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When you turn 21, a pelvic exam is a regular part of your well-woman visit. A pelvic exam is a normal part of taking care of your body. It only takes a few minutes and it doesn’t hurt.

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When should I get my first pelvic exam?

Unless you have a medical problem, you can wait to make an appointment for your first well-woman visit (which is when routine pelvic exams are done) when you turn 21.

What happens during a pelvic exam?

During a pelvic exam, a doctor or nurse examines your vulva and your internal reproductive organs — your vagina, cervixovariesfallopian tubes, and uterus.

If you think you might have an STD, another kind of infection (like a yeast infection), or any other issue with your reproductive health, let your doctor or nurse know at the beginning of your appointment. They’ll talk with you and decide if they need to do any special tests or exams.

In general here’s what happens at a pelvic exam.

First, they’ll give you a few minutes of privacy to undress and put on a paper or cloth gown. Then they’ll come back in and ask you to lie down on the exam table and put your legs up on footrests or knee-rests.

Slide your hips down to the edge of the table. Let your knees spread out wide. Don’t worry — your doctor will talk you through all this. Try to relax your butt, stomach and vaginal muscles as much as possible. This will make you more comfortable.

There are usually 3 or 4 parts to a pelvic exam:

1. The external exam — Your doctor or nurse will look at your vulva and the opening of your vagina. They’re  checking for signs of cysts, abnormal discharge, genital warts, irritation, or other issues.

2. The speculum exam — Your doctor will gently slide a speculum into your vagina. The speculum is made of metal or plastic. It separates the walls of your vagina when it opens. This may feel uncomfortable or weird, but it shouldn’t hurt. Let your doctor know if it does hurt, because they may be able to fix the size or position of the speculum.

If you’d like to see your cervix, just ask. You may be able to see it using a mirror.

Your doctor will then use a tiny spatula or brush to wipe a small sample of cells from your cervix. This sample will be sent to a lab for a Pap test to see if there is any pre-cancer or cancer in your cervix.

If your doctor or nurse is testing you for STDs (like chlamydia or gonorrhea) or other infections, they’ll use a cotton swab to take a sample of the discharge from your cervix. This sample will be tested.

3. The bimanual exam — During this part of the exam, your doctor or nurse will put 1 or 2 gloved and lubricated fingers into your vagina while gently pressing on your lower abdomen with their other hand. This is a way to check for

  • the size, shape, and position of your uterus
  • tenderness or pain — which might mean infection or another condition

  • enlarged ovaries, fallopian tubes, cysts, or tumors

4. The rectovaginal exam — Your doctor or nurse may also put a gloved finger into your rectum. This checks the muscles between your vagina and your anus. This also checks for tumors behind your uterus, on the lower wall of your vagina, or in your rectum. Some doctors put another finger in your vagina while they do this. This lets them examine the tissue in between more thoroughly.

You may feel like you need to poop during this part of the exam. Don’t worry, you won’t. This is totally normal and only lasts a few seconds.

What does a pelvic exam feel like?

Your pelvic exam will only take a few minutes. Some parts of the exam may be uncomfortable, but it shouldn't be painful. If it hurts, say something. Your doctor or nurse may be able to make things 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

  • Breathe slowly and deeply.

  • Let your stomach muscles go soft.

  • Relax your shoulders.

  • Relax the muscles between your legs.

  • Ask your doctor or nurse to describe what’s happening.

How often do I need to get a pelvic exam?

It depends. After your first pelvic exam, your doctor or nurse will tell you when you need to come back. It’ll depend on your medical history and whether you have any health issues.

You may need more frequent pelvic exams if you have

  • a history of abnormal Pap test results

  • a history of sexual health problems

  • a family history of certain kinds of cancer

  • an STD or a sex partner with an infection 

  • recurrent vaginitis

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