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Women's Health

What Happens During a Pelvic Exam

When a woman reaches 21, she should have a complete physical exam, breast exam, and pelvic exam annually. Pap smears are sometimes done as part of the annual exam.

Before the actual exam, a medical and reproductive history will be taken and your weight, height, blood pressure and pulse will be recorded. The information requested will vary depending on the reason for your visit but may include any family history of illness, your present health status and habits, details of your menstrual cycle, your sexual history, present method of contraception and past illness, operations and pregnancy. This information helps us determine your health needs.

Before thel exam, you will be asked to change into a gown or drape in the exam room. Your physician, nurse practitioner, or physician's assistant will then examine your thyroid gland, heart, lungs, breasts and abdomen to help identify potential health concerns. At this time, you can learn how to examine your breasts. Breast self examination is a valuable habit for women of all ages to develop.

Then you will be asked to lie down, slide to the end of the examination table and put your heels in the footrests, called stirrups. Feeling tense, anxious or even embarrassed is common at this time. Deep breathing and relaxation techniques can be helpful. Your clinician will first look at your external genitalia for signs of redness or infection then proceed to examine your internal pelvic organs. To do this, (s)he will separate the walls of the vagina with a speculum. The speculum is a slender metal or plastic instrument that looks like a duckbill. It should not pinch and may be warmed or moistened before being gently inserted into your vagina.

Although the pelvic exam may be an awkward experience, it should not be painful. You may feel pressure that can be uncomfortable but you should not feel pain. Tell your clinician if this is not the case.

At this point, your health care provider can see your cervix. The cervix is the lower portion of your uterus and can be a site of abnormal cell development. The clinician may do a Pap smear at this point. A Pap smear involves collecting cells from your cervix in order to test for cervical cancer.

Additional tests for vaginal or sexually transmitted infections can be taken at this time as well, if necessary. Then the speculum will be removed. A small amount of vaginal bleeding or spotting after your exam can be normal. You clinician will next place two gloved fingers into your vagina while their other hand gently presses on your lower abdomen. This identifies the size, shape, and position of your uterus, fallopian tubes and ovaries. Again, you should feel pressure but not pain.

Finally, a rectal exam may also be performed. Still wearing a glove, your health clinician will insert a finger in the vagina while another well-lubricated finger is gently inserted into the rectum. This is done to determine if there are any masses in the anal canal and also to feel the uterus, cervix, and ovaries. Again, try to relax. If you want to refuse the rectal exam, please let your clinician know.

That's it! Your pelvic exam is over! If you want to use a method of contraception, your health care provider can now help you determine what is right for you.

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