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Female Pelvic Examination: Understanding What is Involved

  • Publish Date : 2015/05/31 - (Rev. 2017/11/06)
  • Author : Thomas C. Weiss
  • Contact : Disabled World


Information including what to expect during a female pelvic exam at the doctors office.

Main Document

A pelvic examination is an examination of a woman's genital system. A pelvic examination examines organs including the vagina, vulva, ovaries, uterus and Fallopian tubes. The woman's bladder and rectum are also usually a part of the examination.

A pelvic examination involves visual examination of the external genitalia and an internal visual examination of the woman's vaginal walls and cervix using a speculum to open the vaginal canal. The examination also involves palpitation or examination by feeling the shape and size of the woman's pelvic organs.

Reasons Why a Pelvic Examination is Performed

A pelvic examination might be performed as part of a regular checkup, or may be performed to investigate abnormal symptoms such as unusual vaginal discharge, abnormal bleeding, or pain. Pelvic examinations are also performed during pregnancy checkups. Pelvic examinations are also needed for cervical cancer screenings, during which a sample of cells from the woman's uterine opening are taken for microscopic examination, also known as a, 'Pap test,' or a, 'Pap smear.' A pelvic examination may be useful in the evaluation and diagnosis of many different conditions, such as:

  • Infertility
  • Pregnancy
  • Genital warts
  • Ovarian cysts
  • Endometriosis
  • Fibroid tumors
  • Rectal bleeding
  • Yeast infections
  • Ectopic pregnancy
  • Bacterial vaginosis
  • Urinary tract infections
  • Infertility ovary syndrome
  • Abnormal uterine bleeding
  • Tumors of the genital organs
  • Sexually-transmitted infections

How a Pelvic Examination is Performed

A pelvic examination is performed in a doctor's office and takes a few minutes. The woman undergoing the examination lies on an examination table, covered with a sheet. The doctor and/or nurse will assist the woman to get in position for the speculum examination, which involves bending the knees and placing the feet in metal supports on the side of the examination table. The speculum is a plastic or metal device that is inserted into the woman's vagina to permit her vaginal walls and cervix to be seen. A small sample of the cells of the woman's cervix is taken by a small spatula or brush for a Pap test. While the woman might experience some level of discomfort, a pelvic examination should not be painful.

Another part of the pelvic examination is a, 'bimanual exam.' A bimanual examination involves placement of two fingers inside the woman's vaginal canal and pressing on the lower abdomen with the other hand to, 'palpate,' or feel the woman's pelvic organs. A rectal examination is also performed at this time. The bimanual examination might reveal enlarged organs or tissue masses.

Preparing for a Pelvic Examination

Due to the fact that a Pap test is commonly performed during a routine pelvic examination, you should schedule the examination when you are not having your period. For 48 hours before the examination you should not do the following:

  • Douche
  • Have sex
  • Use a tampon
  • Use cream or medicine in your vagina
  • Use birth control cream, foam, or jelly

What to Expect During a Pelvic Examination

You can expect to feel a bit of discomfort, yet you should not feel pain during a pelvic examination. The examination itself takes around ten minutes. If you have any questions during the examination, make sure you ask your doctor. During a pelvic examination your doctor or nurse will:

  • Ask you to remove your clothing in private
  • Talk to you about any health concerns you may have
  • Ask you to lie on your back and relax
  • Press down on areas of the lower stomach to feel the organs from outside
  • Help you to get in position for the speculum examination
  • Ask you to bend your knees and place your feet in holders called, 'stirrups'
  • Perform the speculum examination; during the examination a device called a, 'speculum,' will be inserted into the vagina - the speculum is opened to widen the vagina so the vagina and cervix may be viewed
  • Perform a Pap smear; your doctor will use a plastic spatula and small brush to obtain a small sample of cells from your cervix - a sample of fluid may also be taken from the vagina to test for infection
  • Remove the speculum
  • Perform a bimanual examination; your doctor will place two fingers inside your vagina and use the other hand to gently press down on the area - your doctor is noting if your organs have changed in shape or size
  • At times a rectal examination is performed; your doctor inserts a gloved finger into your rectum to detect any tumors or other abnormalities
  • Speak with you about the examination

A sample of cells might be taken as a part of a regular test called a Pap smear or Pap test to screen for cervical cancer, or cells that appear like they may lead to cancer. The sample is placed in a solution and then sent to a laboratory where it is examined. Tests might also be taken to screen for sexually-transmitted diseases.

How Often Should a Woman Receive a Pelvic Examination?

A Pap smear is recommended beginning when a woman reaches twenty-one years of age. Women between the ages of 21-65 should have routine screenings with Pap test every three years. Combining a Pap test with a human papillomavirus (HPV) test may safely extend the interval between cervical cancer screenings from three years to five years in a number of women who are between the ages of 30-65.

HPV testing is not recommended for women in their twenties because people in this age group can have HPV infections that resolve without treatment. Women who are over the age of 65 can cease getting screened if they have had at least three consecutive negative Pap tests, or at least two negative HPV tests within the past decade. Women who have a history of a more advanced pre-cancer diagnosis should continue to receive screenings for at least twenty years.

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