Pelvic Exams and Pap Smears

A pelvic exam is a comprehensive, internal examination of a woman’s reproductive system. This exam may include three parts: an inspection, Pap smear, and/or bimanual exam.

WHY DO WOMEN GET PELVIC EXAMS?
An internal pelvic exam is administered as part of a woman’s primary reproductive health care. Reasons for a pelvic exam can include: screening for sexually transmitted infections (STIs), evaluating the cause of pelvic discomfort, abnormal bleeding or discharge, screening for cervical cancer, and assuring normal position and size of uterus and ovaries. Women are generally advised to receive annual pelvic exams within three years of becoming sexually active, or when they are 21 years of age, whichever comes first.

HOW IS A PELVIC EXAM ADMINISTERED?
A pelvic exam generally has three main parts that can take anywhere from 3-10 minutes. The first part is a visual inspection of the vulva and anus for any unusual lumps, moles or sores. Next the clinician will administer a Pap smear. A pap smear is a screening test for cervical cancer that looks for any changes in the cells of the cervix that could lead to cancer. To look at the cervix and obtain cells, the clinician will insert a speculum into the vagina. A speculum is a spoon-shaped instrument that can be either plastic or metal (hopefully warm!) and is used to open the vagina slightly to view the cervix. Once the cervix is located the clinician will secure the speculum in place and collect cells from the cervix. The clinician may also take a sample of vaginal discharge to check for STIs or other vaginal infections. The last part of the pelvic exam is the bimanual exam. After the speculum is removed, the clinician will place two gloved, lubricated fingers inside the vagina and press on the woman’s belly. Between the outside hand and inside fingers the clinician will be able to feel the cervix, uterus and ovaries for any abnormalities.

IS THERE ANY PAIN INVOLVED IN A PELVIC EXAM?
Pelvic exams bring little or no pain. If the woman is tense, she may experience some discomfort upon insertion of the speculum. During the Pap smear, some women may feel slight cramping sensations or experience some bleeding. This is completely normal.

HOW OFTEN SHOULD A WOMAN RECEIVE A PELVIC EXAM?
It is recommended that a woman receive her first pelvic exam within three years of becoming sexually active or when she reaches the age of 21, whichever comes first. It is wise to have a pelvic exam every year, and most clinics require a pelvic exam every year to renew a birth control prescription. If a woman has an abnormal Pap smear, her health care provider may want more frequent Pap smears. In some cases, if a woman has 3 normal Pap smears in a row, her health care provider may allow her to wait more than one year until her next Pap smear.