Pelvic Exam

Regular pelvic exams help detect cancers in menopausal and postmenopausal women, as the risk of cancer increases in women with age. The exam is also recommended if women have any of the following concerns:

• Bleeding from the vagina that lasts for more than ten days
• Unexplained pain around the vulva or lower belly
• Intense cramps during periods
• Odour, burning or itching due to wetness in the underwear or vaginal discharge, particularly after sexual intercourse
• No periods within three years of breast development or by 15 years of age
• Missed periods, if a woman has had sexual intercourse

No special preparation is required for this test. You may be asked to visit the washroom prior to the test. Occasionally, a urine sample may be needed.

Inform the doctor if you have any health concerns. Before beginning the exam, you may be asked to change into a hospital gown for ease of examination

During the exam, you will be asked to lie down on your back and relax. A nurse or doctor will press the areas of your lower stomach to feel the organs externally. Next, he/she might ask you to slide to the end of the table for a speculum exam.

For the speculum exam, you will be asked to bend your knees and place your legs on feet holders called stirrups. A speculum (a medical tool specifically used to investigate orifices in the body) will then be inserted in your vagina to obtain an open, wide view of the vagina and cervix. After the speculum is in place, a Pap smear test is performed. For the Pap smear, doctors use a tiny brush and a plastic spatula to collect some blood cells from the cervix. A fluid sample from the vagina might also be taken to determine any infection.

After collecting the required samples, the speculum will be removed. At this point, your doctor might also place one or two fingers in your vagina and conduct a manual exam. A rectal examination may be performed if required. Along with the Pap smear, other tests mentioned below might also be performed to check for sexually-transmitted disease (STDs):

• Syphilis test
• Chlamydia test
• Vaginal wet mount
• Herpes test
• Gonorrhoea test
• Tests for bacterial vaginosis (BV)

Some doctors recommend a pelvic ultrasound to check the organs.

Some women might experience mild discomfort or some pressure when the speculum is inserted in the vagina. It is best to relax your hips and legs as much as you can.

Women with a vaginal infection might experience irritation or pain during the examination. A slight pain might occur when the nurse or doctor examines the ovaries. Try to breathe deeply to help feel relaxed. Also, the sample collection for a Pap smear might cause a brief pinching sensation. Inform the doctor if the pain is excruciating.

Normal results:

• Ovaries and uterus are normal in size and located in the right place. There is no pain while moving the uterus slightly
• Urethra or Bartholin’s glands (glands around the opening of the vagina) are not inflamed or swollen
• Cervix, vulva and vagina appear to be normal and have no signs of abnormalities, including inflammation and infection
• No abnormal tissues or nodules (masses) are indicated in the ligaments attached to the uterus or the area between the rectum and uterus
• There is no sign of fibroids or hardened tissues

Abnormal results:

• Signs of STDs, such as genital warts and herpes, might be seen. In this case, additional tests will be recommended to confirm the cause of experienced symptoms
• Abnormalities, such as inflammation and sores, are observed in the cervix, vulva or vagina
• Inflammation or swelling is observed on the urethra or the Bartholin’s glands.
• Uterus does not move even slightly during the exam
• Tenderness or pain is observed in the area between the rectum and uterus or when the uterus is moved slightly
• Ovaries seem enlarged and cause pain when touched, and they do not move
• A small mass is felt near each or both the ovaries
• Sensations of hardened tissues and small masses are indicated
• Uterine fibroids are indicated

Certain conditions might affect the results of a pelvic exam. Your doctor or nurse will discuss if they notice any abnormality in test results.

(Read more: Vaginal health)

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.