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Purpose
Before
During
After
Results
A pelvic exam is a gynecological examination of the internal and external organs in your pelvis. This includes the vagina, vulva, uterus, cervix, rectum, ovaries, and fallopian tubes.
Your healthcare provider inserts a tool called a speculum into your vagina so they can see the organs inside your pelvis. They also examine the external area around your vagina and use gloved fingers to feel your uterus and ovaries. Any abnormal findings may prompt the need for further evaluation and testing.
This article discusses pelvic exams, why they’re done, and what to expect when you have one. It also looks at some of the things that might be found during a pelvic exam.
When Are Pelvic Exams Needed?
A pelvic exam often takes place as part of your preventive care during a routine checkup. Your healthcare provider does this exam to look for changes and screen for early signs of cancer, cysts, fibroids, andsexually transmitted infections(STIs).
Pelvic exams are also used to help diagnose a medical condition when you’re having symptoms such as:
Any of these symptoms can indicate avaginal infectionor an STI, which could affect your future fertility. They may also indicate other conditions likeendometriosis,pelvic inflammatory disease (PID), or a number ofother reproductive disorders.
Parts of a Pelvic Exam
The pelvic exam generally consists of three parts:
If it’s time for yourPap smear—a screening for cervical cancer—you’ll have that as well. Most women only need to have a Pap test starting at age 21 years and then again every three to five years.
If you have symptoms of an STI or you’re at high risk for contracting one, your healthcare provider may also take a sample for an STI test.
During a Routine Checkup
The American College of Obstetricians and Gynecologists (ACOG) recommends seeing a gynecologist starting between the ages of 13 and 15 for a regular health exam.A pelvic exam isn’t usually done until becoming sexually active or turning 21, whichever comes first.
There is currently no consensus among experts on how often a pelvic exam should be performed as preventive care.
The ACOG recommends that women at average risk for cervical cancer have a pelvic exam as follows:
Other professional societies have different recommendations.
Your healthcare provider likely has their own opinion regarding how often you’ll need a pelvic exam based on your medical history and general health, so they’ll tell you how often to schedule one.
During Pregnancy
A pelvic exam is typically performed at the first prenatal care visit. If you have a history of certain gynecological conditions, more frequent pelvic exams may be necessary.
To Diagnose a Condition
Pelvic exams are used to diagnose or look for signs of conditions, such as:
How to Prepare for a Pelvic Exam
There are no food, drink, or medication restrictions for this evaluation.
Vaginal douchingis never a good idea because of the risk of infection it presents.It’s particularly important not to douche for at least two or three days before your pelvic exam. You should also refrain from sexual intercourse for at least 24 hours prior to your examination.
Who Performs Pelvic Exams?
Timing
The best time to schedule your annual pelvic exam and to obtain the mostaccurate resultsfrom your gynecological examination and Pap smear, if applicable, is one or two weeks after your period.
A pelvic exam itself only takes a few minutes, but planning about an hour for the whole appointment is generally a safe bet. This includes time spent waiting, filling out forms, completing your medical history, and so on.
What to Bring
You may want to keep a period diary that you can go over with your healthcare provider during your appointment. You can use a calendar or app to keep track of the dates of your periods, the amount of flow, any pain experienced, discharge, or other symptoms that occur during the month.
Bring along any questions you have about the exam or your gynecological health as well.
Have your insurance card handy, as well as your co-pay, if needed.
If you have concernsYour healthcare provider knows how personal this exam is, so feel free to talk openly and honestly about any feelings of nervousness or anxiety so they can help you feel as comfortable as possible.This might prompt them to take things a little slower; make sure they explain everything they’re doing before they do it; and check to make sure you’re doing alright as the exam proceeds.If you really feel like you can’t bear enduring a pelvic exam, you absolutely have the right to decline. However, avoiding this exam for too long can cause any problems to go undetected.
If you have concerns
Your healthcare provider knows how personal this exam is, so feel free to talk openly and honestly about any feelings of nervousness or anxiety so they can help you feel as comfortable as possible.This might prompt them to take things a little slower; make sure they explain everything they’re doing before they do it; and check to make sure you’re doing alright as the exam proceeds.If you really feel like you can’t bear enduring a pelvic exam, you absolutely have the right to decline. However, avoiding this exam for too long can cause any problems to go undetected.
Your healthcare provider knows how personal this exam is, so feel free to talk openly and honestly about any feelings of nervousness or anxiety so they can help you feel as comfortable as possible.
This might prompt them to take things a little slower; make sure they explain everything they’re doing before they do it; and check to make sure you’re doing alright as the exam proceeds.
If you really feel like you can’t bear enduring a pelvic exam, you absolutely have the right to decline. However, avoiding this exam for too long can cause any problems to go undetected.
Cost and Health Insurance
Since a pelvic exam is often performed as a part of a routine physical or checkup, the cost may vary depending on factors such as whether or not you have a Pap smear or STI testing and what else is included in the cost, such as a separate physical exam. The exam alone can range from $100 to $300 or more.
If you have health insurance through the Affordable Care Act’s Marketplace or other insurance that covers preventive care, an annual pelvic exam will be completely covered as part of your annual well-woman visit.This means you won’t need to pay any out-of-pocket costs.
If you don’t have health insurance, are under-insured, or considered low-income, check with your local or county community health clinic. Many of these offer free or low-cost pelvic exams, STI testing, and Pap smears that you pay for based on your income.
You can also find local providers who do free or lost-cost exams via the Centers for Disease Control and Prevention (CDC)‘sNational Breast and Cervical Cancer Early Detection Program.
What to Expect During a Pelvic Exam
After checking in and filling out any necessary forms, which may include an authorization to bill your insurance or an updated health history, it’s a good idea to empty your bladder so you can be more comfortable during your exam.
If you’re feeling nervous or tense during your pelvic exam try to:
You can also ask your healthcare provider to describe what they’re doing during the exam.
Pre-Exam
After your initial discussion with the nurse, you’ll be directed to take all your clothes off, with the exception of your socks. You will be given a gown and drape to cover yourself until your examination begins.
Your healthcare provider will knock to make sure you’re ready and then enter the room. They will ask about your medical history and discuss any problems you’re having. It’s important for you to be as accurate and complete as you can in answering the questions and describing any symptoms you may have.
Your healthcare provider may have a nurse present during your pelvic exam as a means of protection for both of you, but if you’re not comfortable with someone else being there, feel free to request that it just be the two of you.Conversely, if your healthcare provider doesn’t have a nurse in the room and you would feel more comfortable with someone else there, you can have your partner or friend in the room or request that a nurse comes in during this part of your checkup.
Your healthcare provider may have a nurse present during your pelvic exam as a means of protection for both of you, but if you’re not comfortable with someone else being there, feel free to request that it just be the two of you.
Conversely, if your healthcare provider doesn’t have a nurse in the room and you would feel more comfortable with someone else there, you can have your partner or friend in the room or request that a nurse comes in during this part of your checkup.
Your healthcare provider may listen to your heart and lungs, check your breasts forchanges or lumps, and feel your abdominal area for any irregularities.
Breast Exam
A reliable examination of your breasts takes approximately 30 seconds per breast.
During yourbreast examination, your healthcare provider should discuss monthlybreast self-examswith you and also provide instructions on how to perform them if you’re unfamiliar.
Pelvic Exam Procedure
The pelvic exam itself only takes a few minutes. During each part of the exam, your healthcare provider will probably tell you what they’re going to do, especially if this is your first pelvic exam.
Getting into Position
First, you’ll need to lie back, scoot down to the end of the table, put your feet in the stirrups or on the corners of the table, and spread your knees apart.
This feels uncomfortable, especially the first time or two, but keep in mind that your healthcare provider does pelvic exams regularly. Try taking deep breaths to help relax your muscles if you’re feeling tense.
External Examination
At this point, your healthcare provider may look at the outside of your vaginal area to check for any abnormalities, swelling, sores, or irritation.
Internal Visual Examination
Next, a speculum, a metal instrument that looks like a duck’s beak, is inserted into your vagina with a lubricant to make it more comfortable. The speculum widens your vaginal walls so your healthcare provider can view them, as well as yourcervix.
The speculum can be uncomfortable and you may feel some pressure as it’s opened, but you shouldn’t feel pain. If you do, be sure to tell your healthcare provider. There may be a smaller one they can use instead.
Sample Collection
If you’re having a Pap smear,a sample of cervical tissue is takenwith a small wand or spatula once your cervix is in view.This may cause some brief discomfort, but again, it shouldn’t be painful and it only lasts for a second or two as your healthcare provider collects the tissue.
If you’re also beingtested for STIslike chlamydia or gonorrhea, or other infections such as ayeast infection, pelvic inflammatory disease, orbacterial vaginosis, your healthcare provider will use a cotton swab to take a sample of your cervical discharge for the STI test or your vaginal secretions to test for other infections. The speculum is gently slid out once this part of the exam is complete.
Bimanual Examination
To perform this, your healthcare provider wears gloves and inserts two lubricated fingers into your vagina, places their other hand on top of your lower abdomen, then compresses the tissue between their two hands, feeling for any abnormalities that might have occurred since your last pelvic exam.
The bimanual exam allows your healthcare provider to check the size, shape, and mobility of youruterusto feel for any changes in your ovaries, such asovarian cysts, and to feel for any tenderness or other abnormalities in your uterus or the surrounding tissues like endometriosis,fibroid tumors, or othercommon uterine conditions.
The bimanual exam can be a bit uncomfortable, but should not result in overt pain. Fortunately, this part of the examination usually lasts for less than 30 seconds. Because it can give your healthcare provider important information, it’s worth a bit of temporary discomfort.
Rectal Examination
This is an optional part of a pelvic exam, but if your practitioner does do this, try to relax as much as you can.
After the Exam
Once your pelvic exam is completed, you will be given privacy to get dressed. You may be offered some tissues to wipe off any excess lubricant and a maxi pad or panty liner in case the speculum causes any spotting.
When you’re ready, your healthcare provider will come back to the room to discuss the results of your pelvic exam with you.
After your visit is through, you can go home and resume your normal activities. You may have light spotting and possibly some cramping, but you shouldn’t have pain. These symptoms should not last long. If you have heavy bleeding or severe cramping or pain, contact your healthcare provider.
How long does a pelvic exam take?A pelvic exam will take a few minutes. Some parts of the exam may be a little uncomfortable, but it shouldn’t be painful. If it hurts, say something. Your healthcare provider may be able to make things more comfortable.
How long does a pelvic exam take?
A pelvic exam will take a few minutes. Some parts of the exam may be a little uncomfortable, but it shouldn’t be painful. If it hurts, say something. Your healthcare provider may be able to make things more comfortable.
When to Expect Results
Your healthcare provider can usually tell you right away if they found any problems or abnormalities during your pelvic exam or if it was normal.
In cases where your practitioner took a vaginal fluid sample during your exam to look for a yeast infection or bacterial vaginosis, this sample will be looked at under a microscope for signs of fungus, bacteria, or viruses. Your medical professional may even look at the slides themselves after your pelvic exam.
The presence of these microorganisms is immediately obvious, so you will likely know before you go home if you have one of these infections and leave with a prescription to treat it.
If you had a Pap test, the results for this may take a few days and up to three weeks to get back. Your healthcare provider’s office will likely mail the results to you or call you, but if you don’t hear anything after three weeks, be sure to call.
Results from a cervical swab to check for gonorrhea and chlamydia will take a few days to come back.
Other ConsiderationsIf you have any questions or concerns about the results of your pelvic exam, discuss these with your healthcare provider. This is also a good time to discuss contraception, fertility, sexual health, and any other areas or issues you’re concerned about.
Other Considerations
If you have any questions or concerns about the results of your pelvic exam, discuss these with your healthcare provider. This is also a good time to discuss contraception, fertility, sexual health, and any other areas or issues you’re concerned about.
If your pelvic exam was normal, you’ll need to schedule another one in a year or the time frame your healthcare provider recommends.
If your pelvic exam showed any abnormalities, your practitioner will talk to you about what these findings may mean, as well as about additional testing, follow-up, and/or treatment options. Some of the things that can be found or suspected during a pelvic exam include:
Summary
A pelvic exam is a gynecological exam that can help identify problems with the organs inside and outside of your pelvis. During this exam, your healthcare provider uses a speculum and gloved fingers to examine these organs visually and manually.
Some of the conditions that can be discovered or suspected after a pelvic exam include endometriosis, ovarian cysts, and uterine fibroids. Further tests can confirm these findings.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Planned Parenthood.What is a pelvic exam?American College of Obstetricians and Gynecologists.Your first gynecologic visit.American College of Obstetricians and Gynecologists.Cervical cancer screening (update).American College of Obstetricians and Gynecologists.Pelvic exams.Office on Women’s Health.Douching.HealthCare.gov.Preventive care benefits for women.Centers for Disease Control and Prevention.National breast and cervical cancer early detection program.American Cancer Society.American cancer society recommendations for the early detection of breast cancer.Office on Women’s Health.Endometriosis.Centers for Disease Control and Prevention.About pelvic inflammatory disease (PID).Office on Women’s Health.Ovarian cysts.Office on Women’s Health.Uterine fibroids.Additional ReadingAmerican College of Obstetricians and Gynecologists.Pelvic exams.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Planned Parenthood.What is a pelvic exam?American College of Obstetricians and Gynecologists.Your first gynecologic visit.American College of Obstetricians and Gynecologists.Cervical cancer screening (update).American College of Obstetricians and Gynecologists.Pelvic exams.Office on Women’s Health.Douching.HealthCare.gov.Preventive care benefits for women.Centers for Disease Control and Prevention.National breast and cervical cancer early detection program.American Cancer Society.American cancer society recommendations for the early detection of breast cancer.Office on Women’s Health.Endometriosis.Centers for Disease Control and Prevention.About pelvic inflammatory disease (PID).Office on Women’s Health.Ovarian cysts.Office on Women’s Health.Uterine fibroids.Additional ReadingAmerican College of Obstetricians and Gynecologists.Pelvic exams.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Planned Parenthood.What is a pelvic exam?American College of Obstetricians and Gynecologists.Your first gynecologic visit.American College of Obstetricians and Gynecologists.Cervical cancer screening (update).American College of Obstetricians and Gynecologists.Pelvic exams.Office on Women’s Health.Douching.HealthCare.gov.Preventive care benefits for women.Centers for Disease Control and Prevention.National breast and cervical cancer early detection program.American Cancer Society.American cancer society recommendations for the early detection of breast cancer.Office on Women’s Health.Endometriosis.Centers for Disease Control and Prevention.About pelvic inflammatory disease (PID).Office on Women’s Health.Ovarian cysts.Office on Women’s Health.Uterine fibroids.
Planned Parenthood.What is a pelvic exam?
American College of Obstetricians and Gynecologists.Your first gynecologic visit.
American College of Obstetricians and Gynecologists.Cervical cancer screening (update).
American College of Obstetricians and Gynecologists.Pelvic exams.
Office on Women’s Health.Douching.
HealthCare.gov.Preventive care benefits for women.
Centers for Disease Control and Prevention.National breast and cervical cancer early detection program.
American Cancer Society.American cancer society recommendations for the early detection of breast cancer.
Office on Women’s Health.Endometriosis.
Centers for Disease Control and Prevention.About pelvic inflammatory disease (PID).
Office on Women’s Health.Ovarian cysts.
Office on Women’s Health.Uterine fibroids.
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