What to expect during a pelvic exam

lyndsay.mercier

Question: I’m 19-years-old and am a virgin. Should I still schedule an appointment for a pelvic exam? What can I expect to happen during a pelvic exam?

— New and nervous

Answer: The general rule for pelvic exams is that you should have your first one either between the ages of 18-21 or when you first become sexually active, whichever comes first. Since you are 19-years-old, there really isn’t any immediate necessity to have a pelvic exam right now, but it certainly couldn’t hurt. However, if you are experiencing any pain or discomfort in or around your reproductive organs, extremely painful menstrual cramps, or itchy or foul smelling vaginal discharge, you should schedule an appointment to see a gynecologist just to be on the safe side. Women who have a family history of breast, uterine, ovarian or cervical cancer also might want to have that first pelvic exam sooner than others.

For those women who are sexually active, it is very important to have annual pelvic exams. If you have been sexually active in prior relationships, it is a good idea to get tested for sexually transmitted infections before becoming sexually intimate with a new partner, even if you don’t have any symptoms, as most people with chlamydia or gonorrhea show no symptoms at all. When you visit the doctor for a pelvic exam, you will also be able to work with your doctor to find a reliable method of birth control to back up condom usage.

Most pelvic exams start with answering a number of questions about your general health, including menstrual history and sexual history. Then you are left alone so you can remove all of your clothes and get into a gown.

When the doctor returns, he/she will begin with a breast exam. If this is your first exam, you might want to let them know so they can be sure to explain each step as they go along. After the breast exam, you will scoot down to the end of the table and place your feet in the stirrups. At this point, you can expect a well-lubricated instrument called a speculum to be gently placed into your vagina. This shouldn’t hurt, but it might feel a little uncomfortable when it is opened slightly so your health care provider is able to see your cervix. Most places will hand you a mirror upon request if you would like to know what your cervix looks like. Then, he/she will gently swab your cervix with something that resembles a long Q-Tip, which also shouldn’t hurt, but you might feel some pressure. This swab will later be sent to a lab to test for abnormal cells.

The last part of the exam involves the removal of the speculum and the insertion of his/her two gloved fingers into your vagina. With the other hand, he/she will then gently push down on your lower abdomen in order to feel your fallopian tubes, ovaries and uterus. This is usually the conclusion of the pelvic exam. I’ve heard that some clinics also do a short rectal exam by placing a finger inside the rectum, but in my seven years of pelvic exams I have never yet personally experienced this. If you are sexually active (in the past, present or near future), have a family history of reproductive health issues or are experiencing any pelvic discomfort, you should be having annual pelvic exams. If none of those apply to you, you can wait to have one as long as you make sure you schedule your first by the time you are around 21-years-old.

Editor’s Note: Lyndsay Mercier is a senior Psychology major. She is also the president of Vox: Voices for Planned Parenthood, a trained sexual education peer educator and a teaching apprentice for Psychology of Sex Behaviors. Lyndsay is not a medical doctor and her advice should never replace the advice of a doctor. E-mail her your sexual health related questions at: [email protected]