Pelvic Exam

What is a pelvic exam?

A pelvic exam is a way for healthcare providers to check on the health of your reproductive organs. The word “pelvic” refers to the organs in your pelvis. Pelvic exams are a fast and safe way for your healthcare provider to make sure everything feels and looks OK, and that there are no signs of problems.

Some of the organs that a healthcare provider checks during a pelvic exam are your:

• Vulva.
• Vagina.
• Cervix.
• Uterus.
• Fallopian tubes.
• Ovaries.
• Bladder.

Healthcare providers have different recommendations on how often you need a pelvic exam. As it’s unique to you, your health history and your symptoms, it’s best to talk to your provider about how often you need a pelvic exam.

A pelvic exam is sometimes called a gynecological exam. While gynecologists primarily perform pelvic exams, some primary care physicians and nurse practitioners also offer pelvic exams.

Is a pelvic exam the same as a Pap smear?

No, but your healthcare provider can do a Pap test and a pelvic exam at the same appointment. A pelvic exam is like a physical examination of your pelvic organs, while a Pap smear is one specific test your provider can do to screen for cancer. A Pap involves collecting cells from your cervix and checking them for signs of cervical cancer or other precancerous conditions.

Why do I need a pelvic exam?

Pelvic exams are a part of your routine healthcare. They can also help find the cause of symptoms like pelvic pain or vaginal bleeding. You should have your first pelvic exam by age 21. After that, they become part of your regular preventive care and you receive them every year or every few years depending on your age, health risks and other factors.

Your healthcare provider may also recommend a pelvic exam for the following reasons:

• Family history of ovarian or cervical cancer.
• History of human papillomavirus (HPV) or abnormal Pap test results.
• Pelvic pain or pain during sex.
• Unusual vaginal discharge.
• Irregular bleeding or bleeding when you’re not on your period.
• Checking for problems like uterine fibroids or ovarian cysts.
• Concerns about sexually transmitted infections (STIs) or other uterine infections.
• Pregnancy.
• Checking the fit for an intrauterine device (IUD).

Who should get a pelvic exam?

There are exceptions, but in general, the following people should get a pelvic exam:

• People assigned female at birth (AFAB) who are 21 to 65 years old. (There are some instances where your provider may recommend getting a pelvic exam before age 21.)
• Individuals who have transitioned but not completed gender-affirming surgery (female to male).

If you identify as male but were assigned female at birth, it’s important to find a healthcare provider who understands your health history, makes you feel comfortable and provides the care you need. If you have female organs, you’re at risk for developing cancer in those organs. Pelvic exams should still occur to check for irregularities, STIs and cancer. ­

How often do I need a pelvic exam?

Recommendations on how often you should get a pelvic exam can vary. The timing for your pelvic exams is typically based on your medical history, and if you’re experiencing problems or symptoms. Some healthcare providers recommend annual visits. Others may recommend an exam every three years until you’re 65 years old. Ask your provider when they recommend you come back for routine pelvic exams.

Do I need to do anything to prepare for a pelvic exam?

You don’t have to do anything special to get ready for a pelvic exam. When you arrive at the office, your healthcare provider may ask if you need to use the bathroom. Sometimes, they order a urine sample. If this applies to you, your provider may ask you to pee into a cup in the bathroom before the exam.

If you’re on your period on the day of the exam, your healthcare provider may suggest rescheduling for your comfort. Contact your provider’s office and let them know if you’re on your period and they can let you know what they recommend.

It’s generally a good idea to avoid inserting anything inside your vagina for 24 hours prior to the pelvic exam. This includes avoiding intercourse or using vaginal products like creams or tampons. It’s possible that these can affect the exam or make the exam uncomfortable.

What do you do to prepare for your first pelvic exam?

Your first pelvic exam may bring some anxiety simply because you don’t know what to expect.

The first thing you should do is make sure your healthcare provider is someone you trust and feel comfortable with. When you call to schedule your exam, let them know that it’s your first gynecological visit. Some people feel more comfortable having a female healthcare provider, for example. You’re allowed to choose what healthcare provider performs your exam.

When you go to your appointment, remind them again that this is your first time. Most healthcare providers will take extra care to ensure you understand what they’re doing during the exam and that you feel comfortable.

How long does a pelvic exam take?

A pelvic exam usually takes about 10 minutes.

Is a pelvic exam painful?

You can expect to feel a little discomfort, but you shouldn’t feel pain during a pelvic exam. Take slow, deep breaths and pee before the exam. If you feel pain or discomfort during your exam, tell your healthcare provider.

It can also help to talk to your provider about your worries or concerns that the pelvic exam might be painful before your exam starts. They can walk you through the process and address your concerns.

How can I relax during a pelvic exam?

It’s normal to feel a little nervous prior to a pelvic exam. It can help to:

• Take slow and deep breaths.
• Relax your shoulder, stomach and leg muscles.
• Ask your provider to explain what they’re doing before they do it.

Your provider may ask for your permission before touching you. You can also ask your provider to tell you before they touch you and to explain which areas they will touch.

If you have experienced sexual trauma, speak with your healthcare provider before the exam begins so that they can be supportive of your feelings and make your exam as comfortable as possible. Know that you can stop the exam at any time if you want to.

What is done at a pelvic exam?

When it’s time for your pelvic exam, your provider will start by getting your health history and asking you about any symptoms you’re having or if you have any concerns. A gynecological visit is about more than just the physical exam — it’s also about your overall health, educating yourself on your body and asking questions. It’s within your power to use this time to discuss your body and your sexual health with your provider.

After talking with you for a bit, your provider will give you a gown and sheet (the sheet is sometimes made of heavy paper). Once they leave the room, you’ll undress in private and change into the gown. Once you’re in a gown and your lap is covered by the sheet, you’ll lie back on the exam table and slide your hips down to the edge of the table. You’ll place your feet in holders called stirrups. Let your knees fall outwards like the letter V. Try to relax your legs, butt and abdominal muscles as much as you can.

There are a few different parts to a pelvic exam. Your healthcare provider typically tells you exactly what they’re going to do before they do it. There may be a chaperone in the room. If there isn’t a nurse or other healthcare professional in the room and you would like there to be, you can ask for one. A friend, partner or family member can also accompany you.

A pelvic exam may include:

• External exam: Your healthcare provider will visually inspect your vagina and vulva. They may be looking for signs of infection, irritation or abnormal discharge.
• Manual exam: Your provider will place one or two gloved fingers from one hand inside your vagina. They’ll use the other hand to gently press down on areas of your abdomen. They’ll feel the size and shape of your uterus and ovaries, or if any areas are tender or enlarged. Some people find this part to be slightly uncomfortable, so let your healthcare provider know if you feel pain.
• Speculum exam: Your provider places a small device called a speculum inside your vagina. The speculum widens and spreads your vaginal wall so that your vagina and cervix can be more easily seen. The widening of the speculum can also be uncomfortable but shouldn’t cause pain. Let your provider know if you feel any pain and they may be able to adjust the speculum.
• Pap test: While the speculum is inside your vagina, your provider will use a thin wand or small brush to take a sample of cells from your cervix. They may also take a sample of fluid from your vagina. A pelvic exam can also include an HPV test, which checks for certain high-risk types of HPV.
• Rectal exam (rectovaginal exam): Your healthcare provider may insert a finger into your rectum to detect any tumors or other abnormalities behind your uterus.

Your provider may also listen to your heart and lungs and perform a breast examination.

Remember, not all pelvic exams include Pap tests. Your provider will tell you when this is necessary.

What do pelvic exams check for?

Pelvic exams are a way for your provider to assess your overall reproductive health. Some of the main conditions a pelvic exam helps check for include:

• Cervical cancer: If your healthcare provider does a Pap test during your exam, it’s to look for cell changes on your cervix that could become cancer (precancers).
• Ovarian cancer: A pelvic exam can help your provider feel for unusual lumps or changes in the size or shape of your ovaries.
• Sexually transmitted infections (STIs): Your provider may swab your vagina to test for chlamydia and gonorrhea. They can also visually inspect your vagina for warts or other sores that can be signs of infection.
• Pelvic inflammatory disease (PID): Your provider can detect symptoms of PID like irregular vaginal discharge or pelvic pain.

A pelvic exam can also be a helpful tool to find what’s causing symptoms like irregular vaginal bleeding and pelvic pain.

How will I feel after a pelvic exam?

You might have light bleeding after a pelvic exam, but it should only last a few hours. Mild cramping may occur, but it shouldn’t be painful or last longer than a few hours. If you feel severe cramping or pain, contact your healthcare provider.

What type of results do you get from a pelvic exam?

Your healthcare provider will know certain results during your pelvic exam. They may discuss next steps or treatment with you if they find anything irregular during their exam. This is also a good time for you to discuss any concerns you have about the exam, birth control options, intercourse or anything else.

Results from a Pap or HPV test typically take several days to come back.

What are the benefits of a pelvic exam?

A pelvic exam can:

• Detect certain conditions like infections or cancer early so you can get necessary treatment.
• Find the cause of irregular symptoms like vaginal bleeding or pain.
• Give you peace of mind about your reproductive health.

Are there risks to pelvic exams?

No. Pelvic exams are very safe and effective. They’re one of the best tools your healthcare provider has to detect problems with your pelvic organs.

It’s natural to feel anxious or fearful about pelvic exams due to how personal they are. But it might help to remind yourself of how important this exam is for your health. Be sure to talk to your healthcare provider before your appointment and let them know your feelings. They can help make your experience as comfortable as possible.

Will I bleed after a pelvic exam?

A little spotting (very light bleeding) is normal after a pelvic exam. If you have heavy bleeding, call your healthcare provider.

Do pregnant people need pelvic exams?

Yes, pregnant people need to have pelvic exams. You’ll typically have one at your first prenatal visit. You may also have a Pap if you’re due for one.

Do you need a pelvic exam after menopause?

Because the risk of cancer increases with age, having regular pelvic exams may help prevent certain cancers in people who’ve completed menopause. Your healthcare provider will advise you on how frequently you will need pelvic exams in the future and the best recommendations for this exam as you age.