Your Pelvic Exam
How will it be done by my doctor?
You may need to have checkups even more often if you have
- Want to become pregnant
- sexually transmitted disease (STD)
- continuous sexual health problems
- Unusual vaginal or pelvic pain
- Unusual vaginal bleeding or discharge
- Sores, lumps, or itching of the vulva or vagina
- Any kind of abnormal changes in the breast
- Newly retracted nipples or bleeding or discharge from the nipple
- Missed periods
- Or any other kind of problem.
The Breast Exam
For your pelvic exam, normally you will be asked to get completely unclothed. You will be provided an clinical examination gown. The doctor will make you lie on your back on the exam table. The doctor will examine first your breasts with his/her hands for any abnormality like any lumps, discharge, and thickening. To keep you a comfortable and divert your mind from what he/she is doing, a good doctor will be asking you some questions keeping your mind busy.
Making Position
The doctor will ask you to put your knees up. You will rest your
feet on stirrups or your knees in knee rests.
You will have to slide your hips to the edge of the table towards
doctor to
provides best view to doctor. You will have to spread your knees wide
apart as far as possible.
Keep your abdominal and vaginal muscles relax for your comfort and best result. If your body is not covered and you are feeling odd, you can ask for for a drape sheet to cover your body. The examiners are very respectful of your privacy and are understanding of the situation.
The External Genital Exam
Now for a visual checkup of vaginal area the doctor will check outer lips and spread lips apart to check the vaginal opening area. The doctor will examine the structures of the vulva and will check the tone of the pelvic floor muscles and to check for any signs of redness, irritation, discharge, cysts, genital warts, or other conditions if any.
Speculum Exam
First, not necessarily, but doctor might insert one finger into the
vagina to locate the
cervix and to determine the angle of the vagina. This is done to find
the correct angle to insert the speculum. Now doctor will lubricate
either your vagina by taking lubricant on his/her finger and applying
it inside of your vagina or he/she will lubricate the speculum or both.
The
warm speculum will now be inserted into your vagina completely. The
doctor will gently open the speculum to separate the walls of the
vagina, which are closed and touch each other. So now he/she will be
able to view cervix (the opening to your uterus) clearly and easily.
You may feel some degree of pressure or mild discomfort when the
speculum is inserted and opened.
Once the speculum is in place, the doctor checks for any irritation, growth, or abnormal discharge from the cervix. Tests for gonorrhea, human papilloma virus (HPV), chlamydia, or other STDs may be taken by collecting cervical mucus on a cotton swab. It is possible to have many of these STDs without symptoms.
Pap Smear Test
After checking your vagina and cervix, a cervical brush and then a
spatula will be used to rub a sample of cells off the cervix for lab
testing. This is a Pap test. You may have some staining or bleeding for
a few days.
Lastly doctor will close the speculum and gently take it out. After taking out the speculum, the vaginal walls are checked for redness, irritation, injury, and any other problems.
Pap tests detects -
- The presence of abnormal growth in the cervix
- Infections and inflammations of the cervix
- Thinning of the vaginal lining from lack of estrogen.
Bimanual Exam
The last part of the pelvic exam is done to check your female internal organs, tubes, ovaries and uterus. The doctor will lubricate his/her index and middle fingers with K-Y jelly and insert his/her one or two fingers. The doctor will place these two fingers on the cervix while pressing gently your your abdomen with his/her other hand.
The doctor may make a motion by his/her fingers inside the vagina to check for any pain. He/she will move her abdominal hand also to feel for the size of the ovaries and to try to locate any abnormalities if any.
Rectal Exam
Some doctors do a rectal exam after the pelvic exam. This involves inserting one finger into your anus (the opening where bowel movements leave your body). This is usually done at the end of the bimanual exam. Like other parts of the exam, if you relax and take slow deep breaths, it should not be uncomfortable.
Usually, this whole exam lasts just a few minutes.
If You Feel Tense In-Between
- Breathe slowly and deeply with your mouth open.
- Let your stomach muscles go soft.
- Relax your shoulders.
- Relax the muscles between your legs.
- Ask the clinician to describe what's being done as it's happening.
- You may take your husband or mom with you for moral support with
you.
- If your examiner or gynecologist is a man, you should request
having
another woman in the room. Her presence may help you feel more relaxed.
She may hold your hand or just talk to you to ease your tension.
- Ask in advance if you want to see what's going on and/or have your reproductive organs identified for you. A mirror may be positioned so you can see.
Is Pelvic Exam Safe For A Virgin
Yes, it is. But tell your doctor before that you are virgin and want to keep your hymen safe. Then the doctor will use specially designed speculum called Pederson specula. These, Pederson specula, are of the same length of your index finger. Remember hymen is highly flexible and stretchable and a speculum or a small metal or plastic tool used during the internal exam, will not tear the hymen.
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