The pelvic examination
A pelvic examination is a way for doctors to look for signs of problems in certain organs in a woman's body. The word 'pelvic' refers to the pelvis. The examination is used to check a woman's:
- Vulva (external genital organs)
- Uterus (the womb)
- Cervix (opening from the vagina to the uterus)
- Fallopian tubes (tubes that carry eggs to the womb)
- Ovaries (organs that produce eggs)
- Bladder (the sac that holds urine)
- Rectum (the chamber that connects the colon to the anus)
When are pelvic examinations done?
Pelvic examinations are performed:
Do I need to do anything to prepare for a pelvic examination?
You do not have to do anything special to get ready for this. When you arrive at the clinic, your doctor may ask if you need to use the lavatory. This helps examination to be more comfortable for you. Sometimes, a urine sample is requested.
What can I expect during a pelvic examination?
You can expect to feel a little discomfort, but you should not feel pain. It usually takes a matter of minutes. If you have any questions during the examination, make sure you ask them.
How is a pelvic examination performed?
During a typical pelvic examination your doctor or nurse will:
- Talk to you about any health concerns.
- Ask you to remove your underwear in private.
- 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 sometimes to place your feet in holders called stirrups, or rest your legs on leg supports.
- Perform the speculum examination. During the 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 test if appropriate using a small 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.
- Perform a bimanual examination. Your doctor will place two gloved fingers inside the vagina and uses 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, or if you feel discomfort or pain.
Sometimes a rectal examination is performed. Your doctor inserts a gloved finger into the rectum to detect any tumours or other abnormalities.
- Talk to you about the examination. You may be asked to return to get test results.
What tests are taken during the pelvic examination?
The NHS cervical screening programme in England is changing to testing for HPV first rather than looking for cell changes in the cervix.
In the new testing programme, women will be invited for cervical testing in the same way, but samples taken will be tested for HPV first using a viral DNA test.
If the HPV test is positive, women can have further testing and will be monitored closely for any abnormal cells developing.
Tests may also be taken to screen for sexually transmitted infections.