A Guide to Pelvic Exams: How to Prepare, Does It Hurt, and What Can It Detect?

Pelvic exams are an essential part of women’s health checks. They help identify underlying causes of disease and detect abnormalities in the female pelvic organs—many of which present no symptoms until they are in advanced stages. However, many women still feel anxious, shy, or scared about the procedure. This article addresses those concerns and explains what a pelvic exam can detect.

A pelvic exam (PV or pelvic examination) is a medical procedure used to check for abnormalities in a woman's pelvic organs—both external and internal—such as the vaginal opening, vagina, cervix, uterus, fallopian tubes, and ovaries. It helps screen for cervical cancer, vaginal yeast infections, and sexually transmitted infections (STIs).

While many women feel embarrassed due to the intimate nature of the exam, it's highly recommended to undergo it annually for early detection of serious health issues.

The exam is conducted respectfully, often with female nurses present. Even if the physician is male, tools (not fingers) are used for internal checks, and the patient remains covered with a gown. Visualization is done through an ultrasound monitor.

Routine pelvic exams are important because internal conditions can't be assessed with the naked eye. Skipping these annual exams may result in diseases going undetected until it’s too late.

• • Irregular periods (heavy/light flow, missed periods, post-menopausal bleeding)
  • Abnormal vaginal discharge (color, odor, itching)
  • Vaginal bleeding after intercourse
  • Lower abdominal or vaginal pain
  • Pain or burning during intercourse
  • Frequent or uncontrolled urination
  • Palpable abdominal masses or rapid abdominal swelling
  • Infertility concerns
  • Women aged 30 and above
  • Women who have been sexually active
  • Family history of gynecological cancers (e.g. ovarian, uterine, cervical)

Many women, especially those who have never had sex, worry that pelvic exams are painful. However, physicians are mindful of this. They use different sizes of instruments and can choose smaller tools for virgins to ensure minimal discomfort.

Even for those with sexual experience, the instruments used are significantly smaller than the average male genitalia, so pain is unlikely. Patients may feel slight pressure or fullness, but not sharp pain.

• • Do not douche before the exam—it may wash away signs of infection.
  • Avoid vaginal suppositories or medications for at least 3 days before the appointment.
  • Refrain from intercourse for at least 3 days to ensure clear results.
  • Avoid scheduling during menstruation, unless you have abnormal heavy bleeding.
  • No need to fast before the exam.

1. The doctor starts by asking about your menstrual history and current symptoms.
2. A visual inspection of the vulva and vaginal opening is done.
3. A speculum (duckbill-shaped instrument) is inserted to widen the vagina for viewing the cervix and vaginal walls.
4. The doctor performs a bimanual exam, inserting one or two gloved fingers inside the vagina while pressing on the abdomen with the other hand to feel the uterus and ovaries.
5. If cervical cancer screening is needed, the doctor will collect cells from the cervix for lab testing.
6. If an ultrasound is required, a probe is inserted vaginally to visualize internal structures on a monitor.

Pelvic exams can detect:

• Ovarian cancer
• Cervical cancer
• Uterine fibroids
• Endometriosis
• Chocolate cysts (endometriomas)

Cervical cancer remains one of the leading causes of death in women, making annual screening a vital preventive measure.

Pelvic exams are usually performed before pregnancy to assess reproductive health. During pregnancy, routine internal exams are avoided to prevent risks like premature labor or miscarriage. Exceptions are made if there’s vaginal bleeding or abnormal discharge during pregnancy.

At what age should women start pelvic exams?
Women should begin annual exams around 25–30 years old, or earlier if they’ve had sexual intercourse.

Is it normal to bleed after a pelvic exam?
Mild bleeding may occur due to slight irritation from the ultrasound probe or speculum.

Can you get results immediately?
Most results are given right after the exam. For cervical cancer screenings, lab results take about 1–2 weeks.

Do virgins need pelvic exams?
Yes. Even without sexual activity, conditions like ovarian or cervical cancer can still develop.

A pelvic exam is a routine, usually painless, way to check for serious reproductive health issues in women. It can detect cancers, cysts, and infections. Regular exams—especially after age 30 or following sexual activity—are essential for early diagnosis and effective treatment.

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Pelvic exam + cervical cancer screening for only 2,900 THB
For more info, contact us via LINE: @beyondivf.