Have you ever wondered how does a pelvic gynecological examination is performed and why? This is mostly important if you ever want to become pregnant because you`ll need to perform a few such investigations throughout pregnancy.

Table of Contents
What Can Be Found in a Pelvic Exam?
The pelvic examination represents a complete physical examination of the female pelvic organs performed by the doctor. The pelvic examination helps the doctor evaluate the size and position of the vagina, uterus, cervix, fallopian tubes and ovaries. This investigation is an essential part of preventive medicine and aids in the early diagnose of cancers, infections, STDs and other issues related to sexual organs.
What is a pelvic test for? This investigation can have several reasons for being performed:
- As a part of a routine physical examination of a woman; during this investigation, a Pap test can be performed as well.
- To detect vaginal infections, such as candidiasis or bacterial vaginosis.
- To detect STDs, such as genital herpes, trichomoniasis, papillomavirus, Chlamydia or gonorrhea.
- To determine the causes of an abnormal bleeding.
- To evaluate abnormalities of the genital organs, such as uterine fibroids, uterine prolapse or ovarian cysts.
- To evaluate pelvic or abdominal pain.
- Before the prescription of a contraceptive method; some of them, such as IUDs or diaphragms require a pelvic test to check if they are properly installed.
- To take samples in case of rape.
What Is a Bimanual Pelvic Examination?
Bimanual exam represented a procedure performed by the doctor by inserting 2 fingers into the woman`s vagina until isolating the cervical canal. Then he makes the test for cervical motion tenderness. The second part of the manual exam is performed by the doctor by pressing down the abdomen with the hand in order to find the fundus of the uterus as well as the adnexal structures.
How Is this Examination Performed?
The gynecological investigation and inspection with valves is performed as follows:
- You`ll first need to undress the lower part of your body and lie down upon a gynecological examination chair on your back, and place your thighs on some special supports. Please keep in mind that if the examination takes place in a non-private clinic, it`s possible to need a towel or a disposable diaper to lay down on the chair before sitting on it. In private clinics, usually, there`s a special disposable sheets used.
- After the inspection of the vulva, the doctor gently spreads the labia minora and major and inserts the tool inside the vagina.
- After inserting the dilator, the doctor uses it to extend the walls of the vagina, making the vaginal cavity and cervix available for inspection.
- During the examination, try to relax, take a deep and evenly breath – otherwise the procedure can become a bit unpleasant and may take more than it has to.
The popular gynecological instrument is sometimes named “mirror.” It has nothing to do with common glass mirrors and is named this way due to the conservation of the instrument`s old name, which initially was made out of metal and had a reflective surface.
Currently, doctors use disposable plastic mirrors to prevent transmission of genital infections during pelvic examination.
Often, the doctor takes a small amount of vaginal, cervical or urethral secretion with a special tampon during the inspection for bacteriological analysis, and also makes a small scraping of cervical tissue for cytological smears.
Also, depending on the results of the cervical inspection, the doctor may decide whether the colposcopy is necessary or not.
After the inspection of the valves, the doctor may perform a bimanual palpation of the uterus and uterine annexes.
The bimanual palpation means that the doctor will use his both hands to feel the cervix, uterus, fallopian tubes and ovaries. One hand will be placed on the woman`s abdomen, above the pubic area, and the indicator and middle fingers of the other hand will be inserted deep into the vagina.
The doctor will palpate the cervix using his 2 fingers inserted into the vagina, and the uterus, fallopian tubes and ovaries with the other hand.
Before you leave, ask your doctor when you need to come back to find out the results of the examination.
How Long It Last & How to Prepare for It?
Normally, this test takes around 10 minutes. During this period of time, the doctor will examine you internally and externally, and will collect the necessary samples for the following tests.
It`s good to avoid vaginal washes, sexual contacts as well as the introduction of any substance in the vagina in the last 24 hours before the test. In addition, it would be useful to think about a number of questions if you have concerns regarding this test. This way, you could maximize the benefit of the time spent during the examination.
What to Expect?
If it`s your first pelvic examination, you have all the reasons to be reluctant. During this test, the doctor will examine your vulva, cervix, uterus, fallopian tubes, ovaries and even the bladder, meaning the entire genital system. You`ll receive a robe to change in a specially designed room for this purpose, or you may be asked to take down your clothes from your waist down. Then, you`ll be asked to lie down on the gynecological table and lift your legs. As already mentioned, the doctor will start the consultation by inserting his finger into your vagina and pressing on your abdomen to tap the internal organs. He may also use a speculum to form a more concrete idea regarding the cervix. It`s also possible to take a sample for the Pap test, as this cannot be performed after the first trimester of pregnancy and the first 6 weeks after the birth of the baby. – Read to know more!
How to Reduce the Discomfort Associated with Pelvic Examination?
In order to manage to go over this moment more easily, first of all you could ask your partner or a very close friend to accompany you to the medical clinic. If you feel more comfortable with your mother or sister, don`t be shy to ask for their help. During the investigation, try to relax as much as possible, especially your abdominal muscles, buttocks or thighs. Breathe rarely through your nose or mouth. Ask the doctor to be gentler when using the dilator and also to explain the details of the procedure for your peace of mind.
Is a Pelvic Exam Painful?
A pelvic gynecological examination represents a thorough investigation of the pelvic organs of a woman. This exam aids the doctor see the position as well as the size of the vagina, uterus, ovaries and cervix. While performing the examination, the doctor will insert a dilator into your vagina. Inserting the dilator can sometimes lead to a bit of discomfort, but is rarely painful. If you feel any pain or discomfort during this gynecological test, talk to the doctor.
Can Ovarian Cancer Be Detected with a Pelvic Exam?
A pelvic investigation can always be useful as it`s able to discover some cancers related to the reproductive system very early. However, many early ovarian tumors are very hard or even impossible to be found by even the most experienced doctor. Still, pelvic examinations might aid identify other types of cancers and medical conditions. Women need to talk about the necessity of these investigations with their own doctor.
The Pap test represents an efficient method of cervical cancer, but it`s not really an exam for ovarian cancer. From time to time, ovarian cancers are discovered by Pap tests, but they are generally found at an advanced stage.
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