Definition During a pelvic examination, a doctor checks a woman's outer and inner genitals for any abnormalities.
Who is a candidate for the procedure? The first pelvic examination is not required until 2 years after commencing sexual intercourse. Pelvic examinations allow a doctor to check on normal development and screen for certain health problems, such as cancer of the cervix or ovaries. These examinations should be done regularly throughout a woman's life and when certain health problems are suspected.
A woman might have a pelvic examination for many reasons, such as to:
explore reasons for infertility, which is the inability to get pregnant, urinary incontinence, which is involuntary urine leakage, or sexual dysfunction
evaluate a mass or other symptoms that suggest a reproductive system cancer
How is the procedure performed? Usually a caring, knowledgeable and empathic doctor can do a pelvic examination without causing a woman much discomfort. Mild anaesthesia or analgesics may be used if a woman has experienced trauma, feels great discomfort or has certain health problems. Medications may also be given when an examination must be done on a young girl.
Before the examination starts, the woman lies down on her back on a special table. She may put the heels of her feet into stirrups that help support and open her legs. A cloth or paper drape is usually place over her belly and legs.
First, the doctor checks the normal anatomy of the outer genitals, which include:
the hymen, a thin layer of tissue that partly closes the vaginal opening
the labia, which are the skin folds surrounding the vaginal opening
the urethra, which is the tube that carries urine from the bladder to the outside of the body
the clitoris and vaginal opening
Any moles, ulcers, warts, cysts, discharge, cuts or reddening are recorded.
An internal examination is done next. First, the doctor inserts a tool called a speculum into the vagina. It looks like a long duck bill. The speculum helps hold the vaginal walls apart so that the vagina and cervix, or the opening to the uterus, can be examined. Cultures of any vaginal or cervical discharge may be taken. A Pap smear may be done, too, to screen for precancerous changes in cervical cells.
After the internal examination is done, the speculum is removed. The doctor then places one or two fingers into the vagina. Putting the other hand on the woman's lower belly, the doctor gently presses against the cervix, uterus, ovaries, fallopian tubes and supporting ligaments. Their size, shape and location will be noted. The doctor will also note any pain, tenderness, enlargement or possible links to nearby organs. If a woman is thought to be in labour, her doctor can check how far her cervix has opened and where the baby is within the birth canal.
What happens right after the procedure? Immediately after the examination, the woman can get dressed and speak with the doctor.
What happens later at home? No special care needs to be taken after a pelvic examination.
What are the potential complications after the procedure? There are no complications from a pelvic examination.
Author: Eva Martin, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 12/06/2005 Contributors Potential conflict of interest information for reviewers available on request
