What to Expect During a Vaginal Exam

A vaginal exam, or more accurately, a pelvic exam, is an essential part of taking care of your body. You should have your pelvic exam once you reach the age of 21. It usually doesn’t hurt, only takes about a few minutes, and doesn’t change whether or not you’ve had sexual intercourse before. Here’s what to expect during a vaginal exam.

It should be a part of your routine check-up

When you think of routine physical assessment, you might remember tests like electrocardiogram (ECG), x-ray, urine test, and health interview. Just like these tests, a pelvic exam should also be included in your routine check-up.

The frequency by which one needs to undergo a pelvic exam is still up for debate. Traditionally, women do it every year, but some experts believe that history and current health status must come into play.

Regardless, at least one component of the pelvic exam has a designated frequency. This is the Pap smear, which a woman must do every 3 years.

There are 2 primary reasons for a pelvic exam

During a vaginal exam, you can expect your doctor to assess 2 things: your current gynecological health and any possible medical condition.

Your doctor can look for signs of ovarian cysts, myoma, sexually-transmitted infections, or cancer through the pelvic exam. Additionally, the pelvic exam is necessary if you’re experiencing pelvic pain, abnormal vaginal discharge, or skin changes.

You don’t need any special preparations for the exam

You don’t need to prepare anything for the pelvic exam, but the following pieces of advice can be helpful:

• Schedule the exam when you don’t have your monthly period.
• Know the first day of your last menstrual period.
• Empty your bladder before the procedure to be more comfortable.
• Prepare the questions you’d like to ask your doctor.
• Avoid sexual intercourse or inserting anything in your vagina 48 hours before the exam
• During the vaginal exam, expect questions that may relate to anything about your gynecological health. The doctor might ask you about your menstrual cycle, vaginal discharge, or pelvic symptoms.
• Openly ask your own questions as well.

There will be a consultation before the pelvic exam

During the vaginal exam, expect a consultation with the physician. He or she will take your history and vital signs, review your immunization records, and check for signs of STIs. Moreover, the doctor may even perform a back, breast, and abdominal exam.

The following routine may take place

After the consultation, the doctor will ask you to remove your clothes and wear a hospital gown. They’ll tell you to lie down on your back on the exam table, with your knees bent and your feet on the stirrups or the corners of the table. You’ll also have to slide your body to the edge of the exam table.

After that, the following may take place:

• External exam – Expect that the first part of the pelvic exam involves the doctor checking the outside of your vagina (vulva) for visible signs such as swelling, sores, and color changes.
• Speculum exam – Next, the doctor will insert a plastic or metal speculum to open your vaginal walls to inspect them for abnormal conditions. If your exam includes a Pap smear, the doctor will also take a small cervical tissue sample for laboratory testing before removing the speculum. It’s normal to feel slight discomfort in this part, but generally, it’s not painful.
• Bimanual exam – Afterward, the physician will insert 1 or 2 gloved fingers in the vagina while pressing your lower abdomen using their other hand. This is done to check for any tenderness or pain, enlarged reproductive organs (ovaries, uterus, fallopian tubes, etc) and assess your uterus’s size and shape.
• Rectovaginal exam – Finally, although it’s not always included, the doctor may also insert a gloved finger into your rectum to palpate your rectum, the area behind your uterus, and the lower wall of the vagina. Initially, you might feel an urge to poop, but don’t worry, you won’t.

Overall, you may feel a little uncomfortable—during the pelvic exam—but expect that it’ll be over in a few minutes.

After the vaginal and pelvic exam, expect that the doctor will discuss their findings with you. Don’t hesitate to ask any question you might be having.

Learn more about the Screening & Tests for Women here. 

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