Pelvic Examination

Pelvic Examination

A pelvic examination is an evaluation of the external and internal female reproductive organs within the pelvic region. The purpose is to detect abnormalities that may indicate underlying diseases or medical conditions. The examination includes assessment of the vagina, cervix, uterus, fallopian tubes, ovaries, urethral opening, bladder, and rectum.

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Who Should Undergo a Pelvic Examination?

All women, regardless of age, should have routine pelvic examinations. Many gynecologic conditions do not present symptoms until the disease has progressed, such as endometriosis with ovarian endometrioma (chocolate cyst) or ovarian tumors.

A pelvic examination is especially recommended if you experience any of the following symptoms:

• Severe menstrual cramps or pelvic pain

• Irregular or heavy menstrual bleeding

• Abnormal vaginal bleeding

• Abnormal vaginal discharge

• Genital sores or lesions

• A palpable mass in the lower abdomen

• Infertility or difficulty conceiving

Annual pelvic examinations help detect abnormalities early, allowing for more effective treatment.

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When Should Women Begin Pelvic Examinations?

It is recommended that Thai women begin pelvic examinations at age 25, or three years after becoming sexually active.
Screening should be performed once a year and may be discontinued at age 70.

A pelvic examination should ideally be performed together with cervical cancer screening.

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How to Prepare for a Pelvic Examination

• Schedule the exam on a day when you are not menstruating.

• Wear clothing that is easy to change out of.

• No fasting is required.

• Shaving or hair removal is not necessary.

• If you have abnormal vaginal discharge, avoid washing beforehand so that the doctor can accurately test for infections.

• Avoid sexual intercourse 1–2 days before the examination.

• Empty your bladder before the exam.

 

Steps of the Pelvic Examination

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1. External genital examination:
The doctor inspects and palpates the external genitalia, mons pubis, and lymph nodes to detect abnormalities.

2. Speculum examination:
A speculum is inserted into the vagina to visualize the vaginal walls and cervix. Cervical cancer screening is performed during this step.

3. Bimanual examination:
The doctor palpates the size, shape, and position of the uterus, adnexa (ovaries and fallopian tubes), and evaluates for pelvic adhesions.

4. Rectal examination (if indicated):
May be performed when severe menstrual pain or suspected adhesions are present.

5. Pelvic ultrasound:
Used to visualize the uterus and ovaries, assess uterine cavity abnormalities, polyps, or masses (based on clinical indication).