A pelvic exam is a short check of your vulva, vagina, cervix, womb and ovaries. You undress from the waist down and lie on an examination couch. The doctor looks at the outside first, then gently inserts a speculum to see the internal walls of the vagina and cervix, and then feels your womb and ovaries with a gloved hand. It takes about five to ten minutes, and you can stop at any time.
Key takeaways
- A pelvic exam usually has up to three parts: an external exam, a speculum check, and a hand (bimanual) check. Not every visit needs all three.
- The exam itself usually lasts a few minutes. Most of the appointment is talking.
- It may feel uncomfortable or create a feeling of pressure, but it should not hurt. Tell the doctor straight away if it does.
- In Singapore, cervical screening guidelines recommend a Pap smear from age 25 (every three years until 29, then an HPV test every five years from 30 until 69 years).
- You can ask for a chaperone, ask questions throughout, and say stop whenever you want.
Why would a doctor do a pelvic exam?
A doctor does a pelvic exam to check for issues which can be the cause for the symptoms present. It is part of cervical screening, and it helps explain problems such as unusual bleeding, discharge, pain, bladder leaks or a feeling of something “coming down”.
Common reasons include:
- Routine cervical screening (a Pap test or HPV test)
- Irregular, heavy or painful periods
- Pain during sex, or pelvic pain in general
- Leaking urine, needing to rush to the toilet, or trouble emptying the bladder
- A bulge, heaviness or dragging feeling in the vagina
- Checks before or after pregnancy
At a urogynaecology consultation, the examination also checks how well your pelvic floor muscles (the sling of muscles that holds up your bladder, womb and bowel) are working.
What happens during a pelvic exam, step by step?
The exam follows a simple order, and the doctor should tell you what is about to happen before each step. Here is what a typical visit looks like.
- A conversation first. The doctor asks about your symptoms, periods, pregnancies, bladder and bowel habits, and any medicines. This part often takes longer than the exam.
- Getting ready. You are shown to a private area to undress from the waist down. You are given a sheet or gown to cover yourself.
- Positioning. You lie on your back with your knees bent and apart, sometimes with your feet in support. For some bladder or prolapse checks, you may be asked to lie on your side.
- The outside check. The doctor looks at the skin of the vulva (the outer genital area) for redness, sores, lumps or thinning.
- The speculum check. A speculum is a smooth instrument that gently opens the vaginal walls so the doctor can see the cervix (the neck of the womb). If you are due for Pap smear screening, a soft brush collects a few cells at this point.
- The hand check. With a gloved, lubricated hand, the doctor places one or two fingers in the vagina and presses lightly on your lower tummy with the other hand. This lets them feel the size and position of the womb and ovaries.
- Extra checks if needed. For bladder leaks or prolapse, you may be asked to cough or bear down gently, or to squeeze your pelvic floor muscles.
- Dressing and discussion. You get dressed in private, then the doctor explains what they found and what happens next.
Does a pelvic exam hurt?
A pelvic exam should not be painful. Most women describe it as awkward or mildly uncomfortable, with a feeling of pressure when the speculum opens or when the doctor presses on the tummy.
A few things make it easier:
- Breathe slowly and let your thighs and bottom relax against the couch. Tensing up makes the speculum feel tighter.
- Ask for a smaller speculum. They come in different sizes.
- Empty your bladder before the exam.
- Tell the doctor if you have had pain with sex, a difficult birth or a previous bad experience so they can go slowly.
After menopause, the vaginal lining becomes thinner and drier, which can make the exam more uncomfortable. Mention this, as the doctor can adjust. If this dryness bothers you day to day, it may be part of genitourinary syndrome of menopause, which is worth raising at the same visit.
How should I prepare for a pelvic exam?
You do not need much preparation. The main thing is timing if you are having a Pap test or HPV test.
Tip | Why it helps |
|---|---|
Book when you are not having your period, if a screening test is planned | Blood can make the sample harder to read |
Avoid sex, vaginal creams and douching for about 48 hours before a screening test | These can affect the cells collected |
Wear a skirt or dress if you like | You only need to remove underwear |
Write down your symptoms and questions | Nerves make it easy to forget things |
Empty your bladder before the exam, unless told otherwise | It is more comfortable. For some bladder tests, you may be asked to come with a full bladder |
If your period starts unexpectedly, call the clinic to clarify, as a visit for bleeding problems can still go ahead. Only screening tests are usually rescheduled.
Can I have a chaperone or say no?
Yes. You can ask for a chaperone (usually a nurse who stays in the room), and you can decline any part of the exam. Your consent is needed for each step, and you can change your mind halfway.
If you have never had sex, feel very anxious, or have had a traumatic experience, say so early. The doctor may skip the speculum, use a smaller one, or suggest other checks such as an ultrasound scan.
What happens after a pelvic exam?
Most women go straight back to their normal day. Light spotting after a speculum or screening test is common and usually settles within a day.
Screening results generally come back within a couple of weeks. If something needs a closer look, your doctor may suggest further investigations, depending on the issue. For symptoms such as leaks or a bulge, the findings help decide whether the problem is something like pelvic organ prolapse and/or urinary incontinence, and which treatments make sense.
When should you see a doctor?
Book an appointment if you are due for cervical screening, or if you have any of these:
- Bleeding between periods, after sex, or after menopause
- New or unusual discharge, itch or smell that does not settle
- Pain in the pelvis or during sex
- Leaking urine, frequent urgent trips to the toilet, or a weak stream
- A lump, bulge or a dragging sensation in the vagina
Unsure whether to see a gynaecologist or a urogynaecologist? This explainer on the difference between a urogynaecologist and a gynaecologist may help. You can also contact the clinic to ask what your first visit will involve.
Frequently asked questions
How long does a pelvic exam take?
The exam itself usually takes five to ten minutes. The whole appointment, including the talk before and after, is longer. Allow time for questions so you do not feel rushed.
Can I have a pelvic exam during my period?
Yes, if the visit is about symptoms such as heavy or painful bleeding. If you are having a Pap test or HPV test, it is usually better to book on a day when you are not bleeding, as blood can affect the sample.
Is a pelvic exam the same as a Pap smear?
No. A Pap smear is one test that can be done during a pelvic exam. The pelvic exam is a wider check of the vulva, vagina, cervix, womb and ovaries.
Do I need a pelvic exam if I have never had sex?
Not always. It depends on your symptoms. The doctor may be able to use an external check or an ultrasound scan instead. Tell them at the start so the plan suits you.
Should I shave or wax before a pelvic exam?
No. Hair removal doesn’t affect the exam. Normal washing is all you need.
This article is for general information only and is not a substitute for medical advice. Please consult a qualified doctor in Singapore for advice about your own situation.
Disclaimer: The information provided in this article is for general purposes only and should not be considered as a substitute for medical advice. Always consult with your healthcare provider before making any changes to your current treatment plan or starting any new medications.
Frequently Asked Questions
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- Why do my joints feel “wobbly”? During pregnancy, your body makes a hormone that loosens your joints. This can stay in your body for a few months after birth, making you feel a bit unstable.
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- Does breastfeeding affect recovery? Yes. Breastfeeding keeps certain hormone levels low, which can cause things like vaginal dryness or joint looseness to last a little longer. This is normal and will improve once you stop nursing.