When is a pelvic exam recommended?

Question

Hello doctor,

I have been diagnosed with ovarian cysts. I have been advised to consult a gynecologist and get an ultrasound exam. But I did not get the ultrasound exam done, as I did not have health insurance. My doctor repeated the pelvic exam after six months. I want to know why he has repeated the pelvic exam, and what the criteria are for doing a pelvic exam?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Criteria for doing a PV (per vaginal or bimanual) exam in ovarian cyst suspicion:

Normally, a PV (pelvic) exam is indicated when:

There are pelvic pain symptoms (like back pain, abdominal pain, and bloating).
There is suspicion of a pelvic mass (like an ovarian cyst, fibroid, etc.).
There are menstrual irregularities or pressure symptoms.
Before ordering a pelvic ultrasound (US), if available, you should assess with a PV exam.

In your case, as you had a backache plus past substance use, it was important to rule out other causes.

The PV exam was appropriate to check for uterine size and tenderness, adnexal mass (suggestive of ovarian cyst), and signs of infection or pelvic pathology.

Small ovarian cysts, especially functional cysts, often resolve on their own within six to eight weeks. But some cysts persist or grow. Without ultrasound, a repeat physical exam is the next best way to monitor them.

In your case, I recommend that you do tests in low-cost imaging clinics or community health centers (some offer pelvic US at discounted rates) and monitor symptoms closely for increasing pain, bloating, nausea, and heavy bleeding. If they are present, urgent re-evaluation is needed.

I hope this helps.

Thank you.