A pelvic exam is not generally painful, but it can feel uncomfortable or awkward, particularly if you are not familiar with the procedure. If at any point you do experience pain, inform your provider.
How to Prepare
- Schedule your exam when you do not have your period.
- Write down any questions you have and bring them with you.
- Know the first day of your last menstrual period (LMP) and at what age you had your first period.
- Avoid douching, having sexual intercourse, or inserting anything into your vagina for 48 hours before the exam.
- Empty your bladder before the exam (unless you are having problems with urination).
Consultation with the Clinician
The beginning of the appointment will just be a conversation with your provider. Your provider will:
- Take your medical and gynecological history.
- Take your blood pressure, weight, and other vital signs.
- Examine your body, including your skin and other systems, to check for overall health.
- Check for signs of sexually transmitted infections (STIs), cancer, or other abnormalities.
- Review your immunization record and order vaccines if needed.
- Discuss your potential sexual health needs, such as protection from STIs, and reproductive health needs, such as birth control.
- Perform a clinical breast exam.
- Perform a pelvic exam and if indicated, obtain a pap smear.
During the Exam
A pelvic exam is a thorough check of a woman’s vagina, cervix, uterus, and ovaries. It can be comprised of 3 parts: an external exam, a bimanual (two-handed) exam, and a rectovaginal exam.
- You will be asked to undress either completely or from the waist down.
- When it is time for the pelvic exam, you will lie back on the exam table and place your feet in the stirrups attached to the table.
External Exam
- Your provider will examine your vulva and the opening of your vagina for signs of any abnormal conditions.
- The provider will then insert a speculum into your vagina to spread the vaginal walls apart. The speculum is a device that looks similar to a duck’s beak with 2 pieces hinged together. It may be warmed or lubricated.
- Spreading the vaginal walls allows the provider to examine the walls of your vagina and cervix for any abnormal conditions.
- If a pap test is needed, the provider will use a small brush or spatula to swab some cells from your cervix. This may cause minor bleeding, which is nothing to be concerned about.
- The sample cells will be sent to a lab to be screened for cervical cancer and may be tested for STIs.
Bimanual Exam
- Your provider will insert one or two fingers into your vagina and place the other hand on your lower abdomen.
- This is to feel the size, shape, and texture of your uterus and ovaries and to check for any unusual growths, discomfort, or pain.
Rectovaginal Exam
This part of the exam may or may not be performed. If it is:
- Your provider will insert one finger into your vagina and one finger into your rectum.
- This is done to evaluate your ovaries and uterus ligaments.
After the Exam
Once the exam is complete, you will be given a washcloth or tissues to clean your vaginal area of any discharge or lubricant. If any samples were taken, you will be contacted when the test results are complete.
