Pelvic Exam: A Caring Doc Explains What to Expect

By Dr. Priya Sammani ( MBBS, DFM )

Alright, let’s chat about something that I know can make some folks a little uneasy: the pelvic exam. I see it in my practice – that slight hesitation when it’s mentioned. Maybe you’ve had many, or perhaps you’re wondering about your very first one. My goal today is to walk you through it, just like I would if you were sitting here in my clinic, so you feel more informed and, hopefully, a bit more at ease. A pelvic exam is simply a way for us doctors to check on the health of your reproductive organs. Think of it as a specific physical for that part of your body.

It’s a quick and safe way for us to make sure everything looks and feels okay, and to catch any early signs of problems.

What Exactly is a Pelvic Exam?

When we say “pelvic,” we’re talking about the organs nestled in your pelvis. During a pelvic exam, we’re gently checking on your:

  • Vulva (the outer genital area)
  • Vagina
  • Cervix (the lower, narrow part of the uterus that opens into the vagina)
  • Uterus (or womb)
  • Fallopian tubes (which carry eggs from the ovaries to the uterus)
  • Ovaries (where your eggs are stored)
  • And sometimes, the bladder.

Now, a common question I get is: “Is a pelvic exam the same as a Pap smear?” Not exactly, but they often happen at the same appointment. The pelvic exam is the overall physical check-up of these organs. A Pap smear (or Pap test) is a specific test where we collect a small sample of cells from your cervix to screen for cervical cancer or precancerous changes. So, we might do a Pap test during your pelvic exam.

Healthcare providers, like your family doctor (that’s me!), gynecologists (specialists in female reproductive health), or nurse practitioners, can perform pelvic exams.

Why Might You Need a Pelvic Exam?

Think of a pelvic exam as part of your routine health maintenance. It’s also a key tool if you’re experiencing certain symptoms. We generally recommend your first one around age 21, and then the frequency depends on your age, health history, and any symptoms.

We might also suggest a pelvic exam if:

  • You have symptoms like pelvic pain, unusual vaginal discharge, or vaginal bleeding that’s not your period.
  • You’re experiencing pain during sex.
  • There’s a family history of certain cancers, like ovarian or cervical cancer.
  • You have a history of HPV (human papillomavirus) or have had abnormal Pap test results.
  • We need to check for things like uterine fibroids (non-cancerous growths in the uterus) or ovarian cysts.
  • You have concerns about sexually transmitted infections (STIs).
  • You’re pregnant – it’s a standard part of early prenatal care.
  • We’re checking the fit or placement of an intrauterine device (IUD) for birth control.

Who typically gets a pelvic exam?

Generally, if you have female reproductive organs and are between 21 and 65, a pelvic exam is part of your recommended care. Sometimes, we might advise one before age 21 if there are specific concerns. Even if you’ve transitioned but still have these organs, regular checks are important for detecting issues like STIs or cancer.

How often is it needed?

This is a great question, and it really varies. Some of us recommend them annually, while others might say every few years, especially if your Pap tests are normal and you have no symptoms. It’s always best to chat with your doctor about what schedule is right for you.

Getting Ready for Your Pelvic Exam

Good news! There’s not much special prep needed.

  • You might be asked to empty your bladder before the exam. Sometimes we’ll ask for a urine sample, so you’d do that first.
  • If you happen to be on your period, give our office a call. Sometimes we might suggest rescheduling, mainly for your comfort, but it’s not always necessary.
  • It’s usually a good idea to avoid putting anything in your vagina (like intercourse, douches, creams, or tampons) for about 24 hours before the exam, as these can sometimes interfere with test results or make the exam less comfortable.

Your first pelvic exam?

Feeling a bit nervous is completely normal! The unknown can be a little scary.

My best advice?

  1. Make sure you’re seeing a healthcare provider you trust and feel comfortable talking to. When you book, you can let them know it’s your first time. You can also request a female provider if that makes you more comfortable. It’s your choice.
  2. When you arrive, remind the doctor or nurse it’s your first pelvic exam. Most of us will take extra care to explain everything step-by-step.

What Happens During the Pelvic Exam?

Okay, so you’re in the exam room. We’ll start by chatting – asking about your health history, any symptoms, or concerns you have. This visit is more than just the physical exam; it’s your time to ask questions about your body and sexual health.

Then, we’ll give you a gown and a sheet and step out so you can undress in private. You’ll lie back on the exam table, usually with your feet in supports called stirrups. This position helps us see clearly. The whole exam is usually pretty quick, often just about 10 minutes.

Here’s what a pelvic exam typically involves:

  1. External Exam: We’ll first look at your vulva (the outside area) for any signs of irritation, sores, unusual discharge, or other issues.
  2. Speculum Exam: This is where we use an instrument called a speculum. It’s usually made of metal or plastic and looks a bit like a duck’s bill. We gently insert it into your vagina. The speculum helps to hold the vaginal walls open slightly so we can get a clear view of your vagina and cervix. You might feel some pressure, but it shouldn’t be painful. If it is, please tell us! We can often adjust it. If you’re due for a Pap test or an HPV test, we’ll collect a small sample of cells from your cervix with a tiny brush or spatula while the speculum is in place.
  3. Manual Exam (Bimanual Exam): After removing the speculum, we’ll insert one or two gloved, lubricated fingers into your vagina. With our other hand, we’ll gently press on your lower abdomen from the outside. This helps us feel the size, shape, and position of your uterus and ovaries, and check for any tenderness, lumps, or cysts. Again, you might feel pressure, but let us know if there’s any pain.
  4. Rectovaginal Exam (sometimes): Occasionally, especially if there are specific concerns, we might also do a rectovaginal exam. This involves inserting one gloved finger into your rectum while another is in your vagina. This helps us feel the tissues behind your uterus and along the back wall of your vagina. This isn’t always done.

Throughout the exam, we’ll tell you what we’re doing. You can always ask for a chaperone (like a nurse) to be in the room, or have a friend or family member with you if that helps you feel more comfortable. And remember, you can ask us to stop at any point.

What can a pelvic exam help find?

This exam is a valuable tool for checking your overall reproductive health. It can help detect:

  • Early signs of cervical cancer (if a Pap test is done) or other cancers like ovarian cancer.
  • Sexually transmitted infections (STIs), like chlamydia or gonorrhea, or visual signs of infections like warts.
  • Pelvic inflammatory disease (PID), an infection of the reproductive organs.
  • The cause of symptoms like pelvic pain or abnormal bleeding.
  • Conditions like uterine fibroids or ovarian cysts.

Feeling anxious? How to relax.

It’s so common to feel a bit tense. Try these little things:

  • Take slow, deep breaths. Really focus on your breathing.
  • Try to consciously relax your shoulders, stomach, and leg muscles. Let them go limp.
  • Ask us to explain what we’re doing, step by step.
  • If you’ve experienced sexual trauma, please let us know beforehand. We want to be extra sensitive and supportive and make the exam as comfortable as possible for you. You are in control.

What about after the pelvic exam?

You might have a tiny bit of spotting (light bleeding) or mild cramping afterward, especially if a Pap test was done. This usually stops within a few hours. If you have heavy bleeding or significant pain, please call us.

Understanding Your Results

We can often tell you some things right away during the exam – for instance, if we see any irritation or an obvious issue. If we find anything unusual, we’ll discuss what it might mean and any next steps.

Results from a Pap test or HPV test usually take a few days to a week to come back. Our office will let you know how you’ll get those results.

The main benefits? Early detection of problems like infections or cancer when they’re most treatable, finding reasons for uncomfortable symptoms, and honestly, peace of mind about your health. And thankfully, pelvic exams are very safe. There aren’t really any medical risks involved.

A Few More Common Questions

  • Will I bleed after a pelvic exam? A little spotting is normal, especially if you had a Pap. Heavy bleeding isn’t, so call us if that happens.
  • Do I need a pelvic exam if I’m pregnant? Yes, usually at your first prenatal visit. We’ll also do a Pap if you’re due for one.
  • What about after menopause? Do I still need them? Yes, it’s often still recommended. The risk of some cancers can increase with age, so regular checks remain important. We’ll talk about how often you’ll need them as you get older.

Take-Home Message: Your Pelvic Exam

Here’s a quick rundown of what to remember about a pelvic exam:

  • It’s a routine check-up for your reproductive organs (vulva, vagina, cervix, uterus, ovaries).
  • It helps us detect infections, cancers, and other conditions early.
  • A Pap smear (to check for cervical cancer) can be done during a pelvic exam, but they aren’t the same thing.
  • It usually takes about 10 minutes. You might feel pressure, but it shouldn’t be painful. Always speak up if you’re uncomfortable.
  • You don’t need to do much to prepare, but avoid douching or intercourse for 24 hours beforehand if possible.
  • Talk to your doctor about how often you need one – it varies based on your age and health.
  • It’s okay to feel nervous! We’re here to make it as comfortable as possible.

You’re taking a really positive step for your health by getting regular check-ups. We’re on your team.

Dr. Priya Sammani
Medically Reviewed by
MBBS, Postgraduate Diploma in Family Medicine
Dr. Priya Sammani is the founder of Priya.Health and Nirogi Lanka. She is dedicated to preventive medicine, chronic disease management, and making reliable health information accessible for everyone.
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