Pelvic Exam

Pelvic exams are an important part of a routine annual well-woman exam because they help doctors, nurses, and other health professionals look for any signs of abnormalities that may not cause symptoms. They may be necessary to evaluate symptoms like vaginal discharge, pelvic pain, unexplained bleeding, urinary problems, and fecal incontinence, and they are also often performed during pregnancy to check the cervix.

When a Pap test (Pap smear) is necessary, they are often done in conjunction with a pelvic exam.

Pelvic exams are used to diagnose or look for signs of many conditions, including:

• Cysts, including ovarian cysts
• Gynecologic cancers
• Pelvic inflammatory disease (PID)
• Polyps
• Precancerous changes in the cervix
• Sexually transmitted diseases (STDs)
• Uterine fibroids

Pelvic exams are also done during pregnancy to check the cervix for signs of problems.

You should have a pelvic exam every year when you have your annual appointment with your OB/GYN or primary care provider. You should also call your doctor to make an appointment if you have any symptoms that might be related to your reproductive organs, such as pelvic pain, noticeable lumps or bumps in or around your vagina, unusual vaginal discharge, unexplained bleeding, itching, burning, or redness.

Pelvic exams are quick and usually painless, although some women do experience discomfort. You will be asked to remove your clothes and put on a gown. You will also be given a sheet to cover your legs. Before the exam, your doctor or nurse practitioner will ask you to lie down, put your feet in stirrups, and try to relax. Then he or she will examine your vulva, vagina, cervix, uterus, ovaries, rectum, and pelvis for abnormalities. The examination involves looking and feeling both inside and outside your body. Your doctor will likely use a tool called a speculum to open your vagina so it’s easier to view your vagina and cervix. He or she will feel for your ovaries, both inside and outside your body. If a Pap test is necessary, that will be done at the same time as the pelvic exam.

Throughout the exam, your doctor should tell you what he or she is going to do so you will not be surprised. If at any time you feel uncomfortable or are experiencing pain, let him or her know. The parts of the pelvic exam usually include:

• An external visual exam of the vulva to look for redness, irritation, bumps, sores, or other abnormalities
• An internal visual exam to inspect your vagina and cervix (this is when the speculum will be inserted)
• A Pap test will be done after the internal visual exam if it is necessary
• A physical exam of your internal reproductive organs, checking the size and shape of your ovaries and looking for areas of tenderness or irregularities, then checking your rectum (depending on your age) for growths, irregularities, or tenderness

A pelvic exam can be quite useful in helping diagnose symptoms or conditions that affect the reproductive system. However, it may only be the first step. Some abnormalities are easy to diagnose with a visual exam, but many conditions will require further testing for a specific diagnosis. For example, some sexually transmitted diseases cannot be confirmed without tests. And while a physical exam of the uterus and ovaries may help detect abnormalities, it’s likely that an ultrasound and biopsy will be needed to get a definitive diagnosis.

The results of a Pap test will tell your doctor whether your cervix has abnormal cell growth, and it can also provide information for HPV sub-type testing.

After your exam, your doctor will talk to you about any abnormalities found and what next steps should be. If he or she recommends testing, you’ll talk about the test(s) and what you can expect. Your doctor will also be able to answer your questions about what he or she found and what you can expect from treatment.

If you have a Pap test, your results may not be available for at least a week. Ask your doctor when you should get the results and whether you’ll receive a phone call, email, or postal mail notification. You may also look up your results on MyChart.

Any time you notice abnormalities or changes, you should make an appointment with your doctor. Whether you’re experiencing pelvic pain, unexplained vaginal bleeding, pain during intercourse, urinary problems, vaginal discharge, itching, redness, or skin changes, we’re here to help. Don’t delay. Most conditions are not serious and can be addressed with treatment; however, serious conditions such as ovarian cancer do not always cause obvious symptoms. If you notice any changes or just don’t feel right, don’t hesitate to call.