The Pelvic Exam
Students often have their first pelvic exams at Smith. When you don’t know what to expect and you’ve heard other women complaining, the prospect of putting your feet in the stirrups can be quite daunting. Students often have questions they want answered before they get to the exam, and other times they need help formulating and retaining questions they know they want to ask the Doctor or Nurse Practioner (NP) conducting the exam. When talking with a student about an upcoming appointment, start by talking her through the process of a GYN exam. Ask her if she has any particular concerns that she wants to discuss with the practitioner, such as irregular or painful periods, STI testing, or birth control. If she mentions birth control, offer to go over her options and the risks and benefits of each with her. If she asks questions about STIs and testing or any other reproductive or sexual health issue, reference any materials necessary and answer her to the best of your ability, then help her to write down or remember any remaining questions for the doctor. *** Needs to be modified to be directed at our audience
What happens at a pelvic exam?
First, you will be brought to the office where an assistant will take down some basic information such as? . The doctor or NP will come in shortly after that to talk to you about what you want to get out of your exam. This is the perfect time to bring up any questions or concerns you have, especially if they involve STI testing or measuring for prescription barrier methods of birth control, like the diaphragm. The practitioner will then hand you a gown to put on and leave the room. When the practitioner returns, s/he will have you sit on the table while s/he pulls out the stirrups, which stick out past the end of the table and give you something to rest your feet on. When your practitioner tells you to “scoot down,” s/he means it. It might feel funny, but you’re not in position until your knees are bent and your butt is right on the edge of the table.
Now for the exam itself. First the practitioner will insert one or two gloved fingers into your vagina while pressing down on your abdomen. This is to check and make sure your internal reproductive organs are as expected. After that, the practitioner will insert a speculum into your vagina. It might be cold, and it isn’t exactly “comfortable.” Most women describe a sensation of pressure, but it shouldn’t hurt and in most cases it won’t. If it does, tell your practitioner so s/he can try to make you more comfortable. The purpose of the speculum is to hold your vagina open so that the practitioner can complete the exam. S/he will take a long, thin swab from a tube. This is the pap smear. The practitioner will swab your cervix to collect cells for testing. You’ll feel dull pressure for a moment, but again, it shouldn’t hurt. If you’re being tested for certain STIs, including Chlamydia and Gonorrhea, more swabs will follow, but you won’t feel these as much.
Health services is able to test for Gonorrhea, Chlamydia, Syphilis, Herpes and HIV. If you are receiving your first gynecological exam at Smith College, you will automatically be tested for Chlamydia and Gonorrhea. Every exam thereafter, you must ask to be screened for Chlamydia and Gonorrhea. Syphilis, Herpes and HIV are not tested for automatically, and are performed by request of the patient.
Once the pelvic exam is over, your practitioner might want to show you how to do a breast self-exam. After that s/he will leave the room and you can get dressed. The practitioner will return a few minutes later so that the two of you can wrap up any details, including writing a prescription for birth control.
Written by Amanda Hanley '06
Last Updated: 1-23-06
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