| Questions and Answers about Your First Pelvic Exam
What is a pelvic exam?
A pelvic examination is looking at and feeling
the size and shape of the external and internal reproductive organs. These include the
vulva (outside), and vagina, uterus, ovaries and fallopian tubes (inside).
Why do I need one?
The exam helps to make sure that your
reproductive organs are healthy. It also helps your health care provider detect medical
conditions (such as infections or abnormal Pap smears) that could become serious if not
treated. Many clinicians recommend that you have your first pelvic exam when you become
sexually active or reach the age of 18 years.
Will it hurt?
The pelvic examination will not hurt. Many
women describe the experience as a sensation of crowding or fullness in the vagina;
however, there should be no pain. Sometimes a women will feel discomfort, especially if
she is tense.
I feel scared to have
one. Do other women feel this way?
It is normal to feel uncomfortable,
embarrassed, or even scared. Many women complain that the most objectionable part of the
exam is that it feels undignified to have to expose one's genitals to a stranger. You may
be less embarrassed if you remember you clinician is highly trained and has probably
performed hundreds or thousands of exams. The exam is not an emotional or sexual
experience for the clinician. It is okay to have someone with you, such as your mother or
close girlfriend.
Do I have to take off
all my cloths?
Ordinarily, yes. You will be given a gown and
asked to remove your cloths, including your bra and panties. You can undress in privacy
and put on the gown before the clinician comes in for the exam.
What will it feel
like?
You will feel touching with gloved fingers on
the outside of your genitals. During the bimanual exam you will feel two fingers in the
vagina and the other hand on the abdomen gently pressing the tissue between the two hands.
At one point during the exam, the clinician will insert and instrument called a speculum
into the vagina. The speculum will generally be warmed to minimize discomfort. Clinicians
will commonly complete the exam by doing a rectal examination, placing one finger in the
rectum and one finger in the vagina. The reason for this is the clinician can feel much
higher and deeper in the pelvis to make sure everything is normal.
What is a speculum and
why is it used?
A speculum is an instrument designed to spread
the walls of the vagina open 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 your clinician immediately; often a smaller speculum can be used.
If I'm a virgin, do 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
your own age, or if you have had problems with bleeding, pain or discharge. You will still
be a virgin after the exam. Women who have used tampons for menstrual hygiene may find the
first pelvic exam easier than those who have used external protection such as pads or
panty liners.
What is a Pap test?
A Pap test or Pap smear is a screening test
that helps clinicians detect cellular changes in the cervix (the opening to the womb at
the end of the vagina). The Pap smear includes taking a sample of cells by wiping or
scraping a small wooden stick (similar to a tongue depressor) over the cervix. The cells
are then put on a glass slide and examined by laboratory personnel to look for changes
that might warrant further investigation. During the Pap smear you will feel the swab
being wiped across the cervix; this feels somewhat scratchy, but is not painful.
It's important to understand that the Pap test
is a screening test only. Clinicians do not base treatments on the Pap test, but use it to
determine whether further diagnostic tests are needed. The reason a Pap test is done is to
detect changes before they can become cancer. If your Pap test is abnormal, don't be
alarmed. Many women incorrectly believe an abnormal Pap test means they have cancer. In
fact, the cause of 90% of cervical cell changes is a virus called human papillomavirus
(HPV). Most conditions detected by an abnormal Pap test are minor and easily treated in
the office.
How often do I need to
get a Pap test?
The frequency of your Pap smear depends on
your age and other factors. You should discuss how often you need a Pap test with your
clinician.
What is the most
common position for the 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.
What can I do to 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.
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.
Can I see what is
happening?
Ask your clinician if you can watch the exam.
Many clinicians are happy to show women their external and internal organs and can use a
hand held mirror to help you see. Please ask if you're interested.
How long will it take?
Generally, the whole exam takes no more
than 5 minutes. Although no one likes to have the exam done, it is important to your
health now and in the future. After the first exam almost everyone says it wasn't as bad
as they had imagined. You can be proud of yourself for taking responsibility for your
health. |
