Women’s health centre

Pelvic examination and the menopause

A pelvic examination is a physical examination of the pelvic organs. It is used to examine a woman's:

Uterus (womb)
Cervix (opening from the uterus to the vagina)
Fallopian tubes (tubes that carry eggs to the womb)
Ovaries (glands that produce eggs)

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Why would I need a pelvic examination?

These gynaecological examinations can be carried out for various reasons, at various times in a woman’s life. Women may seek medical advice, for example, if their periods are very heavy or very frequent, or if the woman has lower abdominal pain or other vaginal symptoms and the doctor may decide to do a pelvic examination. In post-menopausal women an examination may be carried out if there is vaginal bleeding or other vaginal symptoms, or lower abdominal pain.

Pelvic examination can help in the early detection of cancer in women before and after the menopause. A cervical smear test (sometimes called a Pap smear) is usually taken during a pelvic examination to check the condition of the cervix. Regular cervical screening is very important in identifying abnormal cervical cells before they develop into cervical cancer. Women are routinely invited to have regular cervical smear tests from the age of 25 in England and from the age of 20 in the rest of the UK.

Pelvic examination can be used to diagnose prolapse, which is a common condition in older women. Pelvic organ prolapse occurs when the pelvic floor muscles become weak or damaged and can no longer support the pelvic organs. This can sometimes cause incontinence.

Pelvic examination can also be used for treatment - for example, removal of polyps.

What can I expect during the pelvic examination?

You can expect to feel a little discomfort, but you should not feel pain. The examination takes about 10 minutes. If you have any questions during the examination, be sure to ask your doctor.

How is the pelvic examination performed?

During a typical pelvic examination, your doctor will:

Talk to you about any health concerns.
Ask you to take off your clothes in private (you may be given a gown or other covering).
Ask you to lie on your back and relax.
Press down on areas of the lower stomach to feel the organs from the outside.
Help you get in position for the speculum examination (you may be asked to slide down to the end of the table).
Ask you to bend your knees and let them fall open.
Perform the speculum examination. A device called a speculum will be inserted into the vagina. The speculum is opened to widen the vagina so that the vagina and cervix can be seen.
Perform a cervical smear. The doctor will use a plastic brush to take a sample of cells from the cervix. Swabs may also be taken from the vagina and cervix to test for infection.
Remove the speculum.
Perform a manual examination with their fingers. The doctor will place two fingers inside the vagina and use the other hand to gently press down on the area he or she is feeling. Your doctor is noting if the organs have changed in size or shape.
Sometimes a rectal examination is performed. Your doctor inserts a gloved finger into the rectum. This can detect any tumours or other abnormalities.