Back in the Stirrups—Again
Taking the pelvic exam, step-by-step.

By Madeleine Gordillo

Your visit to the gynecologist begins like any doctor’s appointment—you fill out forms about your medical history and your reasons for being there. There are many clinics where you can get exams for free, but you may be required to show identification.

At the clinic, you may be asked for blood or urine samples to test for pregnancy and infection. At some clinics, you speak to a counselor before getting examined by a doctor or nurse-practitioner. The counselor, or sometimes the practitioner, reads your form and may ask for more information. (For example, if there is diabetes in your family, she’ll ask which family member has it.) She will also ask why you are there and if you have any questions. If you came for something specific, like birth control, or to find out if you have a sexually transmitted infection, you should tell her that.

The Stirrups

After the counseling session, you go into an exam room, where you are asked to take off your clothes and change into a paper robe. The exam table has metal hoops, called stirrups, attached to the bottom corners.

The examination begins with a breast exam. The doctor will open your robe and tell you to place both hands behind your head. Using the flat side of her three middle fingers, she’ll feel for any abnormal lumps in your breasts and armpits. The doctor should also teach you how to examine your own breasts between doctors’ visits.

The Speculum

Next comes the pelvic exam. This is when the practitioner asks you to lay down and put your heels in the stirrups. They keep your legs spread apart enough so that the doctor will be able to examine you properly.

The doctor will check the outer surface of your vagina to make sure everything looks healthy. Then she inserts the speculum, an instrument used to hold the walls of the vagina open so the doctor can see inside. The doctor will gently insert the speculum into your vagina. Once it’s in place, she will open the mouth of the speculum. Many people fear that this will be painful, but if you relax and don’t tense up, all you should feel is a slight pressure.

The doctor will check the walls of your vagina and the opening of your cervix for any abnormalities (redness, inflammation, cysts, unusual discharge) that could be signs of infection or disease. If you have any questions about your reproductive organs or about what the doctor is doing, you should feel free to ask them during the exam.

The Pap Smear

Next, the doctor will insert a long Q-tip into your vagina to get some cell samples. (You might feel some “poking” at this point.) This is called the Pap smear and it is done to test for warning signs of cancer. If you are sexually active, she will take another sample to test you for gonorrhea and chlamydia. This lasts about a minute. Then the doctor closes the speculum and eases it out.

Next she changes her gloves and spreads lubricant on one or two of her fingers and puts them inside your vagina to feel your cervix and internal organs. You will feel a little pressure at this point. With her other hand, the doctor will press down on your lower abdomen to feel your uterus and ovaries. She does this to feel for any abnormal swelling, tenderness or lumps.

The Results

The doctor will probably spend a few minutes discussing your exam with you when she’s done. You will be told if anything abnormal was found during the exam, such as inflammation of the vagina, any unusual lumps or discharge. The doctor might prescribe something for you or tell you that you need additional tests. Don’t expect the results of your Pap smear and STD culture right away. That usually takes a few days. If anything irregular shows up in those test results, she’ll contact you. If you don’t hear from her, and you weren’t told to call for the results, then everything’s fine.

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