San Francisco, CA — Anyone with a vagina knows that they come with some upkeep -- and we’re not just talking about period products. Once you turn 21, the American College of Obstetricians and Gynecologists recommends you get your first pelvic exam.
As common as pelvic exams are, many girls remain in the dark when it comes to What. Actually. Happens. And that lack of knowledge not only sucks, it can be downright dangerous.
When it comes to something as intimate as a pelvic exam, what IS normal? No worries -- we have real REAL talk answers to all your pelvic exam questions. We went to Dr. Vanessa Jacoby at UCSF to ask what should and shouldn’t happen in a pelvic exam.
A pelvic exam has multiple parts to it. Here’s what actually goes down:
Pre-Exam: Personal Questions
Your provider will ask you questions relevant to your health, relationships, and sexual history. The goal is to help determine your risk factors for certain conditions in order to best treat you. Many of the questions will be about sex -- but the way they’re asked shouldn’t feel judgey or sexual. And If you don’t want to answer a question, you don’t have to!
Part One: External exam
Let’s take a look under the hood, shall we? This is when your clothes come off and your provider’s gloves must come on. You’ll get a hospital gown and a tarp to cover your crotch (and side note, you don’t need to shave for this. They’ve seen it all). They will be looking for any signs of infection, like redness, bumps or lumps. Your doc might touch you very lightly, but nothing is going IN at this point.
Part Two: The Pap Smear
The second part of the pelvic exam is the pap smear. Take a deep breath, because NOW WE’RE GOING IN, Y’ALL. The purpose of the test is to check for abnormal cells, which can turn into cervical cancer if untreated. To do so, your doc is going to put a speculum into your vagina, open it up so they can see what’s happening in there, and then use a tiny spatula to collect a small sample of cells from your cervix. It shouldn’t hurt -- but it’s not going to feel great.
Part Three: The “Bimanual” Exam
Gynos call this the “bimanual exam” because it requires two hands. You may end up calling it the “my-doctor-has-their-fingers-in-my-vagina-but-not-in-a-sexual-way” part of the exam. Your doc will put one to two gloved fingers into your vagina, while pressing gently on your stomach with the other hand. They’re checking for things like an enlarged uterus, ovarian growths, or unusual positioning. The fingers shouldn’t move around or anything. But are they all up in your business? Yup.
So that’s what’s supposed to happen. And even though it’s a bit gross to think about, here are a few important things that should NEVER happen:
- No one should ever watch you change into your gown.
- You should not be completely uncovered -- it’s not a Brazilian wax.
- Your provider should never comment on your body in a sexually suggestive way.
- Your provider should never touch your genitals with an ungloved hand.
It’s a lot to process, but the good news is that you also have rights as a patient. Here are a few you should know about going into your exam:
- You can stop the exam and leave at any time (even mid-exam).
- You can request to have the clinic provide a chaperone (usually a nurse or medical assistant) to stay with you in the room. Or you can bring a friend, family member, or partner and say you want them in the room for your exam.
- You can ask your provider to tell you before they touch your body, or let you know what they are going to do before they do it.
- You can ask if they can use a smaller speculum (there are different sizes).
There you have it -- a pelvic exam demystified. The truth is, even if your doctor is awesome and does everything right, a pelvic exam can still make you feel weird. But knowing more about what to expect will help you determine for yourself where “weird” ends and “wrong” begins.
Reported by Charlie Stuip; Video Edited by Chaz Hubbard and Pablo De La Hoya; Camera operators: Liz Tril, Chaz Hubbard, Pablo De La Hoya; Produced by Teresa Chin; Edited by Lissa Soep