Female Reproductive Exams

Female Reproductive Exams


Needed once each year or more frequently with symptoms. A woman should have a gynecological exam if she:

• Has reached the age of 18
• Is sexually active or is about to become so
• Desires a prescription for oral contraceptives
• Wants to have an IUD inserted
• Needs to be fitted for a diaphragm or cervical cap
• Experiences unusual pelvic symptoms (pain, unusual discharge, abnormal bleeding)
• Wants to learn how to give herself a breast self exam

To prepare for an exam you should

• Make an appointment with someone you’re comfortable with (a woman? Someone you’ve seen before?)
• Know your own health history, your family’s health history, your current (if any) symptoms, and any questions you would like to ask (sometimes writing these things down helps)
• Not have intercourse, douche (you should never douche), use any vaginal medications (including spermicides and lubricants), or use tampons for 24 hours before the exam
• Avoid scheduling during your period; it’s best to schedule in the middle of your cycle, around the time of ovulation
• Urinate before the examination (a full bladder makes the bimanual exam uncomfortable)

What to expect:

1. Family and medical history
2. General physical exam (blood pressure, weight, abdominal exam)
3. Breast Examination: The practitioner will palpate the woman’s breasts, looking for abnormalities and teaching the patient how to examine her own breasts
4. External Examination: The practitioner will look at the external structures of the vulval area. If you are having any unusual symptoms, this is a good time to bring them up.
5. Speculum Examination: A plastic or metal speculum is inserted into the vagina, and it is opened. The vaginal walls and the cervix (opening to the uterus) are examined. If a Pap test is planned, the examiner uses a small spatula-like instrument to gently scrape the cervix. This test microscopically examines cervical cells in order to detect abnormalities, including pre-cancerous changes.
6. Bi-manual Examination: The practitioner inserts one or two fingers into the vagina, and using the other hand on the abdomen, palpates the uterus and ovaries.
7. Recto-vaginal Examination (sometimes performed) — The practitioner places one finger in the vagina, one finger in the rectum, and the other hand on the abdomen. This exam allows palpation of more of the internal structures, and is especially useful for some women whose uteruses are tilted towards the back of their bodies.
8. Pregnancy testing and tests for sexually transmitted infections and HIV are also available. See Pregnancy fact sheet or the STD testing fact sheet for more information.

Does it hurt?
Women who have never had vaginal intercourse are often concerned that a pelvic exam will be painful or even impossible. It is important to know that speculums come in very small sizes, and that the practitioner can insert only one finger into the vagina if necessary. All steps will be taken to ensure that the exam is painless.