The examination is usually carried out with the woman lying on her back with her knees bent. While it may be slightly uncomfortable, it should not be painful. Many women feel embarrassed during a pelvic examination and it may help to discuss this with your doctor. You may also find it helpful if the doctor explains precisely what she/he is going to do.
Your doctor will wear gloves to examine your vulva area (the external and visible part of your genital organs.
A speculum may be inserted to allow the doctor to see the cervix and the vagina. You will feel some pressure when the speculum is inserted, but if you feel tenderness or pain, let your doctor know so that he/she can adjust the speculum, to make you feel more comfortable. The speculum holds open the walls of the vagina so that the cervix can be viewed.
A cervical (Pap) smear may be taken at this time. This involves taking cells from the cervix and vagina with a small flat stick or a small cervical brush. The cells will be smeared on a glass slide and sent to a laboratory for analysis.
A sample of fluid from the vagina or cervix may be taken with a cotton swab. This will be sent to the laboratory for analysis if infection is suspected.
After gradually removing the speculum, your doctor will carry out an examination, also referred to as a bimanual examination because both hands are used — one internally and one externally on the abdomen. This means that the doctor will insert two gloved fingers into the vagina and place the other hand on your abdomen, applying slight pressure. This examination will detect any growths, abnormalities, swellings, or areas of tenderness in the pelvic area. The doctor can examine the cervix (neck of the womb), evaluate the size and position of the womb and can estimate the muscle tone within the vagina. She/he will be able to examine for enlargement of your fallopian tubes and ovaries by pressing on your lower abdomen with the other hand.
The entire pelvic examination takes only a few minutes. If your usual doctor is male, and you would prefer this procedure to be carried out by a female, let him know. This can usually be arranged without any difficulty.