When it comes to the annual preventive care checkup, most women have some apprehension about pelvic exams and pap smears, particularly the first time around. While pelvic exams may leave you feeling vulnerable, it is an important tool for assessing your gynecological health.
Usually pelvic exams and pap smears begin at age 21, unless you request certain types of birth control —like an IUD— where a pelvic exam is required, or if you're having symptoms of certain reproductive conditions that require treatment, like endometriosis.
Sometimes just knowing what's in store during a doctor's visit can help ease anxiety. Here, we'll discuss what to expect during your pelvic exam, including how a pap smear works.
There's a lot that will happen at your preventive care visit prior to your pelvic exam. First, you'll talk to the doctor or an assistant about your health history and they'll take health measurements, such as your weight and blood pressure. Then, your provider will recommend that you empty your bladder before your exam and you'll be left to change into an exam gown. The assistant will leave wipes for you to use.
When your gynecologist or midwife reenters the exam room, she will probably first perform a clinical breast exam and talk to you about performing self-exams during the year. Then she will have you move to the bottom of the exam table, where you will rest your feet in the table's stirrups. You'll be asked to lie back on the table and relax your legs into an open position. Your exam will be more comfortable if you can relax your legs and pelvic muscles. Breathing deeply and slowly will help you with this.
The doctor will first perform a visual check of your vulva tissue to make sure everything looks nice and healthy. They will then tell you that they are inserting the speculum. A speculum is a plastic apparatus that looks similar to a duckbill. It's inserted into your vagina so your doctor can examine your vaginal walls and cervix, checking for lesions, inflammation, and unusual discharge. A speculum can be uncomfortable for some women. You may feel pressure in your bladder or rectum, but the speculum shouldn't be painful. If it is, tell your doctor.
If you require a pap smear, you doctor will perform it during the speculum exam. The American Congress of Obstetricians and Gynecologists (ACOG) recommends that pap smears begin at the age of 21.
How often a woman should get a pap smear depends on several health factors, but the general rule is every three years from age 21 until the age of 30. Women aged thirty and above should receive a pap smear and HPV test every five years.
A pap smear checks a woman for cervical changes that could indicate cervical cancer caused by the HPV virus. A pap smear involves your doctor swiping a long, Q-tip looking swab into your vagina, where cells from your cervix are collected. A lab will later analyze this sample for any cell changes. In comparison to the rest of the pelvic exam, the pap smear only takes a minute and is generally nothing to be worried about!
Your doctor will then remove the speculum and insert one or two of her gloved fingers into your vagina, while pressing with the other hand on your abdomen. This bimanual exam examines the shape, size and location of your uterus, and where your ovaries are. Your doctor will also be feeling for tender areas and growths that could indicate the presence of a condition such as endometriosis.
While your doctor has just collected a lot of information about your health, a pelvic exam generally lasts five minutes or less!
Pelvic exams and pap smears are much more comfortable when working with a health provider that you know and trust. The compassionate midwives and gynecologists at All About Women in Gainesville are passionate about providing competent care in a relaxing and comfortable setting.
If you want to learn more about your first visit with us, read our blog post Your First Gynecology Visit.
And if you’re ready to come in for a preventive care checkup, contact us today to schedule an appointment.