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. Show 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, cervix, ovaries, fallopian 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.  Regardless of whether a pelvic examination is performed, a woman should see her obstetrician–gynecologist at least once a year for well-woman care 12. A preventive service visit also provides an opportunity for the patient and her obstetrician–gynecologist to discuss whether a pelvic examination is appropriate for her. Screening for gynecologic cancer and STIs are common reasons physicians report performing a pelvic examination in asymptomatic, nonpregnant patients. However, studies show that pelvic examinations do not decrease ovarian cancer morbidity and mortality rates 10 4. A pelvic examination is not necessary before initiating or prescribing contraception, other than an intrauterine device, or to screen for STIs. However, a thorough history should be taken from each patient to ensure that there are no indications for performing a pelvic examination. If a patient is found to be asymptomatic, a discussion between the obstetrician–gynecologist and patient regarding the potential risks and benefits of performing a pelvic examination should ensue. Whether to perform a pelvic examination should be based on shared decision making.
Published online on September 24, 2018. Copyright 2018 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher. Requests for authorization to make photocopies should be directed to Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400. American College of Obstetricians and Gynecologists 409 12th Street, SW, PO Box 96920, Washington, DC 20090-6920 The utility of and indications for routine pelvic examination. ACOG Committee Opinion No. 754. American College of Obstetricians and Gynecologists. Obstet Gynecol 2018;132:e174–80. This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of the treating clinician. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence. Any updates to this document can be found on www.acog.org or by calling the ACOG Resource Center. While ACOG makes every effort to present accurate and reliable information, this publication is provided “as is” without any warranty of accuracy, reliability, or otherwise, either express or implied. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented. All ACOG committee members and authors have submitted a conflict of interest disclosure statement related to this published product. Any potential conflicts have been considered and managed in accordance with ACOG’s Conflict of Interest Disclosure Policy. The ACOG policies can be found on acog.org . For products jointly developed with other organizations, conflict of interest disclosures by representatives of the other organizations are addressed by those organizations. The American College of Obstetricians and Gynecologists has neither solicited nor accepted any commercial involvement in the development of the content of this published product. |
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