Female reproductive system
The ovaries, fallopian tubes, uterus, cervix and vagina (vaginal canal) make up the female reproductive system.
During a pelvic exam, a doctor evaluates your reproductive organs. You might have a pelvic exam as part of your regular checkup. Or your doctor might recommend a pelvic exam if you have symptoms such as unusual vaginal discharge or pelvic pain.
A pelvic exam usually lasts only a few minutes. Your doctor checks your vulva, vagina, cervix, ovaries, uterus, rectum and pelvis for any abnormalities. A Pap test, which screens for cervical cancer, is often performed during a pelvic exam.
Why it's done
You might need a pelvic exam:
To assess your gynecological health. A pelvic exam often is part of a routine physical exam to find possible signs of ovarian cysts, sexually transmitted infections, uterine fibroids or early-stage cancer. Pelvic exams are also commonly performed during pregnancy.
There is a lot of debate among experts regarding the recommended frequency of pelvic exams. Ask your doctor what he or she recommends.
- To diagnose a medical condition. Your doctor might suggest a pelvic exam if you're experiencing gynecological symptoms such as pelvic pain, unusual vaginal bleeding, skin changes, abnormal vaginal discharge or urinary problems. A pelvic exam can help your doctor diagnose the causes of these symptoms. Your doctor might suggest additional diagnostic testing or treatment.
How you prepare
You don't need to do anything special to prepare for a pelvic exam. For your own comfort, you might want to schedule your pelvic exam on a day when you don't have your period. Also, you might be more comfortable if you empty your bladder before the exam.
If you have questions about the exam or its possible results, consider writing down your questions and taking them with you to the appointment so that you don't forget to ask them.
What you can expect
A pelvic exam is done 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 might be given a sheet to wrap around your waist for added privacy. Before performing the pelvic exam, your doctor might listen to your heart and lungs and perform an abdominal, back and breast exam.
During the pelvic exam
During a pelvic exam, your doctor inserts two gloved fingers inside your vagina. While simultaneously pressing down on your abdomen, he or she can evaluate your uterus, ovaries and other pelvic organs.
In a Pap test, your doctor uses a vaginal speculum to hold your vaginal walls apart and to see the cervix. Next, a sample of cells from your cervix is collected using a small cone-shaped brush and a tiny plastic spatula (1 and 2). Your doctor then rinses the brush and spatula in a liquid-filled vial (3) and sends the vial to a laboratory for testing.
You'll lie on your back on an exam table with your knees bent and your feet placed on the corners of the table or in supports (stirrups). You'll be asked to slide your body toward the end of the table and let your knees fall open.
A pelvic exam generally includes:
- External visual exam. First, your doctor looks at your vulva, checking for irritation, redness, sores, swelling or 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 see your vagina and cervix. The speculum might be warmed before it's inserted to make it more comfortable for you.
Inserting and opening the speculum causes pressure that can be uncomfortable 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 will swipe a small wand to collect a sample of your cervical cells before removing the speculum.
Physical 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 and pelvis for this part of the exam. Your doctor will insert two lubricated, gloved fingers into your vagina with one hand, while the other hand presses gently on the outside of your lower abdomen.
During this part of the exam, your doctor will check the size and shape of your uterus and ovaries, noting any tender areas or unusual growths. After the vaginal exam, your doctor will insert a gloved finger into your rectum to check for tenderness, growths or other irregularities.
Your doctor should tell you exactly what he or she is doing at each step so that nothing comes as a surprise to you.
After the pelvic exam
After the pelvic exam is over, you can get dressed. Then, your doctor will discuss the results of your exam.
Your doctor can usually tell you immediately if the exam revealed anything unusual. Pap test results might take a few days. Your doctor will discuss with you any next steps, additional tests, follow-up or treatment that you need.
Your pelvic exam is a good time to talk to your doctor about your sexual or reproductive health. If you have questions, be sure to discuss them during your visit.