A pelvic exam is an examination of a woman's outer and inner genitals for any abnormalities.
Who is a candidate for the procedure?
When a young woman reaches the age of 16, or earlier if she has had or intends to have sexual intercourse, she should have her first pelvic examination. Pelvic exams allow a healthcare professional to check on normal development and screen for certain health problems. These exams should be done regularly throughout a woman's life.
A woman might have a pelvic exam for many reasons, such as to:
- check on pelvic pain or unusual vaginal bleeding
- evaluate a mass
- explore reasons for infertility, which is the inability to get pregnant
- find a cause for vaginal discharge, itching, or burning
- get certain types of birth control or start hormone replacement therapy
- have a Pap smear to screen for cervical cancer
- look for causes of urinary incontinence or sexual dysfunction
- look for signs of sexually transmitted disease (STD)
- see how far along she is in labor
- see if she might be pregnant
How is the procedure performed?
A pelvic exam is usually painless, but may cause mild discomfort. Mild anesthesia or pain medicines may be used in unusual circumstances .Although a pelvic exam is not done routinely before a girl is sexually active, special circumstances such as pain, discharge, bleeding problems or rape may require an exam.
Before the exam starts, the woman lies down on her back on a special table. She may put the heels of her feet into stirrups and open her legs. A cloth or paper drape is usually placed over her abdomen and legs. First, the healthcre professional checks the normal anatomy of the outer genitals, which include:
- the clitoris and vaginal opening
- the hymen, a thin layer of tissue that partly closes the vaginal opening
- the labia, which are the skin folds surrounding the vaginal opening
- the urethra, which is the tube that carries urine from the bladder to the outside of the body
Any moles, ulcers, warts, cysts, discharge, cuts, or reddening are recorded.
An internal exam is done next. First, the examiner inserts a tool called a speculum into the vagina. It looks like a long duck bill. The speculum helps hold the vaginal walls apart. The examiner can then look at the vagina and cervix, or the opening to the uterus. Cultures of any discharge may be taken. A Pap smear may be done to screen for precancerous changes in cervical cells.
After the internal exam is done, the speculum is removed. The examiner then places one or two fingers into the vagina. Putting the other hand on the woman's lower belly, the provider gently presses against various pelvic organs. This gives information about the uterus, tubes and ovaries or anything abnormal in the pelvis. The examiner may then insert one finger in the vagina and one into the rectum to feel better behind the uterus.
The examiner will note any tenderness or abnormalities. If a woman is thought to be in labor, her healthcare professional can check how far her cervix has opened.