that occur in connection with conditions such as infections, cancer, or sexually transmitted diseases. 

Manual Exam

The manual exam is when the doctor checks your internal reproductive organs to rule out any irregularities in the ovaries or the uterus. To perform this exam, your doctor will wear lubricated gloves and insert two fingers into the vagina, while using the other hand to gently compress different points of the abdomen. 

This procedure allows the doctor to check for abnormalities in the fallopian tubes or uterus, as well as determine if patients are pregnant. 

What Happens After a Pelvic Exam?

Once the exam is finished, your doctor will give you some privacy to get dressed. 

Should your doctor discover any abnormalities, they will generally discuss it with you once you are dressed and prescribe medication or follow-up visits if needed. 

The pap smear results can take a few days, and patients normally receive a call from the doctor's nurse or receptionist to notify them of the outcome. 

Some women may notice a little spotting after a pelvic exam, but this is nothing to worry about. 

Conclusion

Although pelvic exams can be uncomfortable for some women, they are a vital part of women’s health and wellness. And they should be scheduled annually for any woman over the age of 21.  

Checking the female sexual & reproductive organs can help detect infections, underlying conditions, and cancer to allow for early treatment.  

Women who feel uncomfortable about the thought of a pelvic exam are advised to speak with their healthcare provider for more understanding rather than skip regular checkups. Special care can always be provided for those who are nervous, have disabilities, or women who have been sexually assaulted.   

References

Center For Young Women’s Health – Your First Pelvic Exam - https://youngwomenshealth.org/2013/08/22/pelvic-exam/

Mayo Clinic – Pelvic Exam: An Overview - https://www.mayoclinic.org/tests-procedures/pelvic-exam/about/pac-20385135