NDSU Student Health Service
Choices Program

Your Reproductive Health - The Pelvic Exam

 

Questions and Answers About Your First Pelvic Exam

What is a pelvic exam?

A pelvic exam is looking at and feeling the size and shape of your external and internal reproductive organs. These include the vulva (outside) and vagina, uterus, ovaries, and fallopian tubes (inside).

Why do I need one?

The pelvic exam helps to find out if your reproductive organs are healthy. It also helps your health care provider detect any medical conditions that could become serious if not treated. It is recommended that you have your first pelvic exam when you reach 18 years of age or become sexually active.

Will it hurt?

The pelvic exam will not hurt. Many women describe a sensation of crowding or fullness in the vagina, however there should be no pain. Sometimes a woman will feel discomfort, especially if she is tense during the examination.

It is normal to feel uncomfortable, embarrassed, or even scared. You may feel less embarrassed if you remember that your health care provider is highly trained and has probably performed hundreds or thousands of exams.

Do I need to get undressed?

Usually, yes. You will be given a gown and asked to remove your clothing, including your bra and panties. You will do this in private, before the health care provider enters the room.

How will it feel?

You will feel touching with gloved fingers on the outside of your genitals. You will feel two fingers in the vagina and the other hand pressing gently on your abdomen. At one point during the exam, the health care provider will insert an instrument called a speculum into your vagina. It will be warmed to minimize discomfort. The last part of the exam is a rectal examination. The clinician will place one finger into your rectum and one in the vagina. This allows the clinician to feel much higher and deeper into the pelvis to make sure that everything is normal.

What is a Speculum and why is it used?

A speculum is an instrument designed to open the walls of the vagina gently so that the clinician can see inside. Speculums (made of metal or plastic) come in many shapes and sizes to fit a woman's reproductive anatomy. The plastic ones sometimes make clicking noises when opened. Should the speculum cause you discomfort, tell the clinician immediately; often a smaller size instrument can be used.

If I am a virgin, do a I still need a pelvic exam?

If you are a virgin, it is important to have a pelvic exam if you have not begun to menstruate around the same time as other young women of your age, or if you have had problems with bleeding, pain, or discharge. You will still be a virgin after the examination. Women who have used tampons for menstrual hygiene may find the first pelvic exam easier than those who have used pads or panty liners.

What is the most common position for a pelvic exam?

Various positions can be used for a pelvic exam; however, the most common one is laying on your back with your feet resting in foot rests, called stirrups. You will be asked to move your buttocks down to the end of the table and let your knees fall wide apart. The reason for this position and the stirrups is to provide the clinician adequate access to the genital area.

How can I be more comfortable during the exam?

The reaction of many women to having fingers or a speculum placed in the vagina is to close the legs or squeeze the vaginal muscles tight. While it may be instinctive to clamp down, tensing the muscles often will make you more uncomfortable. The key to the pelvic exam is relaxation. Take slow, deep breaths and try to distract your mind to help you relax.

How long will it take?

Generally, the entire exam takes no more than 5 minutes. Although no one likes having the exam done, it is important to your health now and in the future. After the first exam, almost everyone says it was not as bad as they had imagined. You can be proud of yourself for taking responsibility for your health. If you are interested, you may watch the exam. Many clinicians are happy to show women their external and internal organs and will give you a hand mirror to help you see. Please ask if you are interested.