What to Expect From Your First Pelvic Exam

You may be apprehensive about making your first gynecological appointment.

When should I go?  What will happen?  Why do I need to have a pelvic exam? How do I find a gynecologist?  But having a pelvic exam is a normal and responsible part of taking care of your body and keeping yourself sexually healthy.

Most women, according to the American College of Obstetrics and Gynecology, should have their first pelvic exam by the age of 21 or within three years of becoming sexually active, whichever comes first. Whatever your sexual orientation, pelvic exams are part of a healthy woman’s checkup.

So when should you schedule a pelvic exam? It can be part of your regular health check-up.  But you should also make an appointment if you have any of the following problems:

  • If you have abdominal or vaginal pain.
  • If you have a vaginal discharge that itches, burns, or smells.
  • If you have vaginal bleeding lasting longer than 10 days
  • If you have missed periods or have severe menstrual cramps
  • If you have not had a menstrual period by age 15 or 16

You also need a pelvic exam to be fitted for a diaphragm or have an IUD inserted.

How to get ready for your exam

You do not need to do anything special to prepare for your exam. It is usually best to schedule your appointment when you will not be having your period. Also you should not have sex, douche, or use vaginal creams 24 hours before your visit.  Let your doctor or nurse practitioner know that this is your first pelvic exam.

PlannedParenthood.org provides ample information on well-woman and pelvic exams, including tips for finding doctors and making appointments.

You may be asked questions before your exam about your menstrual periods or your sexual activities.  It is always best to answer honestly so that the doctor is able to provide the best care for you and your lifestyle.

Your well-woman examination may also include other screenings such as a breast exam, weight and blood pressure check -– the pelvic exam itself lasts only a few minutes.

What happens during the actual examination;

You will be asked to undress and given a gown to wear.  You will be asked to lie down on an examination table and place your feet up in holders called stirrups, which are connected to the end of the table.  You will need to slide to the end of the table and hold your knees open for the doctor to perform the exam. It is best to try to stay calm  and breathe steadily to relax your muscles and make yourself more comfortable. It is normal to be nervous.

The exam consists of three parts. First the doctor examines the outside genitals visually, looking for signs of infection or other problems.  Then a speculum, usually warmed, is inserted gently and keeps the walls of the vagina open so the doctor can examine the cervix and vagina. This may cause a feeling of pressure or some discomfort, but relaxing can help. While the speculum is in place, the doctor may swab some cells from your cervix for a Pap smear.  These cells are put on a microscope slide and sent to a lab to check for signs of precancerous or cancerous cells.

The speculum is removed and the doctor will use a lubricated gloved hand to put one or two fingers inside your vagina while pressing gently on your abdomen with the other hand.  This allows him or her to feel your internal organs and  check for any abnormalities.  Sometimes the doctor will also insert one finger into the rectum to check for abnormalities or better feel the internal organs. Sometimes you might feel like you need to have a bowel movement but this sensation passes quickly.  You may have a tiny bit of spotting or bleeding after the exam.

All of this is over in just a few minutes and then you can get dressed  and meet with your doctor to discuss your exam results.  This is a good time to ask the doctor any questions you may have about your sexual health.  You may receive tests for STIs or prescriptions for contraceptives at this time.

Congrats! You’ve survived and made your sexual health an important part of your overall well-being!