Pelvic exams are a necessary and routine screening for women and their reproductive health. You're not alone if you have questions about what to expect during a pelvic exam.
You’re in the right place if you’re unsure about what happens during a pelvic exam or how to prepare for one. This blog gives information about pelvic exams and pap smears, what they are, and what to expect when getting one.
Understanding the Difference Between a Pelvic Exam and Pap Smear
Many people believe a pelvic exam and a pap smear are the same, but that is untrue. A pelvic exam refers to the whole exam, while a pap smear is a part of the pelvic exam. In summary, a pelvic exam is a comprehensive checkup of the pelvic and reproductive organs that assesses overall health. At the same time, a pap smear is a test used to screen for cervical cancer.
Let's break this down a bit more.
What Is a Pelvic Exam?
A pelvic exam is a general examination of the female reproductive organs, such as the uterus, ovaries, and cervix. When administering a pelvic exam, your OBGYN provider will look for abnormalities or issues that could impact reproductive health, such as ovarian cysts, sexually transmitted infections (STIs), or unusual bleeding and discharge.
Generally, doctors recommend that women between the ages of 21-65 should receive a pelvic exam annually. Some healthcare providers may suggest a pelvic exam every three years. Individuals who have transitioned to another gender but have not had female-to-male affirming surgery should also get regular pelvic exams.
While pelvic exams are a routine and standard exam for women, the frequency your doctor recommends a pelvic exam may be impacted by:
- Family history of ovarian or cervical cancer
- Pelvic pain or pain during sex
- Unusual vaginal discharge or bleeding
- Concerns about sexually transmitted infections (STIs)
- You're pregnant
What Is a Pap Smear?
While the pelvic exam refers to the exam as a whole, a pap smear is a specific part. During a pap smear, your doctor will collect a sample of cells from the cervix and test them to detect changes or abnormalities in your cervical cells, which may indicate HPV or cervical cancer.
It is recommended women get their first pap smear at 21 and return for another pap smear every three years. If you are between 30 and 65, your doctor may suggest an HPV test every five years. Pap smears are generally unnecessary for women over 65 if they have had adequate and typical screenings.
Learn everything you need to know about HPV in this blog post!
What You Should Know Before Your First Pelvic Exam
Pelvic exams are important for a woman's health, as they detect several health conditions that can impact the reproductive and pelvic organs. Pelvic exams are essential for addressing the following:
- Gynecological Cancers: Cancers such as cervical, ovarian, and uterine can be found through pelvic exams. Pelvic exams can allow for early detection, improving the chance of successful treatment.
- Reproductive Health Concerns: When examining the cervix, uterus, and ovaries, issues such as polyps, fibrosis, and cysts can be detected.
- Sexually Transmitted Infections (STIs): Pelvic exams often include STI screenings that diagnose infections such as chlamydia, gonorrhea, and genital herpes. Early detection of STIs helps prevent health complications and reduces the spread of these infections.
- Menstrual Irregularities: In certain situations, pelvic exams may help pinpoint the cause of menstrual cycle problems, such as irregular bleeding and missed periods.
- Pelvic Pain: Underlying causes of pelvic pain can be identified, such as endometriosis and pelvic inflammatory disease (PD). Once diagnosed, treatment can be administered to help manage pain and prevent further health complications.
- Vaginal Infections: If you’re experiencing vaginal or vulva itching, discomfort, or burning, a swab taken during a pelvic exam can help determine if a vaginal infection is present, such as a yeast infection or bacterial vaginosis.
- Postpartum and Postmenopausal Care: Changes to the reproductive organs during pregnancy and menopause can be assessed. Health concerns such as vaginal atrophy or prolapse can be monitored and treated.
Can You Get a Pelvic Exam While Menstruating?
If you are menstruating during your pelvic exam, you should not worry or cancel your appointment. Menstruation typically has no impact on a pelvic exam and its results. If you are menstruating during your pelvic exam, you should inform your doctor before the exam begins so they can adjust as needed, but it is unnecessary. You should remove your tampon or internal period products before your exam begins.
What to Expect During a Pelvic Exam
Pelvic exams are brief and usually take under five minutes to complete. If you're unsure of what happens during a pelvic exam, you can expect the following:
- Once in your doctor's office, you will be asked to change out of your clothes and into a gown. Before your exam begins, your doctor may check your heart, lungs, stomach, back, and breasts.
- Your healthcare provider will ask about your medical history, period, sexual activity, and any concerns you may have.
- An additional nurse or medical assistant may be in the room during the exam to provide reassurance and support to the patient and help with patient safety. You can also request a partner, friend, or relative to be in the room with you.
- Once the exam begins, your doctor will have you lie on an exam table with your feet placed on supports at the end of the table called stirrups.
- Your doctor will likely talk you through each step of the exam. They examine your external genitals (vulva) for abnormalities like redness, swelling, or certain growths.
- A plastic or metal instrument called a speculum will be inserted into the vagina to hold the vaginal walls apart. The
speculum allows your doctor to perform an internal exam and look for any abnormalities with the cervix. If a pap smear is conducted, cervical cells will be collected at this time using a small brush or spatula. Speculums come in different sizes, and patients are encouraged to talk with their OBGYN to discuss what size speculum they are most comfortable with. - While wearing gloves, your doctor will perform a bimanual exam by inserting one or two fingers into the vagina while pressing down on your lower abdomen. A bimanual exam helps assess the uterus and ovaries' size, shape, and position. They may continue pressing on various parts of the abdomen to check for tenderness or abnormalities.
- After the pelvic exam, you will get dressed, and your healthcare provider will discuss your exam results. Your doctor can typically address any concerns right away.
- Pap smear results may take a few days. At this time, your doctor will discuss any necessary next steps, such as other tests, appointments, or treatments.
At Moreland OB-GYN, we pride ourselves on offering a warm and safe environment where patients feel comfortable. Schedule your pelvic exam today!
Does a Pelvic Exam Hurt?
While you may experience some pressure or discomfort during a pelvic exam, it should not be painful. Relaxing your body will help make the exam more comfortable. If you are experiencing pain at any point in the exam, tell your doctor immediately.
Tips on How to Mentally Prepare and Stay Relaxed During a Pelvic Exam
Being a bit nervous or having questions before a pelvic exam is normal. While there isn’t much you have to do to prepare for an exam physically, there are a few things you can do to mentally prepare and make sure you're relaxed during the exam:
- Know this is your exam, and you are in charge. You can tell your provider to "stop" at any point during the exam if you are uncomfortable or in pain.
- Talk with your doctor prior and ask any questions you have. If you are nervous, tell your doctor; they can help provide additional ways to relax.
- Ask your doctor to inform you of every step they are taking during the exam. Step-by-step explanations can help you understand what is happening and calm your nerves.
- You can distract yourself by listening to music during the exam. Relaxation techniques like deep breathing can also help keep your mind focused and at ease. During the exam, close your eyes and inhale through your nose for four seconds, then exhale through your mouth for four seconds.
- Give yourself something to look forward to after the exam, like your favorite coffee or lunch with a close friend.
- For your comfort, you can schedule your exam when you don't have your period (but remember, it's OK if you do have it during your exam).
- You may be more comfortable using the bathroom before your exam begins.
Scheduling your first OBGYN appointment? Here’s what to expect during your first visit with your gynecologist.
Why Choose Moreland OB-GYN?
Regular pelvic exams are essential to women’s health and detect reproductive health concerns such as cancers and STIs. Scheduling your routine pelvic exam is the best way to stay on top of your health and ensure you’re living your healthiest and best life.
Moreland’s team of healthcare specialists is dedicated to keeping you comfortable during your pelvic exam. By following a shared decision-making approach, we will take the time to listen to your concerns and walk you through every exam with care and guidance.
We hope you’ll contact us today to schedule an appointment. Don’t deny yourself the healthcare you deserve and need to live your healthiest and most fulfilling life.
