TAKING CARE OF OUR BODIES: THE PELVIC EXAM
There are four parts to a pelvic exam. You will be asked to lie down, let your knees spread wide apart, and relax as much as possible. Usually, the exam lasts just a few minutes. You’ll feel less tense if you do the following:
• 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.
The External Genital Exam
The clinician visually examines the soft folds of the vulva and the opening of the vagina to check for signs of redness, irritation, discharge, cysts, genital warts, or other conditions.
The Speculum Exam
In the speculum exam, the clinician inserts a duckbill-shaped speculum into the vagina to separate the walls of the vagina so that the cervix can be seen. You may feel some pressure or discomfort, especially if you are tense or if your vagina or pelvic organs are infected.
The clinician checks for any irritation, growth, or abnormal discharge from the cervix. If you request them, tests for gonorrhea, HPV (human papilloma virus), chlamydia, or other infections may be taken by collecting cervical mucus on a cotton swab.
The clinician will also use a tiny brush to gently collect cells from the cervix for a Pap test. You may have some slight staining or bleeding after the sample is taken. The cells are tested for the presence of precancerous or cancerous cells. Pap tests can detect:
• the presence of abnormal growth in the cervix
• infections and inflammations of the cervix
• thinning of the vaginal lining from lack of estrogen
The Bimanual Exam
In the bimanual exam, the clinician, wearing a lubricated examination glove, inserts one or two fingers into the vagina. The other hand presses down on the lower abdomen. You may find it somewhat uncomfortable. Deep breathing through the mouth helps. If you feel pain, tell the clinician.
The clinician can feel the internal organs of the pelvis between the two fingers in the vagina and the fingers on the abdomen and examine them for:
• the size, shape, and position of the uterus
• an enlarged uterus, which could indicate a pregnancy
• tenderness or pain that may indicate infection
• swelling of the fallopian tubes
• enlarged ovaries, cysts, or tumors
The Rectovaginal Exam
Many clinicians complete the bimanual exam by inserting a gloved finger into the rectum to check the condition of tissues that separate the vagina and rectum. They also check for possible tumors located behind the uterus, on the lower wall of the vagina, and in the rectum. Some clinicians complete the rectovaginal exam with one finger in the anus and another in the vagina for a more thorough examination of the tissue in between. You may feel as though you need to have a bowel movement. This is normal and lasts only a few seconds.
After the exam, you will discuss the results with your clinician, arrange for any follow-up or consultation that may be needed, and ask any further questions you may have. This is another opportunity to discuss your concerns about sex and sexuality, birth control, pregnancy, abortion, sexually transmitted infections, loss of urine, inherited disorders, infertility, signs of cancer, breast self-exam, or menopause.
If the lab tests indicate anything unusual, you will be contacted when the results are completed. Pregnancy test results are usually ready during your visit. Other test results may take three to 14 days.
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