The SOGC provides the following public education pamphlets designed for patients, clinics and health-care facilities. This material has been reviewed and endorsed by the SOGC’s subject matter experts.
My First Pelvic Exam
How to Turn an Embarrassing Moment Into a Positive Experience
You are going to have your first pelvic exam, and just thinking about it scares you to death!
- "It might hurt"
- "I don't want anyone to look at me down there"
- "It's too embarrassing"
- "The exam will take forever"
- "I'm too scared...I just want to run out of here right now"
Even though it scares you to think about an internal exam, it is really important for you and your doctor to know that your pelvic organs are healthy. Let's explain why…
- "Why do I need to have a pelvic exam?"
Here's Why A Regular Pelvic Exam is A Good Idea
- To check that your pelvic organs (uterus, tubes and ovaries) are of normal size and shape, and located in the normal position.
- To detect infections that may result in vaginal discharge, pelvic pain, or infertility if not treated.
- To detect abnormalities of the cervix such as precancerous conditions which may become cancer if not treated.
- "I know I should have a pelvic exam, but I'm still embarrassed and scared that it will hurt"
It is true that a pelvic exam can be embarrassing, but it does not hurt. During a pelvic exam, you will feel pressure (like someone squeezing you hard), but you should not feel pain.
- "Okay, so I'm getting up the courage to go through with this."
What Exactly Happens During A Pelvic Exam?
First, you will be asked some questions about your medical history. You may also be asked about :
- the first day of your last menstrual period
- whether or not you are sexually active
- whether or not you are using birth control
If you have any problems, such as problems with your periods, vaginal discharge, pelvic pain, or if you think you might be pregnant, be sure and let the nurse know. They will take your blood pressure and ask you to go to provide a urine sample.
Next, you will be shown into an examining room where you will be asked to change into a gown. You may also have a sheet to cover you while you are sitting on the examining table.
You will meet the doctor, review your medical and reproductive history, and may have an exam (head, neck, breasts and abdomen) to check your general health. If you have any reproductive worries, concerns or questions for the doctor, it is a good time to talk about it.
You will be asked to lie down on the examining table and move your bottom to the end of the table. Your feet rest in a comfortable position with your knees bent and spread apart, as your doctor checks your vulva (outer lips of the vagina)
Here is when the exam can become embarrassing!
"What is That Thing That My Doctor Puts Inside of Me?"
A speculum helps your doctor look at your vagina and cervix. It is a slender instrument made of plastic or smooth metal which looks like a duck's bill. It should not hurt when the doctor gently slides it into your vagina. If you do feel any discomfort, let your doctor know. It is very important that you relax the muscles around your vagina at this point, so the speculum can slide in easily like a tampon. If you tense up your muscles, your doctor may have to push to get the speculum in, which could be uncomfortable.
- Relax, relax
- Keep breathing and relax all of your muscles!
"What Does the Doctor See When the Speculum is Inside Me?"
When the speculum is inside your vagina, your doctor can see the walls of your vagina and cervix. Cells will then be gently collected from the surface of your cervix during a Pap test. The sample is then sent to a lab where the cells are looked at under a microscope to make sure they are normal. Although most Pap smears are normal, early treatment of abnormal Pap smears can usually prevent serious diseases like cervical cancer.
Your doctor may also touch a Q-tip to your cervix to check for infections such as chlamydia, gonorrhea or genital warts. Again, early detection and treatment of infections can usually prevent more serious diseases later on. The speculum is then removed from your vagina.
Your doctor will then put a gloved finger into your vagina and check the size, shape and position of your pelvic organs while gently pressing on your lower abdomen. A slippery lubricating jelly may be used. This is where you will feel pressure, but not pain. Again, concentrate on relaxing your stomach muscles so your doctor can check that your uterus, tubes and ovaries are normal.
That's it! Congratulations - you've survived your first pelvic exam!