Surviving Your First Pelvic Exam

When I was 18 years old, I decided it was time to start getting gynecologic care. So I took myself into the University of Alabama’s Health Center…and had one of those moments you never forget. It wasn’t particularly unpleasant. It’s just that my first pelvic exam ever was so extremely different from anything I had ever experienced before that, it continues to stand alone in my memory.

There just simply aren’t that many things in life that compare to one’s first pelvic exam.

And yet, your reaction to that first pelvic exam forms the foundation for how you’ll approach pelvic exams for the rest of your life. I have known women who are terrified every time they need to have a pelvic because their first exam was so unpleasant.

On the other hand, if the first pelvic exam turns out to be not so bad (like mine), then while it may be memorable forever, it won’t live in your mind as an unpleasant experience. So what can you do to make sure that your first pelvic is a good experience?

What does a pelvic exam entail?

You will be asked to get up on a special exam table that will have places called stirrups where you’ll put your feet. With your feet in these stirrups, you will then be asked to lie back and to slide your bottom toward your feet to the end of the table. Your healthcare provider will then sit in a chair between your legs and gently touch your vulva to inspect for any problems. Next, your provider will spread your labia and gently insert a device called a speculum into your vagina. The speculum may be made either of metal or plastic and will look a little like a duck’s bill. The speculum gently opens your vagina so that your provider can see down to your cervix. Your provider will visually inspect your vaginal walls and your cervix, as well as take any necessary swabs or specimens (such as a Pap smear or cultures).

Then your provider will close the speculum and withdraw it from your vagina. He or she will then insert two gloved fingers into the vagina and back to your cervix. Your provider will place the other hand on your abdomen and use both hands to press down on your uterus and ovaries. In some cases, it may be necessary for your provider to also place a finger in your rectum.

How can you make this exam a positive experience? Relax!

Relaxation is the key to making the pelvic exam a positive experience. In order to be able to relax, it’s most important for you to be comfortable with your healthcare provider. Ask yourself, Would you be more comfortable with a woman or a man as your healthcare provider? Ask other women about the providers they see for their pelvic exams, and do some research into the providers available in your area. Talk to the healthcare provider that you select and let them know that this will be your first pelvic exam.

If you find that you are nervous and uncomfortable during the exam, communicate this to the healthcare provider. Then try to relax your vaginal and pelvic floor muscles. Some women find it helpful to take deep breaths, some even text friends or play video games, while others simply try to distract the mind. Strategies that allow you to relax in other situations will also help you relax in this one as well. Focus on keeping your bottom pressed into the table and letting your abdominal and pelvic muscles go.

If you can relax during the exam, the experience will still seem unusual but it doesn’t have to be uncomfortable. So take a deep breath and relax! 

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