A pelvic exam is not a regular part of adolescent health checkups. However, if you have a problem involving your female reproductive organs, such as an unusual discharge from your vagina, a pelvic exam may be needed.

Here is information from the American Academy of Pediatrics about what to expect during your first pelvic exam.

Overall Health Check-in

An overall health check-in may be done before your pelvic exam.

• A nurse or physician’s assistant may measure your height, weight, and blood pressure and update your medical history. You may be asked to provide a urine sample or to empty your bladder so the pelvic exam is more comfortable.
• Your doctor may check your lungs, heart, breasts, and stomach.

Questions

You may be asked questions about your menstrual cycle (period), such as

• When did you get your first period?
• When was your last period?
• Do you have your periods regularly? How often? How long do they last?
• Do you have any pain, cramps, headaches, or mood swings with your periods?
• Do you use tampons, pads, or both?
• Have you ever had vaginal itching, discharge, or problems urinating?
• Do you douche? If yes, how often?

You may be asked questions about your sexual activity, such as

• Have you had any type of sexual intercourse (oral, anal, or vaginal)?
• When was the first time you had sex?
• Did you want to have sex, or were you forced to have sex?
• Have you had sex with more than one person? If yes, how many people?
• Have you had sex with a partner of the same gender, another gender, or both the same and another?
• How old were the people you had sex with?
• Do you use condoms or other types of birth control?

It’s important to be honest. Keep in mind that whatever information you share is confidential and won’t be discussed with anyone else without your permission (unless it involves abuse or is something life threatening). Also, remember that your doctor is available to answer questions or concerns you may have.

The Pelvic Exam

Before the exam, you will need to undress and put on a gown. There will also be an extra sheet you can use to cover yourself.

During the exam, your doctor will check your vagina, uterus, and ovaries. The entire exam takes about only 5 minutes. In addition to your doctor, there will be a nurse or an assistant in the room during the exam. You can also ask your mom, another family member, or a friend to join you if their presence makes you more at ease—it’s up to you. At any time, if you have any questions or feel uncomfortable, let your doctor know.

• Vagina and surrounding areas (vulva). Your doctor will touch and examine these areas.
• Inside the vagina. Your doctor will examine the inside of your vagina by using an instrument called a speculum.
  • A speculum is made of disposable plastic or sterilized metal. The end that is inserted into your vagina is tube shaped (like the shape of a tampon). Once inside your vagina, the tube is expanded to widen your vagina opening so your doctor can see your cervix.
  • The speculum will be gently inserted into your vagina. You will feel some pressure, but it shouldn’t hurt. Take deep breaths and try to relax. This approach will help relax your vaginal muscles and make this part of the test easier.
  • Then your doctor will use a cotton swab or a plastic brush to take a small sample of cells from your cervix. Samples are sent for tests, such as the Pap smear, which tests for changes in the cervix. If needed, you may also be checked for sexually transmitted infections (STIs) with a second cotton swab. However, for many patients with no symptoms, a simple urine test can test for 2 common STIs, chlamydia and gonorrhea.
  • Once everything is collected, the speculum is gently removed. It’s normal to have a little bit of spotting after the Pap smear. You will be given a menstrual pad to use in case there is bleeding.
• Uterus and ovaries. Your doctor will gently insert 1 or 2 gloved fingers into your vagina and press on the outside of your abdomen with their other hand. This process is quick, and you may feel some pressure, but it shouldn’t hurt.

If your doctor finds a disease or another problem, you may be referred to an ob-gyn (obstetrician-gynecologist). This type of doctor specializes in female reproductive health.

Note: Some people think that having a pelvic exam will mean they are no longer virgins, but that’s not true. The pelvic exam doesn’t change whether you are a virgin. It’s also not true that the pelvic exam is a “test” to check whether you are a virgin.

For More Information

American Academy of Pediatrics

www.aap.org and www.HealthyChildren.org

Disclaimer

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

© 2021 American Academy of Pediatrics. All rights reserved.