A pelvic exam is a routine medical procedure that allows a healthcare provider to assess the health of a person’s reproductive organs. This examination involves a visual inspection of the external genital area, an internal assessment of the vagina and cervix, and palpation of internal organs. It serves as a tool for both preventive care and to investigate specific symptoms related to reproductive health.
The Role of Primary Care in Pelvic Exams
Many primary care physicians (PCPs) are trained to perform pelvic exams for routine screenings and common health concerns. This includes family medicine physicians, internal medicine specialists, physician assistants, and nurse practitioners. Their medical education and residencies include training in women’s health screenings, such as pelvic exams and Pap tests. The ability of a PCP to perform these exams can vary based on their individual training, comfort level, and clinic resources.
Choosing a PCP for a pelvic exam offers convenience and continuity of care, as they manage a patient’s overall health history. They can integrate reproductive health into a broader understanding of a patient’s well-being. For generally healthy patients without complex gynecological issues, a PCP can efficiently perform their annual pelvic exam.
Common Reasons for a Pelvic Exam
A pelvic exam may be recommended for several reasons, encompassing both routine preventive care and the investigation of specific symptoms. Reasons include routine physical exams to check overall sexual and reproductive health, such as cervical cancer screening via a Pap test.
They also diagnose conditions when symptoms like pelvic pain, unusual vaginal bleeding or discharge, or painful intercourse occur. Exams can identify issues such as infections, uterine growths, or ovarian cysts. These exams can also assess concerns about sexually transmitted infections (STIs) or check the placement of an intrauterine device (IUD).
What Happens During a Pelvic Exam
A pelvic exam involves several steps to provide a comprehensive assessment of the reproductive organs. The process begins with an external visual inspection of the vulva and outer genital area for irritation, skin changes, sores, or unusual discharge.
Next, a speculum, a plastic or metal instrument, is gently inserted into the vagina to hold the walls open, allowing the provider to view the vagina and cervix. During this, a Pap test may be conducted to collect cell samples from the cervix for cervical cancer screening.
Finally, the bimanual exam involves the provider inserting gloved fingers into the vagina while pressing on the lower abdomen. This allows them to feel the size, shape, and position of the uterus, ovaries, and fallopian tubes, checking for tenderness or unusual growths.
When to See a Gynecologist
While primary care providers can address many routine women’s health needs, specific situations warrant consulting a gynecologist. Gynecologists are specialists in the female reproductive system and offer focused expertise. Complex gynecological issues often require a specialist’s attention, such as persistent pelvic pain, abnormal Pap test results requiring further investigation, or conditions like endometriosis or fibroids.
Situations such as fertility concerns, family planning, or managing symptoms related to menopause are best addressed by a gynecologist. They also perform specialized procedures and provide care for high-risk pregnancies or surgical needs. If a primary care provider identifies a specific finding during a routine exam that requires more specialized management, they will refer the patient to a gynecologist for further evaluation and treatment.