Pelvic exams are an essential part of women’s health care, but they can seem scary if you don’t know what to expect. Let's cover all you need to know about pelvic exams, their medical purpose and preparation.
What is a pelvic exam?
A pelvic exam is the evaluation of the external and internal genitalia and pelvic organs, such as the uterus and ovaries.
Pelvic exams are performed for various reasons, including evaluating gynecologic symptoms, performing a Pap smear, screening for sexually transmitted infections or at your request.
Exam process
- The exam begins with a visual inspection to check for normal anatomy and any skin lesions. If you're experiencing pain, your health care provider may palpate (examine by touch) the area to assess.
- Next, a speculum is gently inserted into the vagina, allowing your health care provider to visualize the cervix and vaginal tissues. This step also includes checking for abnormal discharge. If necessary, a Pap smear, which involves collecting cervical cells for testing, may be performed during this part of the exam.
- After the speculum is removed, your health care provider will use one or two fingers placed in the vagina and the other hand on your lower abdomen to examine your uterus, ovaries and tubes. This step helps detect any abnormalities or tenderness.
- Your provider will communicate with you when to expect results from any testing that was done during the exam.
Are pelvic exams painful?
One common concern is whether a pelvic exam is painful. The exam is not painful. You may feel some pressure during the speculum and bimanual portions of the procedure. It is important that you feel safe during your pelvic exam. You are in control and the exam can be stopped at any time.
Pelvic exams can be triggering or painful for survivors of sexual abuse. If this is true for you, let your ob-gyn know. The following may help make the pelvic exam easier:
- Your ob-gyn should explain what they will be doing ahead of time. They also should be able to talk you through the steps as they happen.
- Your ob-gyn should always ask permission before touching you.
- You may want to have a partner, friend, or family member in the room during the exam.
- You may feel more in control if you can direct the pace of the exam, see more of the exam (such as with a mirror), or put your hand over the ob-gyn’s hand to guide the exam.
- Remember that you can ask to stop the exam at any time.
If you think one or more of these steps might help, let your ob-gyn know. It's essential to communicate any discomfort or pain to your health care provider during the exam.
How frequently should I get a pelvic exam?
Traditionally, a pelvic examination was performed yearly. This recommendation has been discontinued. The American College of Obstetricians and Gynecologists (ACOG) recommends scheduling a pelvic exam based on your medical history or symptoms.
Why might I need a pelvic exam?
Pelvic exams may be necessary if you experience gynecologic symptoms such as:
- Pelvic pain
- Abnormal vaginal bleeding
- Vaginal/vulvar discomfort
- Itching
- Discharge
They are also performed when it's time for a Pap smear or, in some cases, to screen for sexually transmitted infections.
Preparing for a pelvic exam
There is no specific preparation required before a pelvic exam. However, you should avoid using any products in the vagina or on the vulva unless instructed by your health care provider.
Your first pelvic exam
The ACOG recommends that young women have their first reproductive health visit between the ages of 13-15 years. However, a pelvic exam is not typically included in this visit unless you have specific symptoms or concerns.
The recommended age to start Pap smear screening is 21 years.
What is a Pap smear?
A Pap smear may be included in the pelvic exam. This test involves gently swabbing the cervix to collect cervical cells, which are later sent to the lab. It's a screening test to check for cervical cancer and pre-cancerous changes.
Ready to schedule a pelvic exam?
Many of our providers offer online scheduling for your convenience. Find a Trinity Health Michigan women’s health provider near you.
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Blog content by Karen Kemp-Glock, DO, a physician at MercyOne, a Trinity Health ministry; originally published on the MercyOne blog, updated to include additional information from The American College of Obstetricians and Gynecologists.