There are four main parts to a gynecological visit:
Physical exam: Your clinician will perform a typical physical exam—just like your annual physical. The clinician will also ask a number of questions about potentially sensitive topics, including your menstrual cycle, sexual history, sexual partners, drug use, and any history of sexual abuse. Although these are very personal questions, it is important that you give frank and honest answers. Our clinicians aren’t judgmental and, however odd your own experiences may seem to you, they have heard it all before.
Breast exam: Your clinician will feel your breasts for lumps, look for any discharge from your nipples, and teach you how to perform a breast self-exam.
Pelvic exam: Your clinician will examine the outside of your vagina and then insert a speculum to hold the walls of your vagina open for the internal exam. The clinician will look inside your vagina with a light to examine your vaginal tissues and secretions, your cervix, and take any samples needed for testing.
After the speculum is removed, the clinician will perform an exam that involves inserting gloved and lubricated fingers into your vagina while pressing on your abdomen to feel your uterus, ovaries, cervix, and fallopian tubes. The clinician will also test the strength of your pelvic floor muscles and may insert a finger into your rectum to feel for polyps, endometriosis, and other problems.
If you have any questions during the exam, don’t hesitate to ask your clinician what she is feeling for and if everything feels normal. You may feel pressure and sensations similar to cramping during the exam, but it shouldn’t be painful. The more relaxed you are, the less pressure you will feel. If you need to pause and take a break, just let your clinician know.
Pap test: During your pelvic exam, your clinician will use a special brush and a spatula to scrape away and collect some cells from your cervix. Those cells will be tested for any abnormalities. The Pap test also offers an opportunity to test for some sexually transmitted infections.