Pelvic Examination

Gynecologic Exam

How It Is Done

During a pelvic exam, you will:

• Take off your clothes below the waist. You will have a paper or cloth covering around your waist. If you are having a yearly exam, you may need to undress completely so your health professional can also do a breast exam.
• Lie on your back on an exam table with your feet raised and supported by stirrups. This allows the health professional to examine your vulva, urethra, vagina, and other reproductive organs. You may want to wear socks to keep your feet warm while they are in the stirrups.
• Have a drape across your body for privacy during the test. The health professional may use a lamp during the test, and you may ask for a mirror if you want to watch while the test is being done.

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 friend.

External exam

During the external exam, the health professional will:

• Check your vulva and the opening of your vagina for signs of redness, irritation, discharge, cysts, genital warts, and other abnormal conditions.
• Check inside your vagina with his or her gloved fingers for any cysts or pus coming from the Bartholin glands.
• Gently insert the speculum into your vagina . The speculum spreads apart the vaginal walls, allowing the inside of the vagina and the cervix to be examined. The speculum may be plastic or metal and may be warmed with water or lubricated with a vaginal lubricant (such as K-Y Jelly).
• Check the walls of your vagina and your cervix for damage, growths, inflammation, unusual discharge, or discoloration.

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 diseases such as gonorrhea or chlamydia.

Bimanual exam

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.

Rectovaginal exam

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.

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Author:	Maria G. Essig, MS, ELS	Last Updated: June 6, 2007
Medical Review:	Patrice Burgess, MD - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology
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