Pelvic Exam

A pelvic exam is one of the routine procedures performed during gynecological check-ups to examine the external sexual organs and assess the condition of the cervix and vagina. It can also be conducted to detect pathologies of the female reproductive system.

Examen diagnóstico

General Description

The pelvic exam is part of the tests carried out during a routine gynecological check-up. It is performed to assess the health and anatomy of different parts of the female reproductive system: vulva, vagina, cervix, uterus, fallopian tubes, and ovaries. Additionally, it is a common test when symptoms of illness are present, such as pain or abnormal vaginal discharge.

When is it indicated?

As a general rule, an annual pelvic exam is recommended starting at age 21 (earlier for sexually active minors) to monitor women's health. It is also part of the first pregnancy check-up to ensure that the reproductive system is in proper condition.

Additionally, it is one of the recommended procedures to diagnose or rule out pathologies when the following symptoms are present:

Bleeding between periods.
Abnormal color, texture, or quantity of vaginal discharge.
Pain.
Itching or burning sensation.

A pelvic exam can help detect sexually transmitted diseases, cysts, infections, or cancerous tumors.

How is it performed?

During a pelvic exam, the patient lies on her back in the gynecological position, with legs spread and placed on stirrups. The procedure consists of two parts:

Examination of external sexual organs: The vulva is inspected for sores, ulcers, irritation, inflammation, or changes in skin color.
Examination of internal sexual organs:
- First, the specialist palpates the abdomen to assess the condition of the uterus. Then, wearing a lubricated glove, the doctor inserts the index and middle fingers into the vagina while pressing on the lower abdomen with the other hand.
- To examine the vagina and cervix, a speculum is used to keep the vaginal walls open for better visualization.

During routine check-ups, a Pap smear sample is collected following this exam, taking advantage of the patient's position and the use of the speculum.

Risks

A pelvic exam does not pose a health risk or cause side effects.

In very rare cases, using a speculum that is harder than usual may cause a small injury to the vaginal wall, which heals on its own but may result in slight pain or minor bleeding.

What to expect from a pelvic exam

A pelvic exam usually lasts no more than five minutes. To undergo the procedure, the patient must remove clothing from the waist down. Once lying on the gynecological table, the upper thighs are covered with a fabric or paper sheet to maintain the patient's privacy.

During palpation, a slight pressure may be felt in the vagina and uterus. The speculum may feel cold upon insertion, so some gynecologists warm it slightly before use.

Some patients describe the procedure as painful. To reduce discomfort, it is best to remain as relaxed as possible, particularly by relaxing the vaginal muscles.

It is advisable to inform the specialist if this is the first pelvic exam or if the patient is a virgin and has never engaged in intercourse, so they can explain each step and use a smaller speculum if necessary.

After the exam, the patient can easily wipe off any remaining lubricant with a piece of paper, although some residue may be expelled after standing up.

The gynecologist provides results or indicates the need for additional tests once the exam is complete.

Specialties that request a pelvic exam

The pelvic exam is a procedure performed in the field of gynecology and obstetrics. Additionally, family doctors, pediatricians, and emergency physicians may perform it when necessary.