Introduction:
A gynecological evaluation includes two parts, gynecologic history and gynecologic examination. Gynecologic examination refers to the examination of a woman's reproductive system. It includes an examination of breasts and a pelvic examination. A pelvic examination is done if a woman's circumstances require it and the woman agrees. Suppose the woman has any questions or concerns regarding reproductive health or sensitive issues such as sex, birth control, pregnancy, and problems related to menopause. In that case, she should discuss it with the gynecologist.
What Is a Pelvic Exam?
A doctor's visual and physical examination of a woman's reproductive and sexual organs is termed a pelvic exam. The vagina, cervix, fallopian tube, vulva, ovaries, and uterus are examined during the exam. The doctor looks for signs of illness or infections. Pelvic exams are usually done during a yearly physical exam when a woman is pregnant, in case of infections like Chlamydomonas, vaginosis, or trichomoniasis, or when she has pain in her pelvis or lower abdomen region. It can be done as a part of preventive screening, breast examination, or Pap smear.
When Should One Get a Pelvic Exam Done?
There are no specific timings or guidelines for how often or when a woman should undergo a pelvic exam. Depending on a person's medical history, the doctor may suggest a pelvic exam. A girl should have her first pelvic exam at twenty-one unless she has other related health diseases. In most cases, a woman's first pelvic exam would be when she goes for birth control. Women over the age of twenty-one years should give regular pelvic examinations, just like routine general health check-ups. Other specific reasons to undergo a pelvic exam can include:
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Unusual bleeding from the vagina.
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Unusual vaginal discharge.
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Signs and symptoms of ovarian cancer, cysts, etc.
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Doubts of sexually transmitted diseases, yeast infections, or bacterial vaginosis.
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Other problems related to gynecologic or sexual health.
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Family history of cancer in the ovary or cervix.
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Assessment of sexual assaults.
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Pain during sexual intercourse.
How to Prepare for a Pelvic Exam?
For reasons other than the ones related to menstruation, the healthcare provider usually suggests appearing for a pelvic exam when one is not on their period. Sexual intercourse penetrating the vagina should be avoided twenty-four hours before the examination. Douching and inserting anything into the vagina should be avoided a day before the exam. This includes using tampons, vaginal suppositories, gels, or creams.
What Happens During a Pelvic Exam?
The examination usually lasts for about ten minutes. The patient will have to change into hospital robes before the examination and be asked to lie on the exam table with legs spread and feet on footrests called stirrups. The pelvic exam may cause discomfort when it is done. However, it should not be painful. Being relaxed and urinating before the procedure can reduce the discomfort associated.
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Visual Exam: This is the first part of the pelvic exam. The place of examination should be well illuminated so that the healthcare professional can inspect the pelvic area well. The doctor would inspect the vulva and the vagina. They would look for any redness, irritation, discharge, cysts, or something that may indicate a sexually transmitted disease, such as sores. The size of the clitoris, the development of labia minora and majora can be noted. Inspecting the skin between the posterior vaginal fourchette and the anus (perineal body) should be done. The anus and perianal area should also be inspected.
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Speculum Exam: The next step involves inserting a speculum into the vagina. A speculum is a plastic or stainless steel instrument with a hinge resembling a duck's bill. The healthcare professional inserts it into the vagina and opens it inside the vagina. This helps them to see the inside of the vagina. Women are advised to relax their vaginal, rectal, and abdominal muscles and take deep breaths while inserting the instrument. Getting nervous causes the muscles to be stiff, increasing the pain and discomfort while the speculum is inserted.
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Pap Smear: The cervix will be swiped using a small spatula. This helps to collect cells from the cervix, which will be examined later. This helps diagnose cervical cancer, sexually transmitted diseases, etc. Nothing should be inserted into the vagina forty-eight hours before a Pap test. Precancerous cells are often diagnosed in a Pap smear. A Pap smear may or may not be a part of the pelvic examination every time.
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Manual Exam: The healthcare professional will also check the internal reproductive organs like the uterus, fallopian tubes, etc. They would insert two gloved fingers (which are lubricated) into the vagina while using the other hand to feel the abdomen. This helps to examine irregularities in the uterus or ovaries. The size of the uterus can be determined during this test. This helps to check the probability of pregnancy and any abnormalities in the fallopian tubes. Urethrocele (prolapse of the urethra), cystocele (a condition where the bladder bulges into the vagina), rectocele (a condition where the wall in between the rectum and vagina becomes weak), enterocele (prolapse of the small intestine), and uterine descensus (the uterus has descended from the normal position into the vagina) or the loss of urine from the bladder through the urethra can be checked.
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Rectal Exam: A rectal examination might be done at the end of this exam. The healthcare professional inserts their finger simultaneously into the vagina and rectum. Any abnormalities in the tissue between the two organs are checked in this exam.
What Are the Benefits of a Pelvic Exam?
A pelvic exam ensures a woman's sexual and reproductive health. They help to detect life-threatening conditions like cancer or infections like sexually transmitted diseases. It also helps assess the chance of pregnancy or any complications that can arise associated with pregnancy. A pelvic examination will not harm a patient; omitting it can lead to life-threatening conditions.
Conclusion:
Pelvic examination should be a part of the daily routine check-up in every woman after twenty-one. It will not cause any harm to the patient. However, omitting it can cause life-threatening conditions.
