What happens during a pelvic exam?

To have a pelvic exam, you lie on your back on an examining table and put your feet in these things called stirrups. The doctor uses an instrument called a speculum to gently open your vagina and take a look at your cervix. If you’re over 21 years old (whether sexually active or not), she’ll use two swabs to obtain samples for a Pap smear, which tests for cell changes that may indicate cervical cancer. Next the speculum is removed and the doctor inserts a gloved, lubricated finger in your vagina. With her other hand on your abdomen, she feels your uterus, cervix, ovaries, and fallopian tubes. The whole pelvic exam takes only about two minutes, and with a sensitive doctor well versed in teenage health, it should not hurt, although you may feel slightly uncomfortable. Some girls do not handle a vaginal exam well; for them, the doctor can perform a rectoabdominal exam instead, with the gloved finger inserted in the anus rather than the vagina.

A pelvic examination is a painless, though sometimes slightly uncomfortable physical examination of a woman's genital and pelvic area. (You should tell the doctor if you do feel pain at any point in the examination.) During a pelvic exam, you will be asked to lie on your back on the examining table and put your feet in stirrups at the end of the table. The doctor or nurse practitioner will initially examine the genital area for any unusual lesions, swelling or other signs of problems.

After examining the outer part of the genital area, the doctor or nurse practitioner will then do an internal examination by inserting a metal or plastic device called a speculum into the vagina. Metal speculums can sometimes feel cold when inserted, so at many medical facilities they are kept warm until used. Some women feel slight pressure in the pelvic area when the speculum is inserted and used to open the vagina. Through the open speculum, the examiner can see the inside of the vagina and the cervix.

If a Pap test is being conducted during the pelvic exam, the doctor or nurse will insert a tiny brush or spatula to remove a small sample of cells from the surface of the cervix. This causes some women to feel a mild cramp-like discomfort.

Finally, the doctor or nurse will do a digital exam by applying lubricant to his or her fingers (covered by a medical glove) and inserting two fingers into your vagina while pressing gently on your abdomen. This part of the exam is for the doctor or nurse to feel your ovaries and uterus for lumps or other problems. Again, you may feel some pressure during this part of the exam, and it may be slightly uncomfortable, but is usually over quickly. The complete pelvic exam takes only three to five minutes on average. The American College of Obstetrics and Gynecology recommends that women ages 21 and older have annual pelvic examinations.