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By Mayo Clinic staff
A pelvic exam is performed in your doctor's office and takes only a few minutes.
You'll be asked to change out of your clothes and into a gown. You also may be given a sheet to wrap around your waist for added comfort and privacy. Before performing the pelvic exam, your doctor may listen to your heart and lungs and perform a breast exam.
During the pelvic exam
During the pelvic exam, you lie on your back on an examining table, with your knees bent and your feet placed on the corners of the table or in supports called stirrups. You'll be asked to slide your body toward the end of the table and let your knees fall to the sides.
- External visual exam. First, your doctor visually inspects your vulva, looking for irritation, redness, sores, swelling or any other abnormalities.
- Internal visual exam. Next, your doctor uses a speculum — a plastic or metal-hinged instrument shaped like a duck's bill — to spread open your vaginal walls and view your vagina and cervix. Often, the speculum is warmed before it's inserted. Inserting and opening the speculum can cause pressure or discomfort for some women. Relax as much as possible to ease discomfort, but tell your doctor if you're in pain.
- Pap test. If your pelvic exam includes a Pap test (Pap smear), your doctor collects a sample of your cervical cells before removing the speculum. After the speculum is removed, your doctor examines your other pelvic organs for signs of abnormalities. Most experts agree that you should begin having Pap tests at age 21, though some recommend that you begin within three years of becoming sexually active, or by 21, whichever comes first. How often you need a Pap test depends on your age and medical history. Talk to your doctor about when you should have a Pap test.
- Manual exam. Because your pelvic organs, including your uterus and ovaries, can't be seen from outside your body, your doctor needs to feel (palpate) your abdomen for this part of the exam. To do this, your doctor inserts two lubricated, gloved fingers into your vagina with one hand, while the other hand presses gently on the outside of your lower abdomen. This is to check the size and shape of your uterus and ovaries and identify tenderness and unusual growths. After the vaginal examination your doctor also inserts a gloved finger into your rectum to check for tenderness, growths or other irregularities.
Usually, at each step along the way, your doctor tells you exactly what he or she is doing, so nothing comes as a surprise to you.
After the pelvic exam
After the pelvic exam is over, you can get dressed and then discuss with your doctor the results of your exam.
- LeBlond RF, et al. The screening physical examination. In: DeGowin's Diagnostic Examination, 9th ed. New York, N.Y.: McGraw-Hill Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=3658782. Accessed April 9, 2009.
- Special procedures: The Pap test. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp085.cfm. Accessed April 13, 2009.
- Carusi DA, et al. The gynecologic history and physical examination. http://www.uptodate.com/home/index.html. Accessed April 13, 2009.
- Gynecologic problems: Pelvic pain. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp099.cfm. Accessed April 13, 2009.
- Schorge JO, et al. Well woman care. In: Williams Gynecology. New York, N.Y.: McGraw-Hill Companies; 2008. http://www.accessmedicine.com/content.aspx?aID=3148000. Accessed April 9, 2009.
- LeBlond RF, et al. The female genitalia and reproductive system. In: DeGowin's Diagnostic Examination, 9th ed. New York, N.Y.: McGraw-Hill Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=3656235. Accessed April 9, 2009.
- Cervical cytology screening. Washington, D.C.: American College of Obstetricians and Gynecologists. http://journals.lww.com/greenjournal/documents/PB109_Cervical_Cytology_Screening.pdf. Accessed Nov. 20, 2009.
