‘Super Awkward’ are the first two words that pop up in my mind when asked about the pelvic exam. The idea of staring at the ceiling while someone’s just peeking & poking at your genitals, with your legs wide open & apart, isn’t exactly one’s forte. The Physics exam that absolutely tortured me in high school seems like the Almighty’s most bestowed upon gift now compared to the pelvic exam.
Despite the accompanying discomfort & embarrassment, the pelvic exam is very crucial.
The What & Why of Pelvic Exam
The pelvic exam is basically an exam conducted by the doctor to assess the functioning of the reproductive organs, where your vulva (external genital area), vagina, cervix, uterus (the womb), fallopian tubes & ovaries are examined.
It’s done to help diagnose problems like sexually transmitted diseases, genital warts & scars as well as coupled with procedures like pap smear, colposcopy (procedure for getting a close up of the cervix), hysteroscopy ( technique to look inside the uterus) etc to treat & check for cervical tumours, abnormal bleeding, uterine fibroids, polyps etc. It’s even done during pregnancy.
It’s important that women understand that the pelvic exam can be a part of the routine exam a.k.a your regular check up, especially when you visit your gynecologist. A first pelvic exam is advised at the age of 21 years or within 3 years of being sexually active.
The pap smear is usually done during a pelvic exam for cervical cancer screening. And according to the WHO guidelines, all women between the age group of 21-65 years should be screened (for cervical cancer) every three years to detect any precancerous lesions. So, it’s obvious a pelvic exam will be done if you follow these recommendations. But is a pelvic exam advised as a must when one has no associated complaints? No, it’s not.
Pelvic Exam: Procedure & Prepping for it
So, one must keep in mind that since patient load in India is immense, the doctor has a very limited amount of time to give to each patient. Often in most clinics & hospitals, the paperwork will be done as you’re waiting for your turn & upon its arrival, you’ll be asked about the problems you’ve been facing by the doctor. Accordingly, you’ll be briefed about the procedure & a verbal/written consent will be taken.
You may or may not be asked to change into a gown. So, it’s best if you wear comfortable clothing, making it easier for you & the doctor. If you’re wearing pants or leggings, you’ll be given a private moment to remove them along with your underwear & you’ll be requested to lie on the table with your shirt/top lifted up slightly.
At the lower end of the exam table, there may be footrests where you’ll be told to place your feet & with your knees folded, you’ll be told to spread your legs wide open & bring your hips down towards the edge of the table. Super awkward, I know. But don’t worry. The doctor will be there with you to walk you through each step! At this point, the best thing you can do is take a deep breath & relax your thighs & legs; the more you relax, the less awkward you’ll feel.
After this, the pelvic exam can be broken down into a few steps.
Firstly, the doctor will look at your vulva & the opening of the vagina, checking if there’s an abnormal discharge, genitals warts, cysts, redness etc.
Second comes the speculum, which is like a short medical version of tongs, but used to gently open the vagina in order to get a better view of it. You’ll feel something cold being inserted & a stretchy sensation, but it’s never painful usually. If you do feel pain, point it out to your doctor at that moment. It’s during this step taking a swab, a pap smear or colposcopy is incorporated, depending on the problem you’re facing.
The third step is the bimanual examination, where the doctor will insert lubricated gloved fingers slowly into your vagina & apply a little pressure on the lower part of your tummy from the other hand, looking for any ovarian cysts, tumours etc. Remember relaxation of the muscles between your legs is the key to less discomfort.
The fourth step is a rectal exam, which is optional. The doctor will insert a gloved finger into the rectum, checking the strength of the muscular tissue & trying to look for any tumour growing behind the vagina & uterus. It’s totally normal that you feel like pooping when this happens but don’t worry, you won’t.
And yay, it’s finally done. You’ll be given some privacy to wear your clothes & the results of the exam will be discussed with you.
Do you know how much time it takes for the entire exam? Only a few minutes!!!! Its mostly done within 5-10 mins unless you’re getting a certain procedure like hysteroscopy or colposcopy done, where additional time is required.
Always trust your doctor & unhesitantly resolve your doubts & grievances. No doubt the pelvic exam is uncomfortable, but would you prefer 5 mins of awkwardness or bear the torturous two hours of Physics exam? Think again because the best part is nobody ever fails in a pelvic exam!
About the Author:
Teertha Barnwal, a doctor, a medical intern at MGM Medical College, Navi Mumbai. Enjoys writing, singing & adventuring. Meditates & believes that life is the biggest adventure.
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