Routine gynecological care is essential for all women. The annual exam consists of a breast exam, pelvic exam,pap smear, and sometimes a rectovaginal exam. Every woman should have an annual Pap smear as part of a complete pelvic examination after becoming sexually active or reaching age 21, whichever comes first, and continuing as determined by her healthcare provider.

Why do I need an exam?

      To make sure your reproductive organs are normal and to check for other pelvic problems.

      To screen for infection.

      To screen for cervical cancer.

      If birth control is a concern, you and your healthcare provider will decide which methods of birth control are best for you.

      To promote health during pregnancy and childbirth (prenatal care).

Does it Hurt?

The pelvic exam itself usually lasts only two to five minutes. You may feel some pressure, but not necessarily pain. You will feel more comfortable during the exam if you can breathe slowly and keep your vaginal muscles relaxed.

      To prevent added discomfort, be sure to empty your bladder before your exam.

      Don't schedule your exam during you period or for a few days after. If you do, the Pap smear may not show the cells clearly, and might be read as "abnormal.' In this case, you will need to return for another Pap test.

      Don't use any vaginal creams, foams, gels, douches, or tampons for 48 hours before your exam. These products could cause an abnormal result. (University Health Services does not recommend the use of feminine deodorant products.)

      Don't have vaginal sex for 48 hours before your exam. Sex can irritate the cervix or cause discharge (fluids) that can lead to an abnormal result.

What happens during the exam?

Prior to the exam you will be asked to complete a history form so the practitioner will have all the information she needs regarding your health. 

You will undress from the waist down; you may keep your socks on for warmth. If your healthcare provider plans to do a clinical breast exam, you will be asked to remove the rest of your clothing as well. You will be given a sheet to cover you.

You'll be asked to lie down on your back on the exam table. Sliding your buttocks down to the end of the table, you will rest your feet on holders, called stirrups, which are located at the same height as the exam table.

First, your health care provider will examine your external genital area to evaluate you for signs of disease or abnormalities.

Then the healthcare provider will examine the inside of the vagina using a speculum.  The speculum is a slender instrument shaped like a duck bill, which slides inside the vagina much like a tampon. With the speculum in place, your provider can see your cervix (the mouth of your uterus or womb).

Your healthcare provider will use a small plastic spatula or a brush to rub some cells from the cervix for a Pap smear (see picture at bottom). These cells are placed in a special specimen vial and sent to a laboratory for analysis.  A Pap smear tests for precancerous or cancerous changes in your cervix. You will be contacted if your Pap smear shows any abnormal cells.

Chlamydia or gonorrhea testing, if indicated, is done by swabbing the cervix with cotton swabs before the speculum is removed.  Tests for syphilis and HIV are also a part of STI testing, but require blood specimens thus you must consent to these tests specifically.  Again, you will be contacted if the results are abnormal.

If symptoms of any other vaginal infection are present, your healthcare provider will take a sample of your vaginal secretions with a cotton swab for examination under a microscope.

After the speculum is removed, your healthcare provider will put lubricating gel on his or her gloved fingers and gently insert one or two into your vagina while pressing on your abdomen with the other hand. This procedure, called a bimanual exam (See below), allows the provider to examine your uterus, fallopian tubes and ovaries. He or she will check for their proper size and placement, indications of abnormal growths, the presence of pain, or other signs which might indicate a need for further testing.

Remember

You should have a pelvic exam and a Pap smear every year. You do not automatically have a Pap smear every time you have a pelvic exam-only if you are due for one. Sometimes only a pelvic exam is done to look for infections or other problems. Always ask your provider what tests are being done. Be proud of your body and take care of it!