Your First Pelvic Exam

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gynecologist officeYou may be worried about your first pelvic exam. It’s very normal to be uneasy about something when you don’t know what to expect. It’s also normal to feel embarrassed. Hopefully after reading this information, you will be reassured that it’s simple, not painful, and takes only about 5 minutes. Your health care provider understands how you feel and will be sensitive and gentle, help you relax, and answer any questions you have.

What is a pelvic or gynecological exam?

A pelvic exam is a way for your health care provider to examine your female organs and check for any gynecological problems.

When should I have my first pelvic exam?

Inside the female reproductive organs

Inside the female reproductive organs

Most health care providers agree that you should have your first exam when you have symptom such as discharge or pain, or when you turn 21, whichever comes first. There are other important reasons that you may need a pelvic exam.

These may include:

  • Unexplained pain in your lower belly or around the pelvic area, where your vagina is
  • Vaginal discharge or wetness on your underwear that causes itching , burns or smells bad, particularly if you’ve had sex
  • No menstrual periods by age 15 or 16
  • Vaginal bleeding that lasts more than 10 days
  • Missed periods; especially if you are having sex
  • Menstrual cramps so bad that you miss school

Remember, it doesn’t matter how old you are or if you are sexually active, if you have any of the symptoms listed above, you should make an appointment with your health care provider or gynecologist.

Will I need a pelvic exam if I’m a virgin?

Even if you’re a virgin (you’ve never had vaginal intercourse), you may need a pelvic exam if you are having any of these problems. Having a pelvic exam doesn’t change anything, just as using tampons doesn’t change your hymen (the skin that partly covers the opening to your vagina).

What should I do before the exam?

  • When you make your appointment, be sure to let the secretary or nurse know that this is your first pelvic exam. The nurse can answer your questions and help explain what to expect so you won’t be worried.
  • Do NOT have sex, use vaginal creams or douche for 24 hours before the exam.

What kinds of questions will my HCP ask me?

Your HCP will ask you questions about:

  • Your general health, allergies and medications you are taking
  • Your menstrual period, such as how old you were when you first got it, how long it lasts, how often it comes, how much you bleed, the first day that your last period started, if you have cramps; and at what age your breasts started to develop
  • Whether you have ever had sex or have been sexually abused
  • If you have vaginal itchiness or an unusual discharge (drainage) or odor from your vagina

Getting Ready:

  • If you find it helpful, your mom, sister or friend can stay with you. There may also be a nurse or a medical assistant in the room, too.
  • After you have given your medical history, been weighed and had your blood pressure checked, you will be asked to put on a gown.
  • You will need to remove your clothes including your underwear and bra. A breast exam is often done as a routine part of this check-up.

What happens during the exam?

  • Your health care provider will explain the different parts of the exam and ask you to lie down on the exam table. You will be given a sheet to put over your stomach and legs.
  • You will then be asked to move down to the end of the table and place your feet in stirrups (these are holders for your feet).
  • With your knees bent, you will be asked to let your knees fall to each side allowing your legs to spread apart.

This is usually the part when some young women feel embarrassed. Your HCP should make you feel safe and at ease. It’s important to tell him/her if you are scared, nervous, or uncomfortable.

There are 3 parts to a pelvic exam. Sometimes not all the parts are necessary. Ask your health care provider which part(s) will be done for your examination.

Vaginal area

Vaginal area

The External Exam (Part 1): Your health care provider will first look at the area outside of your vagina (clitoris, labia, vaginal opening, and rectum).

The Speculum Exam (Part 2):

  • The speculum is an instrument made of metal or plastic. Your HCP will gently place the speculum into your vagina. After it’s inserted, it will be gently opened so that your health care provider can see your vaginal canal and your cervix (the opening to your uterus). If you like, you can ask your HCP for a mirror so that you can see what your cervix looks like.
  • After checking your vagina and cervix, your HCP may take a thin plastic stick and a special tiny brush (that looks like a broom) and gently wipe away some of the cells from your cervix. This is a Pap test, which senses early changes of the cervix before they become cancer. Most girls have normal Pap tests.
  • If you are having vaginal discharge, your HCP will take another sample to check for yeast and other causes of discharge.
  • If you’re having sex, your HCP will take another sample from the cervix and/or vagina and a urine test to check for sexually transmitted infections. When all of these samples have been gathered, your HCP will close the speculum and gently take it out of your vagina.

Pap testThe Bimanual Exam (Part 3):

  • The last part of the pelvic exam is done to check your female organs (your tubes, ovaries and uterus or womb). Your HCP will insert one or two gloved fingers into your vagina. With the other hand, he or she will gently apply pressure to the lower part of your belly. You may feel slight discomfort or pressure when he or she presses in certain places, but it shouldn’t hurt. If you do feel pain, it’s important to tell your HCP.
  • Sometimes your provider will do a rectal exam. This involves inserting one finger into your anus (the opening where bowel movements leave your body). This is usually done at the end of the bimanual exam. Like other parts of the exam, if you relax and take slow deep breaths, it should not be uncomfortable.

What happens after the exam is over?

When the exam is over, your HCP will tell you what he/she found, if your exam is normal, if you need to take any medications, how to get the results of the Pap and other tests, and when to make your next appointment.

By having a pelvic exam and Pap test and checking in with your health care provider when you have unexplained discharge and/or pain, you are taking care of your reproductive health.