Why are pelvic exams important?
A pelvic exam should be a normal part of your regular wellness visit to your healthcare provider. It takes only a few minutes and is relatively painless, other than applied pressure. A pelvic exam only lasts a few minutes and can typically be performed by an OBGYN, primary physician, or women’s health/fibroid specialist.
The doctor will examine your reproductive organs during the exam including your vagina, uterus, cervix (opening from the vagina to uterus), fallopian tubes, vulva (external genital organs), bladder that holds urine, and rectum that connects the large intestine with the anus. A pelvic exam is often conducted on the women to check for the symptoms of ovarian cysts, sexually transmitted diseases, yeast infections, endometriosis, adenomyosis, and uterine fibroids, as well as any other abnormalities.
When should you consider a pelvic exam?
A pelvic exam should be scheduled when:
- You have pain in pelvic region or lower back
- You are, or think you are, pregnant
- There is unusual vaginal discharge
- You are over the age of 21
- Issues regarding heaviness or length of periods
- There is family history of cancer
- Urinary problems
- You experience pain during intercourse
- Noticed unexplained weight gain or a protruding abdomen
How to prepare for pelvic exam?
If you are pregnant, or think there may be a chance you are, it’s important to note this at the beginning of your appointment. Make a list of medications and make certain they are up to date. If you have any questions, you should prepare well and write these down before you get to your appointment. Remember to inform you doctor at the time of appointment, if you would like them to perform a PAP smear as well. A pap smear test collects cervical cells to check for cervical cancer.
The exam should be scheduled when you are not currently on your period. Additionally, you should avoid the following 48 hours before your exam: 
- Having sex
- Use of tampons
- Use of cream or birth control foam/topical
How is the exam performed?
Here is step-by-step procedure to conduct a pelvic exam:
- You will be given a gown or some other covering to change into prior to seeing the doctor.
- You will meet with the doctor and be able to go over any questions or concerns you may have.
- You will be asked to lie on your back on an exam table or bed.
- The doctor will feel your organs from the outside by pressing on your stomach and side.
- They will conduct a visual external exam checking for abnormalities, swelling, or irritation around your vulva.
- You may be asked to bend your knees and place your feet in the holders called stirrups.
- You will be asked to slide your body toward the end of the table and let your knees fall open.
- Your doctor will use a speculum to spread open your vaginal walls. The speculum might be warmed before it’s inserted to make it more comfortable for you. It may cause a bit of discomfort or pressure for some women.
Your doctor will explain what to expect during the exams beforehand and remind you to let them know if you feel uncomfortable during any stage of the exam. Your gynecologist, primary physician, or women’s health/fibroid specialist may ask you questions related to your periods, sex life, use of pads and tampons, discharge, urinary problems, etc. You may ask questions too, it’s a great time to get answers to your concerns from your doctor. Your doctor may have a nurse in the room during the exam. If it makes you more or less uncomfortable, do not be afraid to speak up and share your concerns. It’s important to remember that their first priority is your comfort and care.
Types of pelvic examinations
Your doctor may perform the below exams on you as part of your pelvic exam:
- External exam: Your vulva and the opening of your vagina will be examined for the signs of irritation, genital warts, cysts and other issues.
- Speculum exam: An instrument called speculum will be gently inserted into your vagina to separate the walls of your vagina. Be relaxed, it won’t hurt you, and if it does, tell the doctor, they will make adjustment in the position accordingly. Your cervix may be seen with a mirror and a small sample of cells will be taken for Pap test to see any signs of cancer in the cervix. A sample of your discharge from cervix may be taken to see the signs of any sexually transmitted infection.
- Bimanual exam: Your doctor or nurse will gently put gloved fingers into your vagina and press on your lower abdomen with the other hand to see the size and position of your uterus, infection, uterine fibroids, cysts and enlarged ovaries. The exam may reveal enlarged organs or tissue masses.
- Rectovaginal exam: Your doctor or nurse may put a gloved finger into your rectum to check for tumors or fibroids behind your uterus, on the lower wall of vagina or in your rectum. The rectum may be checked for lumps or abnormal areas. This exam is less common and may only be performed when there is a specific issue arises.
If you do not consent to a certain part of the exam, be sure to tell your doctor. The examination will hardly take 10 minutes to complete.
What conditions can be diagnosed with a pelvic exam?
Your pelvic exam can treat the below conditions:
- Uterine fibroids and tumors
- Sexually transmitted infections
- Ovarian cysts
- Urinary tract infection
- Bacterial vaginosis (mild bacterial infection in vagina)
- Tumors of the genital organs
- Endometriosis (uterine lining outgrowing to nearby organs)
- Uterine abnormalities
Common method of detecting fibroid growth
Pelvic exam is the most common way of detecting uterine fibroids. Irregularities found in the shape of your uterus during the pelvic exam may indicate fibroid growth. Uterine fibroids, medically termed as leiomyomas or myomas, vary in their shape, location and numbers. Some women may have one large fibroid while some others may have many of them in small sizes. They may be located inside the uterine cavity, within the wall, or attached to the wall and hang down by a stalk. Uterine fibroids commonly occur in the women during their reproductive years and in women who are of African-American descent are more likely to have them.
High estrogen levels during pregnancy seem to trigger the growth of fibroids as they often go of their own after menopause when estrogen level returns to normal. Being overweight may also increase your risk of developing fibroids.
If you are struggling with any of the below fibroid symptoms, it’s important to contact a fibroid specialist to get checked right away.
Symptoms of fibroids:
- Enlarged uterus or protruding abdomen
- Heavy periods
- Periods lasting more than 10 days per month
- Bleeding between menstrual cycles
- Severe cramps
- Fatigue caused by anemia
- Frequent urination or difficulty emptying the bladder
- Pain in the abdomen or lower back
- Pain during sex
If you want to learn more about what your symptoms could mean, take our quick, 2-minute quiz.
Diagnosis of fibroids
To diagnose the fibroids, your doctor may conduct ultrasound of the abdomen or MRI may be needed to determine the size and numbers of the fibroids present. The interventional radiologist will analyze the ultrasound pictures and locate the fibroids. Once the size and location are determined, the doctor will work with the patient to create a personalized treatment plan that fits their individual needs.
When is treatment recommended?
Treatment is recommended when symptoms become difficult to manage or begin to impede on daily life. We often forget that fibroids can affect mental, as well as physical health. Fibroid symptoms can sometimes lead to isolation, especially if you tend to avoid leaving the house or are forced to plan your day around the nearest restroom. If your symptoms are the cause of distress, it’s important to seek out treatment. Fibroid symptoms typically change over time, worsening and getting better in waves. Due to the fact that it is a progressive condition, your symptoms will not get better by just ignoring them.
How to treat fibroids non-surgically
Minimally invasive and non-surgical options are available for the treatment of uterine fibroids and to eliminate painful symptoms. At the USA Fibroid Centers, we provide treatment for fibroids without surgery with the help of a procedure known as Uterine Fibroid Embolization also known as UFE. In this procedure, one of our interventional radiologists will insert a small thin tube called catheter through your upper, outer thigh area. The catheter will be guided through the artery and our interventional radiologist will be able to see the live images of the movement through the ultrasound images.
On reaching to the artery that supplies to your fibroids, tiny particles, known as embolic agents will be released that block the supply of blood, nutrients and oxygen to the fibroids. Due to lack of nutrients’ and oxygen supply, the fibroids eventually die and wither away. This treatment of uterine fibroids is fast and you are able to return home the same day. The procedure also has a quick recovery time and you should be able to attend your normal routine 1-2 weeks following your treatment.
Fibroid treatment near you
USA Fibroid Centers provides treatment for uterine fibroids through its numerous facilities located in California, Florida, Georgia, New York, Massachusetts, Illinois, and New Jersey. Explore our expansive list of locations HERE.