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Pelvic Exam, The

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Pelvic exams are an important way to take care of your health. You should get a pelvic exam if you have ever had sex (even one time) or are having any problems with your periods.

Most women have questions and concerns about their first pelvic exam, but knowing what to expect can help you to feel more at ease. The pelvic exam only takes about 5 minutes, and your pediatrician will talk you through it and answer any questions you may have.

Why do I need a pelvic exam?

“Is a pelvic exam right for me now? If not now, when?” These are good questions to ask your pediatrician.

Basically, a pelvic exam is the best way for your pediatrician to check your reproductive system, which includes your vulva, vagina, cervix, ovaries, fallopian tubes, and uterus. The exam also includes lab tests that can check for problems like diseases that are easily treated if found early. Sometimes the pelvic exam includes tests for sexually transmitted diseases (STDs). However, for many patients with no symptoms a simple urine test can determine if you have 2 common STDs: chlamydia or gonorrhea.

It's also a great time to talk with your pediatrician about things you may be thinking about, such as

  • Changes in your body

  • Your breasts

  • Your periods (menstruation)

  • Sex

  • Pregnancy and birth control

  • STDs

  • Vaginal discharge

  • Anything that hurts or bothers you

First a mini-checkup

Before the exam, your pediatrician may check your height, weight, blood pressure, lungs, heart, breasts, and stomach. You may be asked to give a small sample of urine and to empty your bladder so the pelvic exam is more comfortable.

There are 2 main parts of your exam: the interview and the pelvic exam.

Part 1—The interview

Before the pelvic exam, your pediatrician will ask you questions about your health and your periods. So don't be surprised if you're asked questions like

  • When did you get your first period?

  • When was your last period?

  • Do you have your periods regularly? How often?

  • How long do they last?

  • Do you have any pain, cramps, headaches, or mood swings with your periods?

  • Do you use tampons, pads, or both?

  • Have you ever had vaginal itching, discharge, or problems urinating?

  • Do you douche? If yes, how often?

Don't be surprised if your pediatrician asks you about sex. You may be embarrassed or feel like your sex life is nobody else's business, but your pediatrician needs to know these things to help you protect your health. So be honest! And don't forget, whatever you say to your pediatrician is confidential and won't be discussed with anyone else without your permission (unless it's something life threatening, of course). These questions may include

Have you ever had any type of sexual intercourse (oral, anal, or vaginal)? If yes,

  • When was the first time you had sex?

  • Did you want to have sex, or were you forced to have sex?

  • Have you had sex with more than 1 person? If yes, how many people?

  • Have you had sex with men, women, or both men and women?

  • How old were the people you had sex with?

  • Do you use condoms or other types of birth control?

Remember, you can ask questions too. In fact, this is a great time to ask any questions you may have about your period, tampon use, sex, and other stuff. Your pediatrician has lots of good information and can give you advice on making good decisions, the benefits of not having sex (abstinence), and preventing pregnancy and diseases. So don't be afraid to ask!

Part 2—The pelvic exam

OK, so now it's time for the pelvic exam. You'll be left alone to undress and put on a gown. There will also be an extra sheet that you can use to cover yourself. Remember, the entire exam only takes about 5 minutes. Some girls think that having a pelvic exam will mean they are no longer virgins, but that's not true. The pelvic exam doesn't change whether you are a virgin. It's also not true that the pelvic exam is a “test” to see if you are a virgin. The exam can be done even if you have never had sexual intercourse, because the opening to your vagina is large enough to allow for the exam.

3 simple steps

Your pediatrician will describe each step of the exam. If you have any questions or feel uncomfortable, let your pediatrician know. Your pediatrician will have a nurse or assistant in the room during the exam. You can ask your mom, sister, or friend to join you if it makes you more at ease—it's up to you.

Step 1: The vulva (outside of your vagina and surrounding areas)

Your pediatrician will begin by looking at the outside of your vagina and surrounding areas to make sure everything looks normal.

Step 2: Inside your vagina

Then your pediatrician will use an instrument called a speculum to look inside your vagina. Specula are about the size of a tampon, made of disposable plastic or sterilized metal, and have no sharp edges.

  • The speculum will be gently inserted into your vagina. You will feel some pressure, but it shouldn't hurt. Take deep breaths and try to relax. This will help relax your vaginal muscles and make this part of the test easier.

  • Once the speculum is inside the vagina, it is opened so that your pediatrician can see your cervix.

  • Then your pediatrician will use a cotton-tipped swab or a plastic brush to take a small sample of cells from your cervix. Samples are sent for tests, such as the Pap smear, which tests for abnormalities of the cervix. You may also be checked for diseases like gonorrhea and chlamydia with a second cotton swab.

  • Once everything is collected, the speculum is gently removed. It's normal to have a little bit of spotting after the Pap smear.

Step 3: Uterus and ovaries

The last step of the exam checks your uterus and ovaries. Your pediatrician will gently insert 1 or 2 gloved fingers into your vagina and press on the outside of your abdomen with the other hand. It's quick and may feel a little funny, but shouldn't hurt.

That's it! Most women are surprised when their pelvic exam is over because it really is that quick.

If your pediatrician finds a disease or any other problem, you may be referred to an OB/GYN (obstetrician/gynecologist). This type of doctor specializes in women's reproductive health.

Remember, the pelvic exam is an important part of taking care of your health. Ask your pediatrician if it's right for you.

Your sexual health

The following are 4 important things concerning your sexual health:

  • Having sexual feelings is normal. Whether you decide to have sex is your choice. Talk with your partner about how you feel.

  • Not everyone your age is having sex, including oral sex and intercourse. More than half of all teens choose to wait until they're older to have sex. Abstinence (not having sex, including oral, anal, and vaginal sex) means you won't become pregnant, become a teen parent, or get an STD.

  • If you're going to have sex, using condoms is the best way to avoid getting STDs or becoming pregnant.

  • To make sure you stay healthy, get regular medical checkups, urine testing for STDs, and a pelvic exam.

The persons whose photographs are depicted in this publication are professional models. They have no relation to the issues discussed. Any characters they are portraying are fictional.

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