Pelvic Exam

ExitCare ImageA pelvic (gynecologic) exam is an exam of a woman's outer and inner genitals and reproductive organs. At age 18, or before a woman starts to have sexual intercourse, she should have her first pelvic exam. Pelvic exams allow your caregiver to check on normal development and screen for health problems. These exams should be done regularly throughout a woman's life. Usually, a general physical exam is done first. An exam of the breasts is also done. At this visit, you can ask questions about your health, body, menstrual cycles, sex, and birth control methods. Your caregiver will also ask you questions about your health, family health, menstrual periods, immunizations, and if you are sexually active. The information shared between you and your caregiver is kept confidential.

REASONS FOR A PELVIC EXAM

  • Annual exam and Pap test. A Pap test removes cells from the cervix gently with a spatula and a small brush. The cells are tested for infection, precancer, and cancer.

  • A Pap test is done to screen for cervical cancer.

  • The first Pap test should be done at age 21.

  • Between ages 21 and 29, Pap tests are repeated every 2 years.

  • Beginning at age 30, you are advised to have a Pap test every 3 years as long as your past 3 Pap tests have been normal.

  • Some women have medical problems that increase the chance of getting cervical cancer. Talk to your caregiver about these problems. It is especially important to talk to your caregiver if a new problem develops soon after your last Pap test. In these cases, your caregiver may recommend more frequent screening and Pap tests.

  • The above recommendations are the same for women who have or have not gotten the vaccine for HPV (Human Papillomavirus).

  • If you had a hysterectomy for a problem that was not cancer or a condition that could lead to cancer, then you no longer need Pap tests. However, even if you no longer need a Pap test, a regular exam is a good idea to make sure no other problems are starting.   

  • If you are between ages 65 and 70, and you have had normal Pap tests going back 10 years, you no longer need Pap tests. However, even if you no longer need a Pap test, a regular exam is a good idea to make sure no other problems are starting.   

  • If you have had past treatment for cervical cancer or a condition that could lead to cancer, you need Pap tests and screening for cancer for at least 20 years after your treatment. 

  • If Pap tests have been discontinued, risk factors (such as a new sexual partner)  need to be re-assessed to determine if screening should be resumed.

  • Some women may need screenings more often if they are at high risk for cervical cancer.

  • Make sure your female organs are normal and functioning correctly.

  • Evaluate a mass or other symptoms that suggest a reproductive system cancer.

  • Explore why you are not able to get pregnant (infertility).

  • Find a cause for vaginal discharge, itching, or burning.

  • Get certain types of birth control or start hormone therapy.

  • Look for causes of urinary incontinence or sexual problems.

  • Look for signs of sexually transmitted infection (STI).

  • Follow the progression of labor.

  • Determine if pregnancy is present or how far advanced the pregnancy is.

  • You have severe cramps during your menstrual period.

  • You have pain during sexual intercourse.

  • You have abnormal menstrual periods.

  • You have no menstrual period by the age of 16.

PROCEDURE

  • A pelvic exam is usually painless but may cause mild discomfort.

  • In unusual circumstances or in young girls, medicines may be used for comfort. A pelvic exam is not done routinely before a girl is sexually active. Special circumstances such as rape, trauma, or medical problems may require an exam.

  • You will remove all your clothes and will be given a gown. Usually, there is a nurse in the room during the exam and you can have someone from your family with you also.

  • The general physical exam will be done first.

  • Before the pelvic exam starts, the woman lies down on her back on a special table. She puts the heels of her feet into foot rests (stirrups) with her legs apart. A gown, cloth, or paper drape is usually placed over her belly (abdomen) and legs. First, the caregiver checks the normal arrangement of body parts of the outer genitals. This includes the clitoris, vaginal opening, hymen, labia, and the perineal area between the vagina and rectum. The labia are the skin folds surrounding the vaginal opening. The tube that carries urine (urethra) is also examined.

  • An internal exam is done next. First, the caregiver inserts an instrument called a speculum into the vagina. The speculum has lubricant on it. The speculum helps hold the vaginal walls apart. The caregiver can then examine the vagina and cervix, which is the opening to the womb (uterus). Cultures of any discharge may be taken to check for an infection. A Pap test may be done.

  • After the internal exam is done, the speculum is removed. The caregiver uses latex gloves with a lubricant on the fingers to gently press against various pelvic organs from inside the vagina while the other hand is on the lower belly. The caregiver will note any tenderness or abnormalities.

  • If a pelvic exam is done on a woman who is thought to be in labor, her caregiver can check on the baby and how far her cervix has opened.

  • Following the exam, you will get dressed and can speak with your caregiver.

  • Ask your caregiver when and how often you should return for future visits.

Finding out the results of your test

Ask when your test results will be ready. Make sure you get your test results.

TO HAVE A HEALTHY LIFESTYLE:

  • Follow your caregiver's advice regarding follow-up and future visits.

  • Get the necessary immunizations according to your age and any traveling you may do.

  • Eat a balanced, nourishing diet.

  • Get plenty of rest and sleep.

  • Exercise regularly.

  • Maintain a healthy weight.

  • Do not smoke or take illegal drugs.

  • Drink alcohol in moderation or not at all.

  • If you are sexually active, use some form of birth control if you do not plan to get pregnant.

  • If you are sexually active, practice safe sex by using a condom to protect against sexually transmitted disease (STD).

  • Get help or counseling if you have emotional problems.