What is a pelvic exam?
A pelvic exam (or internal exam) is a test done by a health-care provider to examine your vulva, vagina and cervix for any abnormalities. Sometimes it also involves taking a sample from the vagina or cervix to test for sexually transmitted infections (STIs) or for changes that can lead to cervical cancer.
Why do I need a pelvic exam?
There are several reasons you may need a pelvic exam. Pelvic exams are done to:
- Check that your internal reproductive organs are healthy and inspect your vulva and vagina for any abnormalities
- Test for STIs – this is suggested every year and every new partner
- Take a Pap test to check for early signs of cervical cancer – Paps should start at age 25 and only if you are sexually active
- Diagnose a medical condition if you’re experiencing pelvic pain, or unusual bleeding or discharge
You should have a pelvic exam once you turn 25, and then every 3 years after that if you are sexually active. You may have a pelvic exam before you turn 25 if you are sexually active or if you have any specific concerns.
What happens during a pelvic exam?
First, your health-care provider will ask you questions about your health and sexual activity.
A pelvic exam only takes a few minutes. It’s normal to feel nervous or shy, especially before your first pelvic exam. Remember, if you feel unsafe or uncomfortable, tell your health-care provider to stop. You may also choose to wait to do a pelvic exam at a future visit if you are feeling nervous or uncomfortable.
You will be asked to undress from the waist down and will be given a sheet to place over your lap for privacy. Then, you will lie down on your back on an exam table, with your knees bent and your feet placed in footrests. You will need to slide your body toward the end of the table and have your knees fall open to the sides.
This may feel uncomfortable, especially the first time. It’s important to listen to your provider’s instructions on how to position yourself in order to make the exam more comfortable. Don’t be afraid to ask your health-care provider about any questions or concerns you have!
External visual exam
The health-care provider will look at your vulva and surrounding area to check for redness, irritation, sores and any other abnormalities.
Internal visual exam
The health-care provider will then gently insert a metal or plastic tool called a speculum into your vagina. This is done to open the vaginal walls so they can see your vagina and cervix.
Pap test and STI testing
If your physical exam includes a Pap test (Pap smear), the health-care provider will swab your cervix with a small broom to collect cells. These cells are then tested for signs of cervical cancer. Swabs of the vagina or cervix may also be performed to test for STIs such as gonorrhea and chlamydia.
Bimanual or physical exam
Your health-care provider may need to do a bimanual exam to check the size, shape and position of your internal reproductive organs including the ovaries, fallopian tubes and uterus. They will insert two gloved fingers into your vagina and press on the outside of your lower abdomen (belly) with the other hand. They will check for any tenderness or abnormal growths. To see an illustration of what this exam looks like, click the image on the right.
