What Is A Pelvic Exam?

What Is A Pelvic Exam?

Do you want to know what pops up in related searches if you google “pelvic exam”?

-Does a pelvic exam hurt?

-What happens during a pelvic exam?

-Pelvic exam vs Pap smear

-At what age can you stop having pelvic exams?

You get the point. No one is all that excited about pelvic exams and there MIGHT be some confusion as to what a pelvic exam actually entails. Is it any wonder then that fear and emotional distress are the most common reasons women don’t see their women’s health provider?

So, what is a pelvic exam? It includes ANY of the following components: assessment of external genitalia, internal speculum examination, bimanual palpation, and rectovaginal examination. Now who's ready to schedule their next well woman visit?! Anyone...hello?

Here's the good news. Firstly, a pelvic exam SHOULD NOT hurt. Secondly, you might not need that routine screening pelvic exam to begin with. Let's break it down.

First off: A pelvic exam SHOULD NOT hurt. If it does you have every right to ask your provider to stop. This is a great opportunity to find out if your provider is one who genuinely cares about women and their comfort. If your provider isn’t willing to listen to you or offer ways to make the exam more comfortable, you maaaaaay want to find a new provider. 

One way to make the exam more comfortable is by avoiding stirrups. You don’t have to be in stirrups for the exam- this includes any pelvic exam and even IUD insertions! It is entirely possible perform a pelvic exam, use a speculum and place an IUD with just the exam bed. When you place your feet on the exam bed instead of in stirrups it gives you the power to move and adjust yourself when you need to. Stirrups make it really hard to adjust if you’re in pain or feeling uncomfortable. There are other ways to perform a pelvic exam that give YOU more control; talk to your provider about them at your next visit!  

Secondly, when should you get a pelvic exam? Currently there isn’t enough evidence to support routine screening pelvic exams in low risk, non-pregnant adult women. Yes, you heard me. Routine screening pelvic exams haven’t been found to improve quality of life, or reduce disease specific morbidity and mortality. We don’t know if the benefit of a pelvic exam outweighs the risk in asymptomatic, low risk women. Using a pelvic exam alone to screen for gynecological conditions, other than cervical cancer (hello, Pap smear!), gonorrhea or chlamydia, is lacking in research!

What does this mean for you?

If you are pregnant, symptomatic (I.e. abnormal discharge, odor, at risk for sexually transmitted infections), have family history of gynecological cancer, or are due for a Pap Smear, you SHOULD have a pelvic exam AND this will likely include the use of a speculum. Speculums are used to inspect the cervix, to take samples of the cervix for cervical cancer screenings and to rule out infections, or to place an IUD. Ask your provider to start with the smallest speculum first to minimize discomfort during the exam.

If you are low risk, asymptomatic, not due for a Pap smear, less than 18 years old, have no risk factors for gynecological cancers or sexually transmitted infections, discuss with your provider whether you can opt out of a pelvic exam. 

You should STILL see your women’s health provider annually for a breast exam, to discuss lab work, birth control, preventive medicine, and whatever else is on your mind! 

If you are looking for a feminist women's health provider, have additional questions about this post, or would like to know more about how to have the MOST comfortable pelvic exam contact me at holisticmindbodywoman@gmail.com

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