A pelvic examination is a complete physical exam of a woman's
pelvic organs by a health professional. A pelvic exam helps a health
professional evaluate the size and position of the
ovaries. A pelvic exam may be done to help detect certain cancers
in their early stages, infections,
sexually transmitted infections (STIs), or other
reproductive system problems.
pelvic exam may be done:
Before a pelvic exam:
At the beginning of your visit, tell your health
If you have had problems with pelvic exams in the past or
have experienced rape or sexual abuse, talk to your health professional about
your concerns or fears before the exam.
No other special
preparations are needed before having a pelvic exam. For your own comfort, you
may want to empty your bladder before the exam.
Talk to your
health professional about any concerns you have regarding the need for the
test, its risks, how it will be done, or what the results may mean. To help you
understand the importance of this test, fill out the
medical test information form(What is a PDF document?).
During a pelvic exam, you will:
A female nurse or assistant may stay in the room with you
during the exam. You may also request the presence of your partner or a
During the external exam, the health
If you are due for a Pap test, your health professional
will use a small brush or a wooden spatula to gently collect a sample of
cervical cells. You may have some staining or bleeding after the sample is
taken. A sample of the cervical mucus may also be obtained with a cotton swab
and tested for sexually transmitted infections such as gonorrhea or chlamydia.
This exam is usually done as part of
a pelvic exam. Your health professional will insert one or two gloved fingers
of one hand into your vagina while placing the other hand on your lower
abdomen. By pressing down on the abdomen and moving the fingers around inside
your vagina, your health professional can locate and determine the size, shape,
and consistency of the uterus and ovaries. Any unusual growths, tenderness, or
pain can also be identified.
For this exam, your health
professional will insert one finger into your
rectum and one into your vagina. This helps your
health professional evaluate your ovaries and uterus ligaments. This exam is
not always done as part of a pelvic exam.
The entire pelvic exam takes about 10 minutes. After
the exam is finished, you will be given a washcloth or tissue to wipe your
vaginal area to remove any discharge resulting from the exam, and you will then
dress. Some test results may be available immediately, but results from the Pap
test may take from several days to a couple of weeks.
A pelvic exam is more comfortable if you
and the health professional are relaxed during the procedure. Breathing deeply
and having a light conversation with your health professional may help you
relax. Try not to hold your breath or tense your muscles.
feel some pressure or mild discomfort when the
speculum is inserted into your vagina. Try to relax
your legs and hips as much as you can. You may experience pain or irritation,
especially if you have a vaginal infection. If a metal speculum is used, the
metal may feel cold and hard. The speculum may be warmed with water or
lubricated with a vaginal lubricant, such as K-Y Jelly, before being inserted
into the vagina.
bimanual part of the exam, you may feel an
uncomfortable sensation of pressure or a slight twinge of pain as the health
professional feels your ovaries; breathing deeply may help you relax. You may
feel a brief pinch when the Pap test is taken. Tell your health professional if
any part of the exam is painful.
During the rectovaginal exam,
you may feel as though you are about to have a bowel movement as the health
professional withdraws a finger from your rectum. This is a normal sensation
that lasts only a few seconds. You may have a small amount of vaginal discharge
or bleeding after the exam.
There are no risks linked with a pelvic
A pelvic examination is a complete
physical exam of a woman's pelvic organs by a health professional. A pelvic
exam helps a health professional evaluate the size and position of the
The uterus and ovaries are normal in size
and location. The uterus can be moved slightly without causing pain.
The vulva, vagina, and cervix appear 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 (cul-de-sac) or in the strong
bands of tissue (ligaments) that attach to the uterus to hold it in place. No
fibroids are felt during the bimanual pelvic or rectal exams.
No pelvic pain or tenderness is present.
No hardening of tissue is felt.
Sores, signs of infection, inflammation, or
abnormalities of the vulva, vagina, or cervix are present. Signs of a sexually
transmitted infection (such as genital herpes, genital warts, or syphilis) may be
present. Additional testing will be required to determine the
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 (cul-de-sac)
is touched. The uterus is pushed away from the midline of the abdomen.
The ovaries are enlarged, not movable
(fixed), or painful when touched.
An ovarian mass is present or a mass that
was detected during a previous gynecologic exam is still present or has grown
Small masses (nodules) of abnormal tissue
are felt near the uterus or in the cul-de-sac. Uterine fibroids are felt during
the bimanual pelvic or rectal exam.
Hardening of tissue (induration) is felt.
An area of ulceration or a tear is found.
A mass can be felt near one or both
Many conditions can change the results
of your pelvic exam. Your health professional will discuss any significant
abnormal results with you in relation to your symptoms and past health.
Reasons you may not be able to
have the test or why the results may not be helpful include:
Other Works ConsultedChernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.
May 18, 2011
Sarah Marshall, MD - Family Medicine & Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
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