A pelvic exam involves physically and visually examining the female reproductive and sexual organs. It allows a doctor to look for signs of infection and illness.
The doctor performing the exam may be a gynecologist or an OB-GYN. They will examine the:
- ovaries and fallopian tubes
During a pelvic exam, a doctor will check the following reproductive organs:
- the vulva, which is the external genital organ
- the vagina, which leads from the external organ to the cervix
- the uterus, which is also called the womb
- the cervix, which is the opening between the uterus and vagina
- the fallopian tubes, which carry eggs to the womb
- the ovaries, which produce eggs
- the bladder, a sac-like organ that stores urine
- the rectum, which connects the colon to the anus
Why have a pelvic exam?
These examinations are performed for many reasons, including:
- as part of an annual checkup
- to check that reproductive organs are healthy during pregnancy
- to look for signs of infections
- to determine the cause of pain in the pelvis or lower back
A pelvic exam is often performed on the same day as other preventive screenings – a breast examination and a Pap smear.
Pelvic exams are also part of sexual assault assessments.
A person does not need to do anything before a pelvic exam. They can simply attend their appointment.
The doctor or nurse will usually ask if the person needs to use the bathroom, to help them feel more comfortable during the exam and so that they can be examined without distractions.
If an individual has symptoms of burning during urination or urinary frequency, the doctor may request a urine sample.
The exam does not cause pain, though it may cause some discomfort. It usually takes around 10 minutes.
Pelvic exam procedure
Before the exam, the doctor or nurse practitioner will ask the person to take off their clothes, put on a gown, sit on the exam table, and cover up with a sheet. Then they will ask about health concerns.
The person will then lie on their back and place their feet in footrests. The doctor or nurse will ask them to relax. They will press on the lower part of the person’s stomach and feel for the organs. The doctor will then ask the person to move toward the end of the table and bend their knees.
First, the doctor will examine the vulva for signs of infection, swelling, and sores. Next, they will insert a lubricated speculum into the vagina to widen it, and make the internal organs easier to see.
Then, they may perform a Pap smear. This involves taking a sample of cells from the cervix to check for abnormalities, especially cervical cancer. They may also take a sample of vaginal discharge, to check for infections.
Next, they will remove the speculum and perform a bimanual examination. This involves placing two fingers inside the vagina and pressing down on the pelvis with the other hand. The aim is to check for changes or abnormalities in the reproductive organs.
The doctor may then conduct a rectal exam, by inserting a gloved finger in the rectum to check for tumors and other abnormalities behind the vaginal wall, uterus, and rectum.
If a person feels any pain during the exam, they should let the doctor know right away.
The doctor or nurse practitioner will ask the person if they have any questions or concerns. It is important to be honest about topics relating to sexual health.
Medical professionals are required to keep private information confidential.
After a Pap smear, the doctor will inform the person of their results. If necessary, they will request further testing, either after the exam or after receiving results.
Doctors perform pelvic exams during pregnancy for the same reasons. They look for abnormalities and infections.
Also, a pelvic exam can help a doctor to evaluate the size of the pelvis and cervix. This will help them to evaluate whether cervical weakness could lead to miscarriage or preterm labor.
Pelvic exams are usually done early on in pregnancy. If there are no complications, another exam is performed at around 36 weeks, to check for changes to the cervix.
After that, the doctor will perform an exam as often as needed to determine if the person is in labor.
There is little information about the risks of pelvic exams during pregnancy. It is possible that an exam may increase the risk of infection.
Some reviews show that pregnant women who attended exams still experienced complications. In one trial cited, three times more women who were regularly examined experienced preterm ruptured membranes than women who were not examined.
The American College of Obstetricians and Gynecologists (ACOG) recommends that women have yearly exams, starting at age 21.
However, each person should discuss the best frequency of exams with their doctor.
Pelvic exams are important in maintaining reproductive and sexual health.
ACOG recommends seeing a gynecologist for STI testing if a person becomes sexually active before age 21, but a pelvic exam may not be necessary.
The same organization recommends a Pap smear every 3 years beginning at age 21. For women over 30, it may be a good idea to be screened for human papillomavirus, commonly called HPV, along with a Pap smear. HPV is the virus responsible for cervical cancer.
Depending on the results of these tests, the doctor may advise a person to wait up to 5 years between Pap smears. During this time, it is still a good idea to have a yearly pelvic exam.
Women over 65 should continue to have pelvic exams as recommended by a doctor. Only those with histories of gynecological precancer should continue having Pap smears.