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When you turn 21, a pelvic exam is a regular part of your wellness 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 wellness 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. Tell your doctor if it does hurt, because they may be able to fix the size or position of the speculum.

If you want to see your cervix, just ask. You may be able to see it with a mirror.

If you’re getting a Pap or HPV test, your doctor will use a tiny spatula or brush to wipe a small sample of cells from your cervix. They will send this sample to a lab to see if there are any problems.

If you’re getting a test for STDs (like chlamydia or gonorrhea) or other infections, your doctor will use a cotton swab to take a sample of the discharge from your cervix and send it to a lab for testing.

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, ovarian 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 HPV

  • 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

More questions from patients:

What's a speculum pelvic exam?

During a pelvic exam, a doctor or nurse checks your vulva and your inside reproductive organs — your vagina, cervix, ovaries, fallopian tubes, and uterus.

Using a speculum is one part of a pelvic exam — it’s an instrument that gently opens your vagina so the doctor can see inside. Speculums also help the nurse or doctor reach your cervix so they can do Pap tests and tests for other infections (like STDs).

Your doctor will put lubricant on the speculum, and then gently slide the speculum into your vagina. The speculum opens a little bit to separate the walls of your vagina. Speculum exams may feel weird or a little uncomfortable, but it doesn’t hurt at all for most people.

If you have any questions or concerns about pelvic exams or speculums, talk with your nurse or doctor. If you’re really nervous or worried about pain, tell them. They’ll do everything they can to make your exam more comfortable.

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