A pelvic exam is a way for healthcare providers to look for signs of illness or disease in a woman's body. The word "pelvic" refers to the organs in the pelvis. The exam is used to look at a woman's:
. Uterus (the womb).
. Cervix (opening from the vagina to the uterus).
. Vagina (stretchy canal that connects the uterus and the cervix).
. Fallopian tubes (tubes that carry eggs to the womb).
. Ovaries (glands that produce eggs).
. Bladder (the sac that holds urine).
. Rectum (the chamber that connects the colon to the anus).
Often, a pelvic exam is performed by healthcare providers to assess female reproductive health and gynecological health.
Pelvic exams are a part of your routine healthcare. Women should have their first pelvic exam at age 21. They are then regularly scheduled depending on your age and health risks.
Your healthcare provider may also recommend a pelvic exam for the following reasons:
. Family history of ovarian or cervical cancer.
. Pelvic pain or pain during sex.
. Unusual vaginal discharge or bleeding.
. Concerns about sexually transmitted diseases or infections (STIs).
. You are pregnant.
. Women who are 21 to 65 years of age.
. Individuals who have transitioned but not completed gender assignment surgery (female to male).
If you are a transgender man (identify as male but were assigned female at birth), it is important to find a healthcare provider who understands your health history, makes you feel comfortable and provides the care you need. If you still have female organs (vagina, cervix, uterus and ovaries), you are at risk for developing cancer in those organs. Pelvic exams should be still performed to check for irregularities, STIs and cancer.
Recommendations on how often you should get a pelvic exam can vary. The timing for your pelvic exams are typically based on your medical history, or if you’re experiencing problems or symptoms. Some healthcare providers may recommend annual visits. Others may recommend an exam every three years until you are 65 years old. Ask your provider when they recommend you come back for routine pelvic exams.
You do not have to do anything special to get ready for a pelvic exam procedure. When you arrive at the office, your healthcare provider may ask if you need to use the bathroom. Sometimes, a urine sample is requested. If you’re on your period on the day of the exam, the doctor may suggest rescheduling for your comfort.
The pelvic exam itself usually takes about 10 minutes.
You can expect to feel a little discomfort, but you should not feel pain during a pelvic exam. Take slow, deep breaths and urinate before the exam to help with any discomfort. If you feel pain or discomfort during your exam, tell your doctor.
It can also help to talk to your provider about your worries or concerns that the pelvic exam might be painful before your exam starts. They can walk you through the process and address your concerns.
It is normal to feel a little nervous prior to a pelvic exam. It can help to:
. Take slow and deep breaths.
. Relax your shoulder, stomach and leg muscles.
. Ask your provider to explain what is about to happen.
If you have experienced sexual trauma, speak with your healthcare provider so that they can be supportive of your feelings and make your exam as comfortable as possible.
When it’s time for your pelvic exam, you’ll start by taking off your clothes in private. You are given a gown, sheet or other covering. You will be asked to lie on your back and relax the muscles of your stomach and legs. Your healthcare provider will have you to slide down to the end of the table and place your feet in holders called stirrups.
There are a few things that may happen during your pelvic exam:
. External exam: Your healthcare provider will visually inspect your vagina and vulva.
. Manual exam: Your provider will place one or two fingers inside the vagina and use the other hand to gently press down on the area they can feel from the outside. They will feel the size and shape of your organs or if any areas are tender or enlarged.
. Speculum exam: A duck-billed shaped device called a speculum will be inserted into the vagina. The speculum is then opened to widen and spread the vaginal wall so that the vagina and cervix can be more easily seen.
. Pap test: Your provider will use a plastic spatula and small brush to take a sample of cells from the cervix. A sample of fluid may also be taken from the vagina to test for infection. This is called a Pap test or Pap smear. This test looks for precancerous cells on the cervix. A Pap test is not always performed during a pelvic exam. You should not place anything inside your vagina for 48 hours prior to your Pap test.
. Rectal exam: Your healthcare provider may insert a finger into the rectum to detect any tumors or other abnormalities.
During your pelvic exam, your provider may test for:
. Cervical cancer: If your healthcare provider performed a Pap test during your exam, it’s to look for precancers, or cell changes on the cervix that could become cancer.
. HPV (human papillomavirus): This test is also used to screen for cervical cancer. The test looks for HPV, which can cause cell changes in the cervix. These cell changes can lead to cancer.
. Sexually transmitted diseases or infections (STIs): Your doctor may swab your vagina to test for chlamydia and gonorrhea.
The samples your provider takes during the pelvic exam are sent to a lab where they are examined. Results can take several days.
A little spotting (very light bleeding) is normal after a pelvic exam. If you have heavy bleeding, call your healthcare provider.
You should not feel pain. Mild cramping may occur. If you feel severe cramping or pain, contact your healthcare provider.
Your healthcare provider will know certain results right away after your pelvic exam. If a Pap or HPV test was done, those results typically take a few days.
Yes, pregnant women need to have pelvic exams. The healthcare provider working with you will usually perform a pelvic exam at your first prenatal visit.
Because the risk of cancer increases with age, having regular pelvic exams may help prevent certain cancers in both menopausal and postmenopausal women. Your healthcare provider will advise you on how frequently you will need pelvic exams in the future and the best recommendations for this exam as you age.