Pelvic Examination

Gynecologic Exam

How It Is Done

During a pelvic examination, you will:

• Take off your clothes below the waist. You will have a paper or cloth covering around your waist. If you are having a yearly examination, you may need to undress completely so your health professional can also do a breast examination.
• Lie on your back on an examination table with your feet raised and supported by stirrups. This allows the health professional to examine your vulva, urethra, vagina, and other reproductive organs. You may want to wear socks to keep your feet warm while they are in the stirrups.
• Have a drape across your body for privacy during the test. The health professional may use a lamp during the test, and you may ask for a mirror if you want to watch while the test is being done.

A female nurse or assistant may stay in the room with you during the examination. You may also request the presence of your partner or a friend.

External examination

During the external examination, the health professional will:

• Check your vulva and the opening of your vagina for signs of redness, irritation, discharge, cysts, genital warts, and other abnormal conditions.
• Check inside your vagina with his or her gloved fingers for any cysts or pus coming from the Bartholin glands.
• Gently insert the speculum into your vagina. The speculum spreads apart the vaginal walls, allowing the inside of the vagina and the cervix to be examined. The speculum may be plastic or metal and may be warmed with water or lubricated with a vaginal lubricant (such as K-Y Jelly).
• Check the walls of your vagina and your cervix for damage, growths, inflammation, unusual discharge, or discolouration.

If you are due for a Pap test, your health professional will use a small brush or a wooden spatula to gently collect a sample of cervical cells. You may have some staining or bleeding after the sample is taken. A sample of the cervical mucus may also be obtained with a cotton swab and tested for sexually transmitted infections such as gonorrhea or chlamydia.

Bimanual examination

This examination is usually done as part of a pelvic examination. Your health professional will insert one or two gloved fingers of one hand into your vagina while placing the other hand on your lower abdomen. By pressing down on the abdomen and moving the fingers around inside your vagina, your health professional can locate and determine the size, shape, and consistency of the uterus and ovaries. Any unusual growths, tenderness, or pain can also be identified.

Rectovaginal examination

For this examination, your health professional will insert one finger into your rectum and one into your vagina. This helps your health professional evaluate your ovaries and uterus ligaments. This examination is not always done as part of a pelvic examination.

The entire pelvic examination takes about 10 minutes. After the examination is finished, you will be given a face cloth or tissue to wipe your vaginal area to remove any discharge resulting from the examination, and you will then dress. Some test results may be available immediately, but results from the Pap test may take from several days to a couple of weeks.

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Author:	Maria G. Essig, MS, ELS Carrie Henley	Last Updated: August 7, 2007
Medical Review:	Patrice Burgess, MD - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology Andrew Swan, MD, CCFP, FCFP - Family Medicine
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