Pelvic Exams: All Questions Answered

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What Is A Pelvic Exam?

A pelvic exam is a medical checkup of the female reproductive organs. Regular pelvic exams are an important part of women’s health screening, and play a major role in early diagnosis and treatment of many gynecological diseases, including cancer.

What Does The Doctor Do In A Pelvic Exam?

Pelvic exams are usually performed by a trained gynecologist. They include four main components:

  • External Visual Examination

In the external visual examination, the doctor inspects the external genitalia for any abnormalities, like redness, soreness or swelling.

  • Internal Visual Examination

The internal visual examination is performed with a “speculum” which is a plastic/metal instrument shaped like a duck’s beak. The speculum is inserted into the vagina so that the walls of the vagina and cervix can be examined for any abnormality.

  • Pap Smear

During the internal visual examination, while the speculum is inserted, the doctor will scrape off some cells of the cervical wall for cytological examination. This is called a Pap smear, which is named Pap after the Papanicolaou stain used to view the cells under the microscope.

  •  Physical Examination

As the uterus and ovaries are deep within the abdomen, they are assessed through “bimanual examination” in which two lubricated, gloved fingers are inserted into the vagina, while the other hand presses down on the abdomen.

This method helps the doctor feel the uterus and ovaries, thereby identifying any extra tenderness or abnormalities in size or shape.

In some cases, gynecologists also perform a rectal examination, as part of the physical examination to ensure there is no swelling, lesions or abnormal tenderness in the rectum and anal canal.

When Should I Get A Pelvic Exam?

American College of Gynecologists recommends that all women 21 years or older should get annual pelvic exams as part of their wellness checkup or Health screening programs.

Pelvic exams should also be performed if there are any signs or symptoms of diseases, such as excessive vaginal bleeding, discharge or lower abdominal pain.

Does A Pelvic Exam Hurt?

Pelvic exams are not painful but may cause slight discomfort, possibly during insertion of the speculum. In general, pelvic exams take less than 10 minutes to perform and the ease of the procedure depends on the skills of the doctor.

When Do I Get The Results Of A Pelvic Exam?

The visual and physical examination findings are noted during the procedure and can be discussed with the patient at the same time, depending on clinical judgment.

The Pap smear or cytological examination takes 3-5 days to finalize as the cells are sent to the laboratory for further processing onto a glass slide, which is then viewed by a cytologist before signing off the report.

Are Regular Pelvic Exams Important?

All the female reproductive organs are assessed during the pelvic exam. This way many different diseases can be identified early, before the onset of symptoms.

Cancers of the vulva, uterus, cervix, fallopian tubes, ovaries and bladder can be detected in their early stages through pelvic exams. Pap smears are especially important for the diagnosis of cervical cancer.

Pelvic exams are also instrumental in the diagnosis of sexually transmitted infections, such as chlamydia or trichomonas.

Apart from the physical examination, this is also a good time for the doctor to answer any questions the patient has regarding her menstrual cycle or sexual health.

How Should I Schedule A Pelvic Exam?

Pelvic exams are commonly performed by gynecologists and can be scheduled after clinical consultation.

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