How is a Pelvic Exam Done?

How is a Pelvic Exam Done?

You're not alone if you’re wondering what a pelvic exam involves. It’s a vital part of women’s healthcare that helps doctors check your reproductive organs for any signs of problems. Regardless of the reason—be it a regular checkup, pregnancy or symptoms like unusual bleeding or pain—a pelvic exam is a way for your healthcare provider to verify that all is well.

Understanding what the exam entails can help ease nerves and make the experience more manageable.

What to Expect Before the Exam

Pelvic exams can be nerve-wracking for many women, with up to 64% reporting anxiety or fear surrounding the procedure. This is often due to past trauma, embarrassment or concerns about the speculum tool used during the exam. Before your pelvic exam, a little preparation can make the process smoother and less stressful. Here’s what to expect and how to get ready:

  • Schedule the exam. Try to schedule your exam for a time when you’re not on your period unless your healthcare provider advises otherwise. This can make the exam more comfortable for you and easier for the doctor to perform certain tests, like a Pap smear, without menstrual blood interfering.
  • Pre-exam instructions. Your doctor might give you specific instructions to follow in the hours or days leading up to your exam. Standard advice includes avoiding sexual intercourse, douching or using tampons 24 to 48 hours before your appointment. These activities can affect test results or make the examination more difficult.
  • What to wear and what to bring. Wear comfortable, easy-to-remove clothing on the day of your exam. You’ll be asked to undress from the waist down and given a gown or sheet for coverage, so clothing that’s easy to remove and put on will make the process easier.

If you are visiting a new provider, bring medical records or information regarding your menstrual cycle, past Pap smears or reproductive health. Also, have a list of any medications you’re currently taking, including contraceptives or hormone replacement medications.

  • Discuss your medical history. Be prepared to discuss your medical history with your healthcare provider. This includes details about your menstrual cycle, such as the date of your last period, its duration and regularity and any symptoms you experience during or between cycles, like cramping or spotting. 

You should also be ready to talk about your sexual activity, including any issues or concerns like pain during intercourse and your use of contraceptives. This conversation can help your OB/GYN provide the best care tailored to your needs.

The Pelvic Examination Procedure

First and foremost, your healthcare provider will ensure your privacy and comfort throughout the exam. They will explain each step before proceeding and obtain your consent. Communicating openly with your provider is important, especially if you feel anxious or uncomfortable. This is an excellent opportunity to ask them questions like “How does a speculum work?” or “Why do I experience pelvic pain?”

The exam usually takes place in a private room with an exam table. You’ll find a sheet or gown to cover yourself and the room should have a speculum and gloves, which are essential for the exam. What is a speculum? The speculum is a medical device used to gently open the vaginal walls for internal examination, while the healthcare provider wears gloves to maintain hygiene during the vaginal exam.

The following are procedures your OB/GYN will perform during a full pelvic exam:

  • External examination. You lie on the exam table with your knees bent and feet in supports, covered by a sheet for privacy. The exam begins with a visual inspection of the vulva to check for any abnormalities or signs of infection, such as redness, lesions, swelling, lumps or discharge.
  • Speculum examination. Next, your doctor will lubricate the speculum and gently insert it into the vagina. This allows your healthcare provider to view the vagina and cervix. During this part of the exam, they may collect samples for a Pap test or to test for sexually transmitted infections. 

While you might feel pressure, inserting the speculum shouldn’t be painful. If you experience discomfort or the speculum hurts, let your provider know. Taking deep breaths and using visualizations can help you remain calm and relaxed during the exam. 

  • Bimanual examination. After the vaginal speculum exam, your provider may conduct a bimanual exam. They will insert one or two gloved, lubricated fingers into the vaginal canal while using their other hand to press gently on your abdomen. This allows them to feel the size, shape and position of your uterus and ovaries, checking for abnormalities or discomfort.
  • Rectovaginal exam (optional). In some cases, your doctor may need to perform a rectovaginal exam. This involves the insertion of a gloved, lubricated finger into the rectum while the other hand presses on your abdomen. This exam can help assess the health of your lower abdomen and pelvis, including checking for tumors or other abnormalities behind the uterus, on the lower wall of the vagina or in the rectum.

After your pelvic exam, your healthcare provider will discuss any immediate findings and answer your questions. They’ll also explain how you’ll receive your test results from the Pap smear or STI test (typically between a few days and a few weeks) and the next steps you’ll need to take if abnormalities are found or further testing is necessary. Before you leave, you’ll discuss when to schedule your next exam based on your age, health status and current exam findings. 

Use Nella for a More Comfortable Pelvic Exam

Regular pelvic exams are essential for maintaining overall health and for the early detection of STIs and cervical cancer. However, anxiety about the exam procedure, tools or results can prevent you from visiting your OB/GYN and getting the care you need. 

Nella can help make your pelvic exam more comfortable and less stressful. This disposable speculum is crafted from temperature-neutral plastic instead of stainless steel and it is a small-sized speculum no wider than a standard tampon. Talk to your doctor about switching to Nella or purchase your own Comfort Kit and have it delivered to your provider before your next exam. 

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