Published on: 11/13/2015IST

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How Often Should You get Pelvic Exam And Pap Test?

User Image Jyoti Negi Last updated on: 11/13/2015, Permalink

A pelvic exam is performed in your doctor's office and takes only a few minutes.

You'll be asked to change out of your clothes and into a gown. You may be given a sheet to wrap around your waist for added privacy. Before performing the pelvic exam, your doctor may listen to your heart and lungs and perform a breast exam. A pelvic exam will involve your healthcare provider looking for signs of infection or any other conditions. It will most likely include taking a few cells from your cervix for a ‘Pap test’. A Pap test can find pre-cancerous cell changes of the cervix. Sometimes a Pap test is also called a Pap smear.

Pap tests are usually part of a regular pelvic exam. During a Pap test, your health care provider inserts a metal or plastic speculum into your vagina. The speculum is opened to separate the walls of the vagina so that the cervix can be seen. The health care provider then uses a small sampler — a spatula or tiny brush — to gently collect cells from the cervix. The cells are sent to the laboratory to be tested. Detecting problems early can help you get the treatment you need to keep healthy.

After your first pelvic exam, your health care provider will tell you how often you should have gynecological care, including pelvic exams. How often you need exams will depend on your medical history and personal health needs. Generally, a Pap smear is recommended for women from 21 years of age. Women ages 21-65 should have routine screening with Pap test every three years. Combining a Pap test with a human papillomavirus (HPV) test can safely extend the interval between cervical cancer screenings from three years to five years in many women between the ages of 30-65, according to the U.S. Preventive Services Task Force (USPSTF).

Also according to USPSTF guidelines, HPV testing is not recommended for women in their 20s because people in that age group can have HPV infections that resolve without treatment.

But please note that may need more frequent pelvic exams if you have a history of abnormal Pap test results a history of sexual health problems a family history of certain kinds of cancer a sexually transmitted infection or a sex partner with an infection recurrent vaginitis. In some cases, a pelvic exam is needed in order to prescribe hormonal birth control — the pill, the patch, the ring, or the shot. A pelvic exam is always needed for inserting an IUD or fitting a diaphragm.

A pelvic exam generally includes:

  • External visual exam. First, your doctor visually inspects your vulva, looking for irritation, redness, sores, swelling or other abnormalities.

  • Internal visual exam. Next, your doctor uses a speculum — a plastic or metal-hinged instrument shaped like a duck's bill — to spread open your vaginal walls and view your vagina and cervix. The speculum may be warmed before it's inserted.

    Inserting and opening the speculum causes pressure that can be uncomfortable for some women. Relax as much as possible to ease discomfort, but tell your doctor if you're in pain.

  • Pap test. If your pelvic exam includes a Pap test (Pap smear), your doctor collects a sample of your cervical cells before removing the speculum.

  • Bimanual exam. Because your pelvic organs, including your uterus and ovaries, can't be seen from outside your body, your doctor needs to feel (palpate) your abdomen and pelvis for this part of the exam. To do this, your doctor inserts two lubricated, gloved fingers into your vagina with one hand, while the other hand presses gently on the outside of your lower abdomen.

    During this part of the exam, your doctor checks the size and shape of your uterus and ovaries, noting points of tenderness or unusual growths. After the vaginal exam, your doctor inserts a gloved finger into your rectum to check for tenderness, growths or other irregularities.

Usually, at each step, your doctor tells you exactly what he or she is doing, so nothing comes as a surprise to you.

After the pelvic exam

After the pelvic exam is over, you can get dressed and then discuss with your doctor the results of your exam.

Do I Need to Do Anything to Prepare for a Pelvic Exam?

Because a Pap test is typically performed during a routine pelvic exam, you should schedule the exam when you are not having your period.

In addition, for 48 hours prior to the exam, you should not:

  • Douche
  • Use a tampon
  • Have sex
  • Use birth control foam, cream, or jelly
  • Use medicine or cream in your vagina

What Can I Expect During a Pelvic Exam?

You can expect to feel a little discomfort, but you should not feel pain during a pelvic exam. The exam itself takes about 10 minutes. If you have any questions during the exam, be sure to ask your doctor.

How Is a Pelvic Exam Performed?

During a typical pelvic exam, your doctor or nurse will:

  1. Ask you to take off your clothes in private (You will be given a gown or other covering.)
  2. Talk to you about any health concerns
  3. Ask you to lie on your back and relax
  4. Press down on areas of the lower stomach to feel the organs from the outside
  5. Help you get in position for the speculum exam (You may be asked to slide down to the end of the table.)
  6. Ask you to bend your knees and to place your feet in holders called stirrups
  7. Perform the speculum exam. During the exam, a device called a speculum will be inserted into the vagina. The speculum is opened to widen the vagina so that the vagina and cervix can be seen.
  8. Perform a Pap smear. Your doctor will use a plastic spatula and small brush to take a sample of cells from the cervix (A sample of fluid also may be taken from the vagina to test for infection.)
  9. Remove the speculum.
  10. Perform a bimanual exam. Your doctor will place two fingers inside the vagina and uses the other hand to gently press down on the area he or she is feeling. Your doctor is noting if the organs have changed in size or shape.
  11. Sometimes a rectal exam is performed. Your doctor inserts a gloved finger into the rectum to detect any tumors or other abnormalities.
  12. Talk to you about the exam (You may be asked to return to get test results.)

What Tests Are Taken During the Pelvic Exam?

A sample of cells may be taken as part of regular test called a Pap smear, or Pap test, to screen forcervical cancer or cells that look like they might lead to cancer. The sample is placed in a solution and sent to a lab where it is examined. Tests also may be taken to screen for sexually transmitted diseases.

How Often Should I Get a Pelvic Exam?

A Pap smear is recommended starting when women reach 21 years of age. Women ages 21-65 should have routine screening with Pap test every three years.

Combining a Pap test with a human papillomavirus (HPV) test can safely extend the interval between cervical cancer screenings from three years to five years in many women between the ages of 30-65, according to the U.S. Preventive Services Task Force (USPSTF).

Also according to USPSTF guidelines, HPV testing is not recommended for women in their 20s, because people in that age group can have HPV infections that resolve without treatment.

Women over age 65 can stop getting screened if they’ve had at least three consecutive negative Pap tests or at least two negative HPV tests within the previous 10 years, according to the guidelines. But women who have a history of a more advanced precancer diagnosis should continue to be screened for at least 20 years.


11/13/2015 | | Permalink