Talking about pelvic exams can bring up a mix of emotions and questions, whether it’s your first time hearing about them or you’re scheduling your next appointment. Essentially, a pelvic exam is a physical examination of the female reproductive organs.
Surprisingly, despite its importance in preventative health care, a study found that only about 56.5% to 63.5% of women aged 21-44 have had a pelvic exam in the past year. Understanding what is done during a pelvic exam, why they’re necessary and what to expect can make the experience feel less daunting and help you take charge of your health.
What is a Pelvic Exam?
A pelvic exam evaluates the health of the female pelvic organs. This includes the uterus, cervix, ovaries, fallopian tubes and vaginal canal. The exam is vital for reproductive health care, identifying issues such as sexually transmitted infections (STIs), irregularities with the menstrual cycle and early signs of cervical, uterine and ovarian cancer.
It is also important for family planning and diagnosing reproductive system problems, such as ovarian cysts or fibroids. Typically, the exam includes three main steps: the external visual exam, the speculum exam and the bimanual exam.
- External visual exam. Your healthcare provider examines the outside of your vulva and vagina for any abnormalities such as irritation, redness, sores or swelling.
- Speculum exam. Next, a device called a speculum is gently inserted into the vagina. The speculum is carefully opened to allow the doctor to see the vagina and cervix. This part of the exam can feel a bit uncomfortable for some, but a speculum tool is critical for collecting a sample of cells from the cervix for Pap tests, which screen for cervical cancer and for examining the cervix and vaginal walls for any issues.
- Bimanual exam. Finally, the healthcare provider will insert one or two lubricated, gloved fingers into your vagina while the other hand gently palpates the abdomen from the outside. This allows them to assess the size, shape and position of the uterus and ovaries and determine if there are any abnormal growths or signs of discomfort.
The Importance of Routine Pelvic Exams
Regular pelvic exams allow healthcare providers to detect potential issues early, often before they present any symptoms, making them invaluable for preventive healthcare. Other reasons why regular pelvic exams are so important include:
- Early detection of cancer. Through routine Pap smears, which are part of the pelvic exam, your doctor can identify precancerous changes in the cervix and treat them before they develop into cancer. Early detection increases the chances of successful treatment and survival.
- Identifying infections and conditions. Pelvic exams also help identify yeast infections, bacterial vaginosis and STIs like chlamydia and gonorrhea. Early treatment of these infections can prevent more serious health issues, including infertility and pelvic inflammatory disease (PID). Additionally, conditions like endometriosis and ovarian cysts can be detected through pelvic exams, allowing for earlier management and treatment.
- Family planning and fertility. If you are considering starting a family, pelvic exams can help your OB/GYN assess factors affecting your fertility and pregnancy. These exams can uncover potential obstacles to conception, such as structural abnormalities or ovarian issues and help you make decisions on appropriate fertility treatments or interventions.
- Menstrual disorders. Regular pelvic exams can help diagnose and treat menstrual disorders, including irregular periods, heavy bleeding or painful menstruation. Identifying the underlying causes of these symptoms, which could range from hormonal imbalances to uterine fibroids, is essential for effective treatment and relief.
- Educational opportunity. Healthcare providers can offer valuable advice on contraception, HPV vaccination and safe sex practices during these visits. You can also ask your doctor about the pelvic exam itself to help you feel more at ease, such as how a speculum works.
Who Needs a Pelvic Exam?
The American College of Obstetricians and Gynecologists (ACOG) recommends that all women start getting pelvic exams at the age of 21 or once they are sexually active. Healthy women should visit their OB/GYN annually for a well-woman check and undergo a pelvic exam with a Pap smear and/or HPV test every three years.
However, there are other circumstances where you may need to attend more frequent OB/GYN appointments for a pelvic exam, including:
- You have symptoms of a medical condition. If you experience symptoms such as unusual vaginal discharge, irregular or heavy menstrual cycles, pelvic pain or symptoms suggestive of a sexually transmitted infection (STI) or urinary tract infection (UTI), you may need a pelvic exam to diagnose the issue. This includes girls or women under the age of 21 or menopausal women.
- You need contraception. If you want to start birth control that requires a physical examination like an intrauterine device (IUD), you may need a pelvic exam as part of your consultation and treatment plan.
- You’re post-menopausal. Women who have gone through menopause still need pelvic exams. The focus might shift to screening for gynecological cancers, assessing pelvic organ prolapse and addressing post-menopausal symptoms like dryness or pain during intercourse.
- You have a history of gynecological issues or cancer. Women with a history of gynecological problems or cancers may require more frequent exams to monitor their condition and manage any ongoing treatments or preventative measures.
- You’re pregnant. While not a traditional pelvic exam, pregnant women undergo similar examinations to monitor the health of the pregnancy and detect any issues early.
Make Your Pelvic Exam Experience More Comfortable
Many women are anxious about attending regular pelvic exams because they are worried they’ll feel pain when the doctor inserts the speculum to inspect the walls of the vagina. In addition to relaxing your muscles, you can ask your doctor about using a different speculum for the procedure.
For a more comfortable exam, you need the Nella disposable speculum. The Nella vaginal speculum is made from a smooth plastic that won’t feel cold on your skin. It’s as slim as a standard tampon and its operation is so silent that you’ll barely notice your doctor using it.
If you need to book a pelvic exam, talk to your doctor about using Nella or have your own Comfort Kit delivered to your doctor’s practice before you visit.