Your First Pelvic Examination - What to Expect

Introduction

A pelvic examination is a short, yet very important procedure. Pelvic examinations are used to check for normal female reproductive development, test for infections or sexually transmitted diseases, and screen for abnormal growths or cells. A pelvic examination appointment is a good time to discuss problems or concerns about your period, birth control, and preventing sexually transmitted disease. It is also a good time to receive a breast examination or schedule a mammogram if indicated. The American College of Obstetricians and Gynecologists recommend that girls should first visit a gynecologist between the ages of 13 and 15. Cervical cancer screening (Pap smear) should be done during your pelvic exam starting at age 21, and should be repeated once every 3 years.

A pelvic examination may be performed by a health care professional with special training in women’s reproductive health. It may be performed by your primary care doctor, nurse practitioner, physician's assistant, or gynecologist, a doctor that specializes in female reproductive medicine. You may choose to be examined by a female or male health care provider. Some women are more comfortable discussing their concerns with or being examined by a female doctor. It is an individual choice, and the most important thing is that you feel comfortable with your healthcare provider. If a male doctor examines you, a female assistant will usually be in the room during the pelvic examination.

Before Your Exam

You should avoid douching, using tampons, or sexual intercourse for 24 hours before your test. Try to schedule your appointment for a time when you do not have your period, as blood or fluid may interfere with your test results. If you should happen to get your period, contact your doctor’s office to see if they want you to reschedule.

During Your Exam

A nurse may take your weight, pulse, and blood pressure and complete paperwork before your doctor meets with you. You will be asked to undress from the waist down for your pelvic examination. You will be provided with a sheet to cover yourself up with. Let your health care provider know if it is your first pelvic examination.

The examination is short. It usually lasts just a few minutes. You will lie on your back on the exam table for your examination with your buttocks at the edge of the table. You will bend your knees and place your feet in stirrups that are attached to the table. This positions your pelvis for the examination. Your doctor will wear gloves and examine your outside genital area for sores, irritation, or swelling.You should let your doctor know if you have had any problems with sores or itching. You should specifically point out areas of concern. For the internal examination, your doctor will gently insert a speculum into your vagina. A speculum is a metal or plastic device that opens the vagina to allow your doctor to view your vaginal tissue and cervix. The speculum may feel odd or uncomfortable, but it should not be painful. It can be helpful to relax as much as possible when it is inserted. Your doctor will use a light to view to look in your vagina for any redness, sores, swelling, or discharge. Your doctor may use a swab to take a sample of your discharge to help diagnose an infection or sexually transmitted disease.

With the speculum in place, your doctor may conduct a Pap smear test to check for cervical cancer (once every 3 years starting at age 21). A Pap smear identifies abnormal cellular changes, precancerous cells, or cancerous cells. Your doctor will gently scrape your cervix with small instruments to obtain cell samples.You may feel slight pressure, but it should not hurt. The cell samples are preserved and sent to a laboratory for examination. Your doctor will gently remove the speculum.

Your doctor will also examine your uterus and ovaries to make sure they are the right size and check for cysts or growths. To do so, your doctor will put lubricant on two gloved fingers and gently insert them into your vagina. Your doctor will gently press on your lower abdomen to feel your uterus and ovaries. You may feel a little pressure, but it should not hurt.

Some doctors may conduct the exam in a different order or may prefer to talk with you before or after the pelvic examination. You may experience slight bleeding after your exam. If necessary, your doctor will contact you when the results of your test(s) are received.

Diagnosis