Pelvic Exam Test and Procedure
Overview
A pelvic exam helps check important parts of the female reproductive system. These exams may be part of a regular health visit, but not everyone needs one every year. Doctors might suggest a pelvic exam if someone has certain symptoms, like pelvic pain or unusual discharge.
During the Exam:
- Lasts a few minutes.
- Checks the vulva, vagina, cervix, ovaries, uterus, rectum, and pelvic area.
- A Pap test for cervical cancer might be included.
Pelvic exams help find changes or problems in these organs and guide further care if needed.
Reasons for Performing a Pelvic Exam
Doctors often use a pelvic exam to assess the well-being of a person’s sexual and reproductive organs. This exam helps in many areas of health care, from checking for common conditions to guiding important decisions about birth control and preventive health.
- Routine Health Checks: Doctors include this exam as a basic part of preventive care. They look for early signs of issues like ovarian cysts, uterine growths, or certain cancers. During pregnancy, pelvic exams help monitor both the mother and the developing baby, especially at the first prenatal visit.
- Finding the Cause of Symptoms: If someone has unexplained pain, odd discharge, unusual bleeding, or changes in skin around the genital area, doctors use a pelvic exam to learn more. The exam may lead to further tests or treatments.
- Decisions on Reproductive Health: For those considering contraception or dealing with menopause symptoms, a pelvic exam helps guide safe birth control choices and manage problems related to menopause or hormonal changes.
Additional Details
Some medical conditions related to the pelvic exam include:
| Reproductive Concerns | Infections & Inflammation | Changes & Other Issues |
|---|---|---|
| Infertility | Vaginitis | Uterine fibroids |
| Ovarian cysts | Pelvic inflammatory disease (PID) | Prolapse conditions |
| Menopause changes | Yeast infection | Vaginal or vulvar pain |
Doctors also use the exam to check for problems like endometriosis, polycystic ovary syndrome (PCOS), early miscarriage, and other disorders.
Getting Ready
There is usually no need for special steps before a pelvic exam. For added comfort, it helps to choose a day when there is no period. It can also be helpful to empty the bladder before arriving.
People may want to write down any questions or concerns about the exam or results, and bring the list with them. This can make it easier to remember important topics. Let the provider know about any medical history or recent changes before the exam begins.
What You Can Expect
What Happens While the Exam Takes Place
A pelvic health check takes place in a private room at the clinic. The provider asks the person to change into a gown after removing clothing from the waist down. Sometimes, a sheet offers added privacy. A chaperone, such as a nurse or assistant, may be present, and patients can request one if not already provided.
The person lies on a table with bent knees, feet placed in stirrups or on the table corners. This position allows the doctor to examine the pelvic area easily. The doctor first looks at the outside, checking the vulva for redness, swelling, sores, or other problems. They look for any discharge that could signal infection or irritation.
Next, the doctor performs an internal exam. The doctor gently inserts a speculum, made of metal or plastic, into the vagina. The device spreads the vaginal walls for a clear view of the vagina and cervix. Sometimes, the doctor uses a warm speculum or lubricant to make this step more comfortable.
Some people feel mild pressure but should alert the doctor if they have any pain. Often, the doctor performs a Pap test during this step by using a small, soft brush or wand to collect cells from the cervix for testing. This checks for unusual cell changes.
After the speculum exam, the doctor puts on new gloves and uses lubricant. With two fingers, the doctor gently enters the vagina, while the other hand presses on the lower belly. This bi-manual exam allows the doctor to feel the uterus and ovaries.
They look for tenderness, lumps, or changes in size or shape. Any discomfort or pain is noted and discussed. In some cases, the doctor may gently place one gloved finger in the rectum to feel for any growths, polyps, or pain behind the pelvic organs.
Common Parts of the Exam
| Exam Step | What the Doctor Checks | Tools Used |
|---|---|---|
| External Visual Exam | Skin changes, sores, swelling | None |
| Internal Visual Exam | Cervix, vaginal discharge, irritation | Speculum |
| Pap Test | Cell changes in cervix | Wand/brush |
| Physical Palpation | Uterus, ovaries, cysts, polyps, pain | Gloved fingers, lubricant |
| Rectal Exam (if done) | Growths or tenderness | Gloved finger |
The doctor talks through each step, explaining what they are checking. This helps reduce worry or surprise for the patient.
What to Expect After the Exam
After the exam, the patient gets dressed in private. The doctor then reviews what they found during the exam. If the doctor notices any problems, such as unusual discharge, cysts, or pelvic pain, they explain what these findings could mean. They may discuss next steps, which might include more tests, a follow-up appointment, or treatments if needed.
If the doctor performed a Pap test, the results usually come later, and the doctor will contact the patient with the findings. It is normal to have mild discharge from the lubricant after the exam or light spotting if a Pap test was performed. Most people can return to regular activities right away.
The doctor may also ask about sexual history, any pelvic complaints, or changes in periods to better understand overall health. This helps create a more accurate care plan if issues are found. If there are questions or worries, patients should speak with their doctor. This way, any concerns about the pelvic health check can be quickly addressed.
Findings
A pelvic exam can reveal issues like cervicitis, bacterial vaginosis, or signs of pelvic inflammatory disease right away. The lab may take a few days to process tests such as the Pap smear or Pap test for cervical cancer screening.
Other laboratory checks detect sexually transmitted infections, including chlamydia, gonorrhea, and HPV. The provider may advise patients about early detection, further STD testing, or follow-up visits for possible ovarian or cervical cancer.
