A pelvic exam can be performed by an OBGYN, primary physician, or fibroid specialist and is typically a normal part of your regular wellness visit. It takes only a few minutes and is a relatively painless process, other than brief moments of applied pressure.
During the exam the doctor will examine your reproductive organs, including your vagina, uterus, cervix (opening from the vagina to uterus), fallopian tubes, vulva (external genital organs), bladder, and rectum, which connects the large intestine with the anus. A pelvic exam is often conducted on a woman to check for the symptoms of ovarian cysts, sexually transmitted diseases, yeast infections, endometriosis, adenomyosis, uterine fibroids, and any other abnormalities.
When Should You Consider a Pelvic Exam?
A pelvic test 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
If you are concerned about a medical condition, such as uterine fibroids, you can use our symptom checker to determine if you need to schedule an appointment.
What Are the Benefits of a Routine Pelvic Exam?
The primary benefit of scheduling routine pelvic exams is to ensure normal pelvic health and to discover any pelvic issues before they become noticeable or severe. If a condition is diagnosed in the early stages, more treatment options may be available to you, and the prognosis is typically better.
Another benefit of routine pelvic exams is that your physician can screen for sexually transmitted diseases (STDs), which can often go undetected. Many STDs can lead to long-term pain or sterility if left undiagnosed and untreated. It is also often at this time that your doctor can discuss contraception options or other concerns or questions regarding your reproductive health.
Without a pelvic exam, certain types of cancer may not be diagnosed until it’s in later stages. These include vaginal, cervical, ovarian, and uterine cancer. A pelvic exam often can detect cancers of the uterus, vulva, cervix, fallopian tubes, bladder, ovaries, and rectum. Your doctor can determine what type and which stage the cancer is in once a diagnosis has been made.
How to Prepare for the 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 your medications and ensure they’re up to date to share with your doctor. If you have any questions before your exam, write them down and bring them with you to the day of your appointment. Inform your doctor at the time of your appointment if you would like them to perform a PAP smear. 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 activities 48 hours before your exam:
- Having sex
- Using tampons
- Using a cream or birth control foam/topical
Are Pelvic Exams Painful?
Pelvic exams are generally painless, with only some mild discomfort from pressure being applied internally to the pelvic area during the exam.
If you experience pain during a pelvic exam, you should let your doctor know as it may be a sign of an underlying issue. There should also be no pain after a pelvic exam, and you should be able to go on about your day normally.
How Are Pelvic Exams Performed?
Here is the 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 fibroid specialist may ask you questions related to your periods, sex life, use of pads and tampons, discharge, urinary problems, or other women’s health issues. You may ask questions too, and 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 anything makes you uncomfortable, do not be afraid to speak up and share your concerns. It’s important to remember that their priority is your comfort and care.
Types of Pelvic Examinations
Your doctor may perform the below exams 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 a speculum will be gently inserted into your vagina to separate the walls of your vagina. Making sure you relax is very important as this will prevent pain and discomfort. If you feel any pain, tell the doctor, and they will make adjustments in the position accordingly. Your cervix may be seen with a mirror and a small sample of cells will be taken for a Pap test to see any signs of cancer in the cervix. A sample of your discharge from the cervix may be taken to test for 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 determine the size and position of your uterus, and check for 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 a specific issue arises.
If you do not consent to a certain part of the exam, be sure to tell your doctor. The examination usually takes 10 minutes to complete.
What Does a Pelvic Exam Show?
A pelvic exam can show the below conditions:
- Uterine fibroids and tumors
- Sexually transmitted infections
- Ovarian cysts
- Urinary tract infection
- Bacterial vaginosis (mild bacterial infection in the vagina)
- Tumors of the genital organs
- Endometriosis (uterine lining outgrowing to nearby organs)
- Uterine abnormalities
Common Method of Detecting Fibroid Growth
The 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 others may have many small growths. 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 women during their reproductive years and affect up to 70% of all women by age 50.
If you are struggling with any of the below fibroid symptoms, it’s important to contact a fibroid specialist to get checked right away:
- 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
How Are Fibroids Diagnosed?
To diagnose fibroids, your doctor may conduct an ultrasound of the abdomen, or an 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 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. Since it is a progressive condition, your symptoms will not get better by just ignoring them.
What Are the Treatments for Fibroids?
Non-surgical options are available for the treatment of uterine fibroids and to eliminate painful symptoms. At USA Fibroid Centers, we provide treatment for fibroids without surgery with the help of Uterine Fibroid Embolization or UFE. In this procedure, one of our interventional radiologists will insert a small thin tube called a 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 the artery that supplies blood to your fibroids, tiny particles, known as embolic agents, will be released to block blood flow to the fibroids. Due to a lack of nutrients and oxygen, the fibroids eventually die and wither away. This outpatient treatment allows you to return home the same day. It has a quick recovery time, allowing you to return to your normal routine 1-2 weeks after your treatment.
Find Fibroid Treatment Near You
USA Fibroid Centers provides treatment for uterine fibroids at state-of-the-art facilities located throughout the country. If your recent pelvic exam has identified uterine fibroids or you would like to schedule one, USA Fibroid Centers is here to help.
Call us at 855.615.2555 or schedule your consultation online with one of our fibroid specialists today, and receive the care you need to improve your quality of life.