Why It Is Done
Experts differ on how often a pelvic exam is needed. Talk to your doctor about when to have this test.
pelvic exam may be done:
- As part of a woman’s regular physical checkup. The exam may include a
Pap test. To learn more, see the topic
- To find vaginal infections, such as
yeast infections or
- To help find sexually transmitted infections, such as
human papillomavirus (HPV).
- To help find the cause of abnormal uterine bleeding.
- To look for problems like uterine fibroids,
ovarian cysts, or
- To find the cause of pain.
- Before prescribing a method of birth control.
Some methods, such as a diaphragm or
intrauterine device, require an exam to make
sure the device fits well.
- To collect evidence in cases of suspected sexual assault.
How To Prepare
Try to schedule the exam when you are not
having your period. The blood can affect Pap test results. But the exam can be done during your period if you have a new vaginal discharge or new or increasing pain in that area.
Before the exam:
use douches, tampons, vaginal medicines, or vaginal sprays or powders for at
least 24 hours.
- If you have abnormal vaginal discharge, don’t have sex for 24 hours before the exam.
At the start of your visit, tell your doctor or nurse:
- The first day of
your last menstrual period and how long your period lasted.
- If this is your first pelvic exam.
- If you are using a method of birth control.
- If you are or might be pregnant.
- If you have pelvic-area symptoms such as itching, redness,
sores, swelling, or an unusual odor or increased vaginal discharge. If you have
been performing regular vaginal self-exams, discuss with the doctor or nurse any changes you have
noticed. To learn more, see the topic
- If you
have had surgery or other procedures, such as
radiation therapy, involving the vagina, cervix, or
If you have had problems with pelvic exams or using tampons before or
have experienced rape or sexual abuse, talk to your doctor or nurse about
your concerns or fears before the exam.
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
have a paper or cloth covering around your waist. If it is your yearly
exam, you may need to undress completely so your doctor or nurse can also
check your breasts.
- Lie on your back on an exam table with your feet
raised and supported by stirrups. This allows the doctor or nurse to
look at your
urethra, vagina, and other reproductive organs.
- Have a drape across your body for privacy during the
test. The doctor or nurse may use a lamp during the test.
You can 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
A pelvic exam can involve three steps: the external exam, bimanual (two-handed) exam, and rectovaginal exam.
During the external exam, the doctor or nurse will:
- Check your vulva and the opening of your
vagina for signs of redness, irritation, discharge,
genital warts, and other abnormal conditions.
- Check inside your vagina with gloved fingers for any
cysts or pus coming from the
- Gently insert the
speculum into your vagina. The speculum spreads apart the vaginal walls. This lets the doctor or nurse see the inside of the vagina and the cervix. The speculum may be
plastic or metal. It 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
If you are due for a Pap test, the doctor or nurse
will use a small brush or a wooden spatula to gently collect a sample of
cells from your cervix. You may have some staining or bleeding after the sample is
taken. A sample of the cervical mucus may also be collected with a cotton swab. The mucus may be tested for sexually transmitted infections such as gonorrhea or chlamydia.
Your doctor or nurse will insert one or two gloved fingers
of one hand into your vagina while placing the other hand on your lower
belly. By pressing down on your belly and moving the fingers around inside
your vagina, the doctor or nurse can find and feel the size, shape,
and texture of the uterus and ovaries. Any unusual growths, tenderness, or
pain can also be identified.
Your doctor or nurse will insert one finger into your
rectum and one into your vagina. This helps the doctor or nurse evaluate your ovaries and uterus ligaments. This exam is
not always done as part of a pelvic exam.
the exam is finished, you will be given a washcloth or tissue to wipe your
vaginal area to remove any discharge from the exam. Then you will get dressed. Some test results may be available right away. But getting results from the Pap
test may take several days to a couple of weeks.
How It Feels
A pelvic exam is more comfortable if you are relaxed. Breathing deeply
and having a light conversation with the doctor or nurse 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 feel 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.
bimanual part of the exam, you may feel an
uncomfortable sensation of pressure or a slight twinge of pain as the doctor or nurse feels your ovaries. Breathing deeply may help you relax. You may
feel a brief pinch when the Pap test is taken. Tell your doctor or nurse 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 doctor or nurse 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
The uterus and ovaries are normal in size
The vulva, vagina, and cervix look normal
Glands around the opening of your vagina
No masses (nodules) of abnormal tissue are
There is no pelvic pain or tenderness.
No hardening of tissue is felt.
Sores, signs of infection, inflammation, or
The glands around the vagina (Bartholin’s
The uterus cannot be moved (even slightly)
Pain or tenderness is felt when the uterus
The ovaries are enlarged, not movable
An ovarian mass is found. Or a mass that
Small masses (nodules) of abnormal tissue
Hardening of tissue 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 doctor or nurse will talk to you about any significant
What Affects the Test
You may not be able to have the test, or the results may not be helpful, if:
- You are having your period.
- You have a vaginal
- You used a douche or vaginal cream or preparation within 24
hours of the exam.
What To Think About
A pelvic exam is usually not needed to get a prescription for hormonal birth control.
A pelvic exam is not always done to check for sexually transmitted infections (STIs). It depends on your symptoms.
Tests used to check for STIs include:
Pelvic ultrasound is another test used to check a woman’s
pelvic organs. To learn more, see the topic Pelvic Ultrasound.
Vaginal self-exam may help you better understand your body,
know what is normal for you, and find early signs of infections or other
abnormal conditions that might require medical attention. A self-exam should
not replace a pelvic exam and Pap test done by a doctor or nurse. To learn more, see the topic
Vaginal Self-Examination (VSE).
Other Works Consulted
- Chernecky 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.
Primary Medical Reviewer Sarah Marshall, MD – Family Medicine
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer Kevin C. Kiley, MD – Obstetrics and Gynecology
Current as ofOctober 6, 2017