What to Expect During a Routine Pelvic Exam at the OB/GYN

A pelvic exam is a standard diagnostic evaluation typically performed by obstetricians and gynecologists as a way to diagnose illnesses in a woman's body. Typically, the exam is used to look at the: “vulva, uterus, cervix, fallopian tubes, ovaries, bladder and rectum”(Cassoobhoy, 2020). These exams are usually performed during a yearly gynecological physical exam, when the patient is pregnant or the doctor is looking for any vaginal infections. Pap smears are generally included in this examination therefore it is recommended that patients should schedule their exam when they are not on their menstrual cycle. Other recommendations include avoiding tampon use, sexual activity, topical birth control and other vaginal treatments for 48 hours prior to the appointment.

Patients may be nervous about getting a pelvic exam, especially when it may be their first time. However, this exam is not meant to be painful and should not take more than 10 minutes. Slight discomfort may be expected, but any concerns should be discussed with the performing physician.

During these exams, patients can expect to:

• Be asked to take off clothing and put on a patient gown

• Discuss health concerns

• Be asked to lay on their back on an examination table

• The physician may palpate the patient’s stomach

• Get into position for a speculum exam and place their feet into stirrups (holders to elevate the patient’s feet)

• The speculum exam may be performed which involves inserting a speculum into the patient’s vagina to open the vaginal canal. This allows the physician to visualize both the cervix and vagina to note any abnormalities or concerning changes.

• A pap smear may be performed which includes obtaining a cell culture sample from the patient’s cervix. Fluid may be taken from the patient’s vagina to evaluate for any infections.

• The speculum will then likely be removed.

• A bimanual exam may be performed which may be uncomfortable for some patients. The physician will place both of their fingers inside the patient’s vagina and gently palpate the area that they are feeling, observing any changes.

• A rectal exam may be performed.

• Once the entire exam is completed, the physician will likely discuss their findings with the patient and any tests may need to be ordered.

Pelvic exams are typically recommended with the same frequency as a pap smear. The U.S Preventive Services Task Force recommends that women over the age of 21 should have an exam at least every 3 years. Contact your physician to discuss any pending overdue exams! They are the best form of prevention!

The Breast and Cervical Cancer Early Detection Program provides no-cost breast and cervical cancer screening exams such as mammograms, pap smears, pelvic exams, and clinical breast exams to women between 50-64 years of age, those who are uninsured, or are low income.

References:

Cassoobhoy, A. (2020, August 17). Pelvic examination for women: Purpose & procedure explained. WebMD. Retrieved August 2, 2022, from https://www.webmd.com/women/guide/pelvic-examination