What I Wish I Knew About Pelvic Exams
Pelvic Exam. Possibly one of the most terrifying phrases known to the female-bodied population. It is a phrase that often evokes images of patients lying in a paper gown with their feet in stirrups while a doctor places a spotlight on their genitals and proceeds to poke around, for what seems like an eternity. It can be awkward. Terribly awkward. but it’s important to remember that a routine pelvic exam is an important part of healthcare for female-bodied people - and it doesn’t have to be awkward.
During this routine visit, the doctor will discuss any health-related questions or concerns you have, maybe discuss birth control options and safe sex practices, and give you any advice for your overall wellness. At this visit, the doctor will also conduct a physical exam which includes breast, vulvar, and rectal exams, as well as a pap smear. Pap smear. The main event of a pelvic exam. And the part most people are afraid of.
So, what is a pap smear? A pap smear is a routine screening that occurs during a pelvic exam. The doctor will insert a speculum to gently open the walls of your vagina and then use a long cotton swab to delicately wipe some cells from your cervix (your cervix is the muscle that serves as the opening of your uterus). The swab will then go to the lab where it will be screened for any abnormalities, including pre-cancer or cancer cells.
Having a pap smear can be a very vulnerable experience. I mean, you’re lying on your back with your feet in stirrups, it doesn’t get more vulnerable than that. But, there are several ways to make your routine pelvic exam and pap smear a more empowering experience, here are five ways how. I only wish I had known about these sooner!
1. Speak up
Having a pelvic exam can cause a lot of anxiety, especially if it’s your first. Talking about it can help alleviate your fear. Letting the doctor know you are afraid gives you both the opportunity to have an open dialogue about it. Knowing what the exam entails, what it will feel like, and how long it will last can help you mentally prepare, which can help reduce tension, which will help reduce anxiety and even discomfort.
2. Get hands-on
If the idea of having a stranger open your vaginal muscles makes you feel embarrassed, ask to insert the speculum yourself. Many doctors appreciate the willingness of patients to get involved. Plus, it can help you feel more in control.
3. Swab yourself
This is on par with suggestion number two. Ask if you can swab your cervix (or in some visits your anus) yourself. Doing this allows you to become familiar with your anatomy and lets you to dictate the pressure of the swab.
4. Take a peek
Not everyone has a speculum at home *(but you can buy one!) with which to examine their vagina or cervix, so, take advantage of your pelvic exam by asking the doctor if you can watch what they are doing. Many doctors have mirrors on-hand you can use to follow along. Remember, it’s your body. It’s ok to look.
5. Cop a feel
During this routine exam, the doctor will do a breast exam and check the size of your uterus/ovaries by pressing on your stomach. Ask to do it, too. Have them show you how to conduct a breast and external pelvic exam so you will know how to do it at home. Plus, you will be able to identify any changes over time, hence, becoming body literate.
A pelvic exam can be awkward, embarrassing, and even uncomfortable, but it doesn’t have to be. Knowing what to expect and getting involved can help you feel more in control, can help you gain more understanding of your body, and can help empower you in a situation that can make you feel vulnerable. Be an active participant in your healthcare and utilize your pelvic exam as an opportunity to learn as much as you can.
When and how often should you have a pelvic exam? Well, it is generally recommended you schedule your first exam after you become sexually active (or just before if you are planning to use hormonal birth control or **LARCs). If you have not become sexually active by age 21, it’s time to schedule an exam. For routine healthcare screening, schedule an exam every three years.
*If you would like a suggestion for buying a cervical examination kit, we will gladly make one
**LARC = long-acting reversible contraceptive
AMY SUTHERLAND - FOUNDER
Amy Sutherland (she/her) has been passionate about sexual health since before she hit puberty. She has spent most of her adult life working as a professional writer focusing on health and wellness. More particularly, women’s reproductive health.