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Your First Pelvic Exam

Conditions

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A pelvic exam is a physical exam to check the health of a girl’s female organs.

During a pelvic exam your doctor can check for signs of illness or problems in your:

  • Uterus (womb)
  • Cervix (opening from the vagina to the uterus)
  • Fallopian tubes
  • Ovaries

Patients can be seen by Texas Children's experts in Adolescent Medicine and Pediatric and Adolescent Gynecology.

When should I have my first pelvic exam?

Your first pelvic exam is usually after you become sexually active or when you turn 21, whichever comes first.  

You may need a pelvic exam sooner if you are experiencing problems with your period or have other symptoms, including: 

  • Pain in your lower abdomen or pelvic area
  • Vaginal burning, itching or foul-smelling discharge
  • Period hasn’t started by age 15 (amenorrhea)
  • Periods that last more than 7 days
  • Missed periods, especially if you are having sex
  • Menstrual cramps that cause you to miss daily activities (dysmenorrhea)

What should I do to prepare for my first pelvic exam?

When you schedule your appointment, be sure to mention that this is your first pelvic exam so your doctor can explain each step of the exam and answer any questions you may have.

Try to schedule the exam for a date that you won’t be on your period.

If it will make you more comfortable, bring your mother or another person with you to stay in the examining room with you.

What can I expect at my visit?

Before the exam you will:

  • Be weighed and have your blood pressure taken
  • Provide a urine sample, or be given the opportunity to go to the bathroom and empty your bladder, so you’ll be more comfortable during the exam
  • Remove all clothing  – including bra and underwear – and put on a gown; you will also be given a sheet to cover up with
  • Be asked about your medical history, menstrual periods, sexual activity, and birth control 

What should I expect during the pelvic exam?

The pelvic exam itself is simple, takes only a few minutes, and is not painful. You may feel a little uncomfortable and embarrassed, but that’s normal. The entire exam is over very quickly.

A typical pelvic exam includes several parts:

  • External exam – While lying on your back on the table, the doctor will press down on your lower stomach to feel the organs from the outside. The doctor may also do a breast exam, pressing on different areas of your breast to check for lumps or abnormalities.
  • Speculum exam – You will be asked to slide down to the end of the table, bend your knees and rest your feet in holders called “stirrups.” After examining the outside of your vagina, the doctor will gently insert an instrument called a “speculum” into your vagina and opens it up to view inside the vagina.
  • Pap smear – A small brush is used to gently swipe a tiny sample of cells from your cervix (the opening of the uterus) to test for cervical cancer or pre-cancerous changes.  New recommendations suggest that this testing should begin at age 21 years.  
  • Other tests – If you have abnormal discharge or are sexually active, additional samples may be taken to test for infections and sexually transmitted diseases (STDs).
  • Manual exam – To check your ovaries and uterus – which can’t be seen – the doctor will place two gloved fingers inside your vagina and then press down with the other hand on the outside of your lower abdomen to feel the size of the ovaries and uterus and check for cysts or growths. Sometimes a rectal exam is also performed, in which the doctor inserts one gloved finger into your rectum to check for tumors or other abnormalities.  

If you are interested, you can ask for a mirror during the exam to learn more about your body and what the doctor is doing during the exam. W

If your doctor or nurse is male, a female assistant will be called into the room during all parts of the exam.

What happens after the pelvic exam?

After the exam your doctor will talk to you and ask you if you have any questions.

A small amount of discharge or even a few spots of blood is normal after a pelvic exam and Pap test.

Do I need a pelvic exam if I have never had sex?

Yes, a pelvic exam checks the overall health of your female organs. It is important to have them whether you are sexually active or not, to detect any problems early, when they are most treatable.