Find Dr. Cullins' Answers to Common Sexual Health Questions
Q&A with Dr. Cullins
Pelvic exams can help you stay healthy and find any problems. But many of us feel nervous about getting pelvic exams because they are about our sexual and reproductive organs. It’s very common for women to be especially worried about having their first pelvic exam. If you are feeling anxious or uneasy about your pelvic exam, the information on this page may be helpful. Knowing what to expect can help you relax.
Whether you are straight, lesbian, bisexual, married, single, sexually active or not, a pelvic exam is a normal part of taking care of your body. During a pelvic exam, a health care provider examines your vulva and your internal reproductive organs — your cervix, ovaries, fallopian tubes, uterus, and vagina.
During your pelvic exam, your provider will look for signs of infection and other conditions. It will most likely include taking a few cells from your cervix for a Pap test. This is to protect you from cervical cancer. Detecting problems early can help you get the treatment you need to keep healthy.
The pelvic exam is often part of a woman's periodic gynecological visit — also called a gyn exam. Gynecology is health care for women. A gyn exam checks out a woman's health — especially her sexual and reproductive health. It may include
Unless you have a medical problem, you should have your first pelvic exam and Pap test when you turn 21.
Before needing pelvic exams, young women are encouraged to have periodic gyn visits with their health care providers. During these visits, a young woman can ask questions and talk with her health care provider about growing up, changes in her body, and any concerns she has. These checkups help make sure that she is healthy and developing as she should. Most often, these early visits do not include a pelvic exam.
After your first pelvic exam, your health care provider will tell you how often you should have gynecological care, including pelvic exams. How often you need exams will depend on your medical history and personal health needs. You may need more frequent pelvic exams if you have
When to Contact Your Health Care Provider
Contact your health care provider if you have any concerns about your sexual and reproductive health or you have any of these symptoms:
These may be signs of an infection or serious condition that may need treatment. It is best to get them checked out as soon as possible.
You can get gynecological care at your local Planned Parenthood health center, a clinic, or from a private health care provider.
There are some simple steps you can take to prepare for your exam.
First, your health care provider will ask you questions about your medical history and your family's medical history.
These questions help you get the care that's right for you, so try to be as honest and as complete as you can. The questions may include
Other questions might be about alcohol or other drug use, allergies, illnesses, previous pregnancies, problems holding urine, risk for infection, smoking, and any surgery you might have had.
You can ask questions, too! You might want to ask questions about
Don't let embarrassment be a health risk. Make sure you ask all the questions that you want to ask. Tests that you may need usually can be done quickly during the appointment.
The pelvic exam part of your gyn exam should only take a few minutes. Some parts of the exam may be uncomfortable, but it shouldn't be painful. If it hurts, be sure to tell your health care provider, who may be able to adjust things to help you be more comfortable. This exam is for you, so don't be afraid to speak up.
You'll feel less tense during your pelvic exam if you
Your health care provider will ask you to undress and put on a paper or cloth gown. Next, you will be asked to lie down on the exam table and put your feet on footrests at the end of the table. (Some tables have knee rests instead.)
Slide your hips down to the edge of the table. Let your knees spread out wide. Relax as much as possible. Relax your buttocks and your stomach and vaginal muscles. This will make you more comfortable. The exam will be more complete, too. You can cover your lower abdomen and thighs with a sheet to feel less exposed.
There are usually four parts to the pelvic exam:
1. The External Exam — Your health care provider will look at the folds of your vulva and the opening of your vagina. This part of the pelvic exam checks for signs of cysts, discharge, genital warts, irritation, or other conditions.
2. The Speculum Exam — Your health care provider will gently insert a lubricated speculum into your vagina. Made of metal or plastic, the speculum separates the walls of the vagina when it opens. This may feel uncomfortable but not painful. Let your health care provider know if it is. She may be able to adjust the size or position of the speculum. If you would like to see your cervix, just say so. You may be able to see it using a mirror.
The provider will then use a tiny spatula or small brush to take a small sample of cells from your cervix. This sample will be given a Pap test to see if there is any precancer or cancer in the cervix.
If you think you may be at risk of having a sexually transmitted infection, tell your health care provider. Your health care provider can use a cotton swab to take a sample of the discharge from your cervix. This sample will be tested for sexually transmitted infections.
3. The Bimanual Exam — During this part of the exam, your health care provider will insert one or two gloved and lubricated fingers into your vagina while gently pressing on your lower abdomen with the other hand. This is a way to check for
4. The Rectovaginal Exam — Your health care provider may put a gloved finger into your rectum. This checks the muscles between your vagina and your anus. This also checks to see if there are tumors behind the uterus, on the lower wall of the vagina, or in the rectum. Some health care providers put another finger in the vagina, too. This lets them examine the tissue in between more thoroughly.
You may feel like you need to have a bowel movement during this part of the exam. This is normal and only lasts a few seconds.
At the end of your pelvic exam, make sure to find out when you should expect results from any tests you had. If you were prescribed medications, make sure that you follow the instructions for how to take them.
Q&A with Dr. Cullins