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When is a pelvic exam done?
This is NOT usually a part of your routine well check exam as a teenager.
This is usually done when you turn 21 years old.
Most internal medicine physicians, family practice physicians, and gynecologists perform this exam.
This may need to be done sooner if you have pain anywhere in your pelvis or you are having abnormal/unusual vaginal discharge.
If your primary care provider thinks you need a pelvic exam, they will always explain why it is important.
You will likely then be referred to a gynecologist, as a pediatrician rarely does this.
How do I prepare for a pelvic exam?
Try to schedule it when you are not having your period.
Some people get nervous about it. Practicing some relaxation techniques you can use during the exam beforehand may be very helpful.
Box-breathing, as shown below, is a great relaxation technique.
Start at the top and follow the arrows.
What happens during a pelvic exam?
Before the exam:
You will be asked to undress and given a sheet or gown to put on for the exam.
You may be asked to remove only the bottom part of your clothing or the bottom and the top.
You will be given privacy to undress and cover yourself with a sheet or gown.
Your provider will talk to you about what to expect for the following parts of the exam.
They will have you lie on your back with your bottom near the end of the table.
They will encourage you to relax.
They will help you place your feet in stirrups (metal triangular footrests) that come out of the end of the table.
This is to help you feel most comfortable in this position.
They will ask you to relax your knees out to the side as much as you can.
During the exam:
Your primary care provider will encourage you to relax as much as possible.
They will continue to tell you what they will do next.
They will have gloves on to do the exam.
They will check the external genital area (you can think of this as the area covered by your underwear) – this includes the areas outside of your vagina, like your labia
They will check the inside of your vagina and cervix with a speculum.
A speculum is a thin piece of plastic or metal with a hinged piece on one end that allows it to open and close.
They will tell you before they insert it.
They will open it up once they are in the correct position.
This may feel like pressure, but it is not painful.
They will use a light to examine the area.
If discharge or blood makes it hard for them to see, they might use a cotton swab to remove it.
If they need to do any testing, like checking for an infection, they may also use a cotton swab.
They will slide the speculum out.
They will use gloves with some lubricant (it is jelly-like) to then check your vagina and cervix with two fingers.
At the same time, they will use the other hand to press on your lower abdomen (belly) on the outside and check for any discomfort or pain you might have.
Once this is finished, you are all done with the exam.
After the exam:
The primary care provider will leave the room to allow you to get dressed.
You can ask any other questions or talk about any other concerns.
If you were tested for infections, your primary care provider will let you know when they will be back and how they will communicate the result with you.
You may have a little bit of bloody discharge or mild cramping from the procedure.
This is normal.
This usually goes away in a few hours.
This publication was adapted from information within the American Academy of Pediatrics Patient Education Handouts and Nemours TeensHealth
Reviewed by: TT D.O, AR D.O. | 10/2024