Your First Pelvic Exam: What To Expect
Pelvic exams are an important part of maintaining a woman’s health. But many of us feel nervous about getting a pelvic exam — especially the first one — because of the exam’s focus on our sexual and reproductive organs.
Whether you’re nervous or just curious about what to expect in your first pelvic exam, the information on this page may be helpful.
What is a pelvic exam?
A pelvic exam is an examination of your pelvic area, including your vulva and your internal reproductive organs — your cervix, ovaries, fallopian tubes, uterus and vagina. During a pelvic exam, your doctor or nurse looks for signs of infection and other conditions. The exam may include taking a few cells from your cervix for a Pap test; this can help protect you from cervical cancer.
Pelvic exams are generally part of a woman’s periodic gynecological visit, also known as a gyn exam. As part of a gyn exam, your healthcare provider may:
• take your medical history
• conduct a general physical exam
• test for sexually transmitted infections
• conduct a breast exam
• perform vaccinations
• discuss with you any issues that come up during your visit
When should I have my first pelvic exam?
Unless there is a medical concern, you should have your first pelvic exam when you turn 21. (Medical concerns can include vaginal bleeding or discharge; pain, swelling or tenderness of the vulva or vagina; increased vaginal pain, itching or discomfort, and sores or lumps on the vulva or vagina.)
However, girls should begin having regular gyn visit between the ages of 13 and 15. Most often, these early visits do not include a pelvic exam.
During gyn exams you can ask questions and talk with your healthcare provider about the changes taking place in your body and any concerns you have. Regular gyn exams can help make sure that you’re healthy and that your body is developing as it should.
How often should I have a pelvic exam?
How often you will need a pelvic exam or a gyn exam will depend on your medical history and your personal health needs. This is something you’ll discuss with your healthcare provider.
You may need more frequent pelvic exams if you have:
• a history of sexual health problems
• a history of abnormal Pap test results or a family history of certain kinds of cancer
• a sexually transmitted infection or a sex partner with an infection
• recurring vaginitis
In some cases, a pelvic exam is needed in order for you to be prescribed hormonal birth control such as the pill, the patch, the ring, or the shot. A pelvic exam is always needed for inserting a birth control device such as an IUD or determining the correct size for a diaphragm.
What happens during a pelvic exam?
During a pelvic exam, your healthcare provider will ask you to undress and put on a paper or cloth gown. Next, you will be asked to lie face-up on the exam table and put your feet on footrests at the end of the table. You can cover your lower abdomen and thighs with a sheet to feel less exposed. Relax as much as you can: pelvic exams are generally more comfortable and thorough if your buttocks, stomach and vaginal muscles are relaxed.
Pelvic exams may consist of four parts:
1. The external exam
Your healthcare provider will look at the folds of your vulva and the opening of your vagina. This part of the exam checks for signs of discharge, warts, irritations and other conditions.
2. The speculum exam
During this part of the exam, your healthcare provider will gently insert a lubricated medical instrument called a speculum into your vagina. The speculum separates the walls of the vagina when it opens. This may feel uncomfortable but should not be painful. Your healthcare provider will then use a small brush or a tiny spatula to take a small sample of cells from your cervix. This sample will be given a Pap test to see if there is any pre-cancer or cancer in your cervix. To test for sexually transmitted disease or infection, your healthcare provider can also use a cotton swab to collect discharge from your cervix. Be sure to speak up if you think you may be at risk of having a sexually transmitted infection.
3. The bimanual exam
In this part of the exam, your healthcare provider will insert one or two gloved and lubricated fingers into your vagina while gently pressing on your lower abdomen with the other hand. By checking on the size, shape and position of the uterus, as well as looking for any tenderness or pain, you can be checked for a variety of conditions ranging from pregnancy, fibroids and infections.
4. The rectovaginal exam
To check for tumors or other irregularities behind the uterus, on the lower wall of the vagina, or in the rectum, your healthcare provider may put a gloved finger into your rectum. You may feel like you need to have a bowel movement during this part of the exam. This is normal and only lasts a few seconds.