Pelvic Exam

Why It Is Done

A pelvic exam may be done:

• To collect samples of cells for cervical cancer screening.
• To check for vaginal infection.
• To check for sexually transmitted infections, such as chlamydia or herpes.
• To help find the cause of abnormal uterine bleeding.
• To look for problems like uterine fibroids, ovarian cysts, or uterine prolapse.
• To help find the cause of pelvic or belly pain.
• Before inserting an intrauterine device (IUD).
• To collect evidence if you've been sexually assaulted.

How To Prepare

If you have any fear about having the test, tell your doctor or nurse.

No other special preparations are needed. For your own comfort, you may want to empty your bladder first.

How It Is Done

• During a pelvic exam, you will:
  • Take off your clothes below the waist. You will get a paper or cloth cover to put over the lower half of your body.
  • Lie on your back on an exam table with your feet and legs supported by footrests.
• The doctor may:
  • Put on gloves and check the opening of your vagina for sores or swelling.
  • Gently put a tool called a speculum into your vagina. It opens the vagina a little bit. You may feel some pressure. The speculum lets your doctor see inside the vagina.
  • Use a small brush, spatula, or swab to get a sample for testing. The doctor then removes the speculum.
  • Put one or two gloved fingers of one hand into your vagina. The other hand goes on your lower belly. This lets your doctor feel your pelvic organs. You will probably feel some pressure.
  • Put one gloved finger into your rectum and one into your vagina, if needed. This can also help check your pelvic organs.

You may have a small amount of vaginal discharge or bleeding after the exam.

How long the test takes

This exam takes about 10 minutes.

How It Feels

You may feel some pressure or mild discomfort when the speculum is placed into your vagina. If a metal speculum is used, the metal may feel cold. The speculum may be warmed with water or lubricated with a vaginal lubricant, such as K-Y Jelly, before being placed.

During the bimanual part of the exam, you may feel some pressure or mild discomfort as the doctor or nurse checks your ovaries.

During the rectovaginal exam, you may feel as though you are about to have a bowel movement as the doctor or nurse withdraws a finger from your rectum. This is normal and lasts only a few seconds.

Risks

There is a small chance that the doctor will find something on a pelvic exam that would not have caused a problem. This is called overdiagnosis. It could lead to tests or treatment you don't need.

Results

Some test results may be ready right away. But results from a culture or a Pap test may take several days or a few weeks.

Normal

• The uterus and ovaries are normal in size and location. The uterus can be moved slightly without causing pain.
• The vulva, vagina, and cervix look normal with no signs of infection, inflammation, or other abnormalities.
• Glands around the opening of your vagina (Bartholin's glands) or urethra (Skene's glands) are not swollen or inflamed.
• No masses (nodules) of abnormal tissue are felt in the area between the uterus and rectum or in the ligaments that attach to the uterus to hold it in place. No fibroids are felt.
• There is no pelvic pain or tenderness.
• No hardening of tissue is felt.

Abnormal

• Sores, signs of infection, inflammation, or abnormalities of the vulva, vagina, or cervix are seen. Signs of a sexually transmitted infection (such as genital herpes, genital warts, or syphilis) may be seen. More tests will be needed to find the cause.
• The glands around the vagina (Bartholin's glands) or urethra (Skene's glands) are swollen or inflamed.
• The uterus cannot be moved (even slightly) during the exam.
• Pain or tenderness is felt when the uterus is moved slightly or when the area between the uterus and rectum is touched. The uterus is pushed away from the midline of the belly.
• The ovaries are enlarged, not movable (fixed), or painful when touched.
• An ovarian mass is found. Or a mass that was found during a previous exam is still there or has grown larger.
• Small masses (nodules) of abnormal tissue are felt. Uterine fibroids are felt.
• Hardening of tissue is felt.
• An area of ulceration or a tear is found.
• A mass can be felt near one or both ovaries.

Many conditions can change the results of your pelvic exam. Your doctor or nurse will talk to you about any significant abnormal results.