During a pelvic exam, a healthcare provider uses palpation—a technique involving hands and fingers—to assess reproductive organs like the vagina, cervix, uterus, and ovaries. This method helps evaluate their size, consistency, and tenderness. While the exam checks various structures, ovarian palpation is a specific focus.
Understanding Ovarian Palpation
It is sometimes possible to feel the ovaries during a pelvic exam, though it is not always straightforward. Healthy, normal-sized ovaries can be difficult to palpate, especially in individuals with a higher body mass. Patient relaxation also influences the success of ovarian palpation. In postmenopausal individuals, ovaries naturally become smaller and are typically not palpable, making any palpable finding a potential concern.
Techniques for Ovarian Assessment
The primary method for ovarian palpation is the bimanual pelvic examination. During this procedure, the healthcare provider inserts one or two lubricated, gloved fingers into the vagina. Simultaneously, the other hand gently presses on the lower abdomen. This two-handed approach allows the provider to feel the pelvic organs between their internal and external hands, assessing the size, shape, position, and mobility of the uterus and, if possible, the ovaries.
Clinical Indications for Examination
A doctor may attempt to palpate the ovaries for several reasons, often prompted by specific symptoms or to evaluate reproductive health. This examination helps investigate concerns such as pelvic pain, which can be caused by various gynecological conditions. Abnormal vaginal bleeding or discharge can also indicate a need for ovarian assessment. A pelvic exam, including ovarian palpation, is also performed to check for growths like uterine fibroids or ovarian cysts.
Interpreting Examination Findings
Normal ovaries, if palpable, typically feel almond-shaped and are about 2 to 5 centimeters in length in reproductive-aged individuals. Findings that may prompt further investigation include tenderness, enlargement, or the presence of a mass. A palpable ovary in a postmenopausal individual is often considered an abnormal finding. Palpation alone is usually not definitive for diagnosis, and any suspicious findings typically lead to additional tests.
Complementary Diagnostic Approaches
Since ovarian palpation has limitations and may not detect all abnormalities, other diagnostic tools are frequently used. Transvaginal ultrasound is a common imaging technique, using a small probe inserted into the vagina to create detailed images of the ovaries and surrounding structures. This method identifies the size, appearance, and internal characteristics of ovaries, including cysts or tumors. Other imaging techniques, such as CT scans and MRI, may also be employed to further evaluate ovarian health, particularly if a mass is detected or cancer is suspected.