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What Happens During a Pelvic Exam

“I love being able to do a girl’s first pelvic, so I can help her realize it’s not a big deal,” says gynecologist Holmes. “First, I show her the speculum we use on teenagers -- it’s about the size of a super tampon.”

When it's time for your first internal pelvic exam, you'll lie on your back, your bottom scooted down to the end of the exam table. You'll put your feet in two metal stirrups, so that your legs are bent and spread apart. You’ll wear a paper robe and have a sheet covering you for privacy. There are two parts of the exam:

  • Vagina and cervix exam. The gynecologist will insert a closed speculum -- a metal or plastic gadget that looks kind of like tongs -- into your vagina. Then the doctor opens the speculum to hold the vaginal walls apart, in order to get a good look inside to make sure the walls, discharge, and cervix look healthy. If you are 21 or older or it's been about 3 years after first having sex, the doctor may use a small brush to take some cells from your cervix for a pap smear.
  • Bi-manual exam. After removing the speculum, the gynecologist will slide one or two gloved and lubricated fingers into your vagina. With the other hand, the doctor presses on the abdomen from the outside. In this way, the doctor can check that your fallopian tubes, uterus, and ovaries are in the right position, and that there is no swelling or growths. The doctor is also checking for pain.   

When you schedule your exam, ask the doctor's office what you should do if you're having your period. Some doctors may ask you to reschedule if your period is heavy. Menstrual blood can interfere with the results of a pap smear.

3 Ways to Relax During a Gynecologic Exam

A pelvic exam may be uncomfortable, but it shouldn’t be painful. The key is to relax. Holmes offers these tips if you have the jitters during an exam:

  • Do deep, slow breathing.
  • Let your legs relax open as far as they will go.
  • Don’t squeeze your butt cheeks together. “If you squeeze your bottom, it squeezes around the speculum,” she says.

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