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The American College of Obstetrics and Gynecologists recommends undergoing annual pelvic examinations starting at age 21.  Screening for cervical cancer is also recommended starting at that age, irrespective of sexual activity.  Pelvic examination of women younger than 21 is recommended only when indicated by medical history/medical need.

A pelvic examination will typically include a visual inspection, an internal examination using a speculum, and a manual exam using a gloved finger.  A breast exam is also an integral part of the visit In the USA,  while not necessarily so in other countries.

With the vagina often being this mysterious, dark structure that a woman never sees, we routinely show our patients their vagina & cervix through an open speculum.  We urge all of you who have not seen them to ask your clinician to use a mirror and show you — it will demystify this body part and will give you a visual of its simple structure and looks.

Wonder about the history of stirrups?  You may also want to read  Love Gyno Exam? and Tips for Gyno Exam and Anxious Gyno Exam and Abnormal Pap.

When to see the doctor for a non-routine pelvic exam?

•    If you experience sudden pain in the lower abdomen/pelvis
•    If you bleed/spot outside of your period
•    If you notice an usual smelly vaginal discharge; if you experience burning, itching
•    If you experience unusual vaginal dryness that causes discomfort, and interferes with sexual activity (typical of menopause and during/after cancer treatment)
•    If you notice genital sores, pimples, lumps, etc.
•    Any time you have a concern

September is ovarian cancer awareness month and we’d like you to learn the signs of this disease.  Note: the symptoms are not specific to ovarian cancer and may mimic those of many other conditions, including digestive problems:

•    Abdominal pressure, fullness, swelling or bloating
•    Pelvic discomfort or pain
•    Changes in bowel and/or bladder habits
•    Loss of appetite, or a quick feeling of fullness
•    Increase abdominal girth / clothes fitting tighter around waist
•    A persistent lack of energy
•    Low back pain

An advice for the menopausal women from trusted radiologists: have an annual transvaginal ultrasound to monitor your gynecologic organs.  While this is not (yet!) practiced as routine preventive care, it has proven to provide early detection of cancer.  Transvaginal ultrasound is a simple, painless test — advocate for yourself!

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