A pelvic exam is not required until you are 21 years old and sexually active for the purpose of performing a PAP Smear. A pelvic exam is only required before 21 if you are having any vaginal discharge or problems.
Before the actual exam, a medical and reproductive history will be taken and your weight, height, blood pressure and pulse will be recorded. Other information may be requested depending upon the reason for your visit. This may include information about your family's history of illness; your past illnesses, surgeries, or pregnancies; details of your menstrual cycle; your sexual history and present method of contraception, and your present health status and habits. This information helps us to determine your health care needs.
What Happens During a Pelvic Exam
For the complete physical exam, you will be asked to change into a gown. The nurse practitioner will then examine your thyroid gland, heart, lungs, breasts and abdomen to help identify potential health concerns. At this time, you can learn how to do a breast self-examination.
Then you will be asked to lie down, slide to the end of the examination table and put your heels in the footrests, called stirrups. Feeling tense, anxious or even embarrassed is common at this time. Deep breathing and relaxation techniques can be helpful. Your clinician will first look at your external genitalia for signs of redness or infection and then proceed to examine your internal pelvic organs. To do this, (s)he will separate the walls of the vagina with a speculum. The speculum is a slender metal or plastic instrument that looks like a duckbill. It should not pinch and may be warmed or moistened before being gently inserted into your vagina. Though the pelvic exam may be an awkward experience and you may feel pressure that can be uncomfortable, it should not be painful. If you do experience any pain, inform the clinician.
After the speculum is inserted, the clinician can see your cervix. The cervix is the lower portion of your uterus and can be a site of abnormal cell development. The clinician may do a PAP smear at this point if needed. Additional tests for vaginal or sexually transmitted infections can be taken at this time as well. Then the speculum is removed. After your exam, a small amount of vaginal bleeding or spotting may occur; this is normal. Next, the clinician will place two gloved fingers into your vagina while his or her other hand gently presses on your lower abdomen. This identifies the size, shape, and position of your uterus, fallopian tubes and ovaries. Again, you should feel pressure, but not pain.
Finally, a rectal exam may also be performed. Still wearing a glove, the clinician will insert a finger in the vagina while another well-lubricated finger is gently inserted into the rectum. This is done to determine if there are any masses in the anal canal and also to feel the uterus, cervix, and ovaries. Again, try to relax. If you do not wish to have the rectal exam, please let your clinician know.
That's it! Your pelvic exam is over!