Pelvic Exam

A physical examination of a woman's pelvic organs, including the cervix, uterus, and ovaries.

Pelvic Exam: What It Is, How It Works, and Why It Is Important

A pelvic exam is a medical procedure that involves examining the internal and external organs of the female reproductive system. It can help detect any abnormalities, infections, or diseases that may affect the health and function of the vagina, cervix, uterus, ovaries, and fallopian tubes. A pelvic exam can also be used to screen for cervical cancer, monitor pregnancy, or provide contraception. In this article, we will explain what a pelvic exam is, how it works, and why it is important.

How is it done?

A pelvic exam is usually done by a doctor, a nurse, or a midwife in a clinic or a hospital. It often takes only a few minutes, and it is not painful, although it may cause some discomfort or pressure. The exam consists of three main parts:

  • The external exam: The doctor or nurse will ask you to lie on your back on an exam table with your knees bent and your feet in support called stirrups. They will then look at your vulva, which is the outer part of your genitals, and check for any signs of infection, irritation, or injury. They may also gently press on your lower abdomen to feel your bladder and uterus from the outside.

  • The speculum exam: The doctor or nurse will insert a device called a speculum into your vagina. The speculum is a metal or plastic instrument that can be opened and closed to widen the vagina and allow the doctor or nurse to see your cervix, which is the opening of the uterus.

    They may then use a small brush or a spatula to take a sample of cells from your cervix. This is called a Pap smear, and it is a test that can detect abnormal cells that may lead to cervical cancer. They may also take a sample of fluid from your vagina to test for any infections, such as chlamydia, gonorrhoea, or trichomoniasis.

  • The bimanual exam: The doctor or nurse will remove the speculum and insert two gloved fingers into your vagina. They will then use their other hand to press on your lower abdomen and feel your uterus, ovaries, and fallopian tubes from the inside. They will check for any lumps, tenderness, or pain that may indicate a problem, such as fibroids, cysts, or endometriosis. They may also do a rectal exam, which involves inserting a finger into your anus to check for any tumours or other abnormalities.

Why is a pelvic exam important?

A pelvic exam is important for several reasons, such as:

  • To check your sexual and reproductive health: A pelvic exam can help you prevent or treat any conditions that may affect your fertility, pregnancy, or sexual function. It can also help you choose the best method of contraception for you, or provide you with emergency contraception if needed. A pelvic exam can also help you learn more about your body and your menstrual cycle, and address any concerns or questions you may have.

  • To diagnose a medical condition: A pelvic exam can help you find out the cause of any symptoms you may have, such as pelvic pain, abnormal bleeding, vaginal discharge, or sexual problems. You may need further tests or treatments depending on the diagnosis. A pelvic exam can also help you detect any diseases or infections that may not have any symptoms, such as cervical cancer or sexually transmitted infections, and treat them early before they become more serious or spread to other parts of your body.

  • To monitor your health over time: A pelvic exam can help you track any changes in your reproductive organs as you age, and adjust your care accordingly. For example, you may need more frequent pelvic exams if you have a history of cervical cancer or other conditions or less frequent exams if you have had a hysterectomy or are in menopause. A pelvic exam can also help you identify any risk factors or lifestyle habits that may affect your health, such as smoking, drinking, or stress, and provide you with advice and support to improve them.

How often should you have a pelvic exam?

The frequency of pelvic exams may vary depending on your age, health status, and personal preferences. Some general guidelines are:

  • If you are younger than 21, you do not need a pelvic exam unless you have symptoms or risk factors that require one, such as sexual activity, abnormal bleeding, or pelvic pain.

  • If you are between 21 and 29, you should have a pelvic exam and a Pap smear every three years, unless you have symptoms or risk factors that require more frequent exams, such as a history of cervical cancer or sexually transmitted infections.

  • If you are between 30 and 65, you should have a pelvic exam and a Pap smear every three years, or a Pap smear and human papillomavirus (HPV) test every five years, unless you have symptoms or risk factors that require more frequent exams, such as a history of cervical cancer or sexually transmitted infections.

  • If you are older than 65, you may not need a pelvic exam or a Pap smear if you have had normal results in the past and no new risk factors, unless you have symptoms that require one, such as abnormal bleeding or pelvic pain.

You should always talk to your doctor or nurse about your individual needs and preferences, and follow their recommendations for pelvic exams. You should also report any changes or concerns you may have about your reproductive health, and seek medical attention if you have any symptoms that may indicate a problem.

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