Prevention of HPV
My first pelvic exam and Pap test
During the Exam
Pelvic exams can be a bit embarrassing, especially the first time. It’s perfectly normal to be embarrassed, but remember that your doctor is a professional who performs Pap tests all of the time, and there’s really nothing to be afraid of.
If you’d like, you can have someone stay with you in the room during the exam. It could be a parent or another family member, or a friend who will sit with you through the exam. Or, if it makes you more comfortable, you can ask that another staff member at the doctor’s office stay in the room. It’s totally up to you, just let your doctor know what you’d prefer.
Here’s what you can expect:
After you’ve had a chance to change, your doctor may start the exam by asking you some questions. If you have any concerns about your reproductive health, now is the time to ask. Also, if you think you might be pregnant, let your doctor or the nurse know and you may be offered a pregnancy test to be sure.
Don’t worry about being shy or nervous about asking your doctor questions. This is your doctor’s job, there is probably nothing that you can ask them that they haven’t been asked before!
You and your doctor may talk about:
Your menstrual cycle (a.k.a. your periods) – If you’ve been having any spotting, pain, or unusual bleeding, be sure to let your doctor know. Your doctor may also ask you for the date that your most recent period first began, how long your periods usually lasts, and when you first got your period.
Whether you are sexually active or not - Your doctor will ask you if you’ve ever had sex, and may ask some questions about your sex life. Be honest. Remember, except for some rare cases (if you are being abused or if your doctor feels that you are in danger, for example), what you and your doctor talk about is just between the two of you. Your doctor will not speak to your parents or anyone else about the exam or anything you talk about.
Discharge, pain or other problems - You may be asked if you’ve had any unusual vaginal discharge, pain or other symptoms that could be a sign of an infection or other problems. You should also inform your doctor if you think that you may be pregnant.
If you are using birth control – If you have any question about birth control, or if you’re having any concerns about the birth control method you’re using, be sure to ask your doctor.
Check-up and Breast Exam
After you’ve had a chance to ask and answer questions, or possibly at the same time, your doctor may perform a general check-up exam, which may include a breast exam.
The check-up part of the exam tests your general health, much like other check-ups you may have had with your doctor.
If you’ve never had a breast exam before, you might be a little embarrassed. Don’t be. Breast exams are really important because they can find any lumps or changes in your breasts, which can help your doctor spot any potential problems early. During this exam, your doctor will press down lightly on your breasts, feeling for any lumps or anything that feels unusual.
REMEMBER! Most breast lumps, especially those in younger women, are not related to breast cancer. If you think you feel a lump in your breast, ask your doctor about it, but remember – breast cancer is extremely rare in young women! Most often, any lumps are just part of normal breast development.
If you’ve noticed any unusual changes to your breasts recently or if you’ve been having any pain in your breasts, this would be a good time to ask your doctor about it
The Pelvic Exam and Pap test
This special instrument called a speculum is used to gently spread open the inside walls of your vagina |
With the speculum fitted in the vagina, the doctor collects cells from the surface of your cervix to be used in a Pap test
(see images above and below) |
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If this is your first pelvic exam, this might be the part where things start to get a bit embarrassing.
First, your doctor will ask you to lie down in a comfortable position on the examination table, with your knees bent and your legs spread apart. Your can rest your legs on special “stirrups” to make you more comfortable during the exam.
Your doctor will examine your vulva (the outer lips of your vagina). Next, your doctor will look at the inside walls of your vagina and at your cervix. (Your cervix is the entrance to your uterus, located at the back of your vagina). To do this, a special instrument called a speculum is used to gently spread open the inside walls of your vagina. The speculum is made of plastic or smooth metal and looks a little bit like a duck’s bill.
You may feel some discomfort when your doctor gently slides the speculum into your vagina, but it shouldn’t hurt. Do your best to relax your stomach muscles and the muscles around your vagina so that the speculum can slide in easily. If you tense up your muscles, it is more difficult for your doctor to insert the speculum, so you may feel some discomfort. That’s why it’s really important to relax as much as you can. Try taking deep breaths. If you’re really tense, it might help to try looking at any posters or pictures on the walls to take your mind off the exam.
If you do feel any pain or discomfort, be sure to let your doctor know. If it is too uncomfortable it is always possible to do the exam at another visit.
Once the speculum is in place, your doctor can see the walls of your vagina and your cervix to make sure that everything looks right. Then, your doctor will collect some cells from the surface of your cervix to be used in a Pap test. Your doctor will collect these cells, and later they will be examined by a specially trained professional who will look at the cells under a microscope. Looking at the cells under a microscope allows the specialist to ensure that they are normal and healthy.
The Pap test is very important, because it can detect microscopic changes to cells. In some cases, these changes might be early stages of serious diseases like cervical cancer. Cervical cancer is dangerous, but it progresses very slowly. By catching these changes early, doctors are able to treat and prevent cervical cancer from progressing.
Before the speculum is removed, your doctor may perform another test to look for infections such as chlamydia or gonorrhoea. This test is performed by rubbing a long cotton swab (it looks like a long Q-Tip™) against your cervix. The swab sample is then tested to help detect these infections.
Like the Pap test and cervical cancer, detecting these infections early makes all the difference. Chlamydia and gonorrhoea can usually be treated very easily with antibiotics, but if an infection goes untreated for a long period of time, it can cause serious problems including infertility.
It’s important to note that this particular test is not always performed during a pelvic exam, and that you should not rely on a pelvic exam to detect sexually transmitted infections. If you are interested in getting tested for sexually transmitted infections, speak with your doctor or your local sexual health clinic.
After these tests are performed, the doctor will gently remove the speculum. It shouldn’t hurt while it is removed.
Now, your doctor will perform the final part of the pelvic exam. Wearing gloves, your doctor will place two fingers inside your vagina to feel your reproductive organs. They may use a slippery lubricant during this test to help make you more comfortable. By pressing down on your abdomen with the other hand, while feeling inside with his or her fingers, your doctor will be able to feel your reproductive organs. This allows them to check the size, shape and position of your ovaries, fallopian tubes, and uterus. You shouldn’t feel any pain during this procedure, but you will feel pressure as your doctor feels your organs.
Scared about your first pelvic exam? Try these tips:
- Do your homework: A pelvic exam is a lot like any other exam – if you want to breeze through it, you’ve got to do your homework. There are lots of good websites, brochures, and other resources out there to give you an idea what you can expect. Knowing what the exam is all about is the best way to put your mind at ease.
- Talk to someone who’s been there: Why not ask a family member what the test is like? Mothers, aunts, older sisters, cousins can all give you the first-hand scoop about what to expect. Or, ask a friend who has had the test before or a teacher or school nurse.
- Let your doctor know that you’re nervous: If it’s your first time getting a pelvic exam, your doctor knows it can be a bit scary. Let them know that you’re a bit nervous about the exam. They can go through the exam with you step-by-step so there are no surprises.
- If all else fails: So… you’ve gotten all the information, you’ve spoken with people and you know exactly what to expect…but YOU’RE STILL SCARED. Relax – even if you know exactly what to expect, it’s normal to be a bit scared. Once you’re there, chances are it won’t be nearly as scary as you may think. And, if all else fails, remember that the embarrassing part of the exam doesn’t last that long, and once you’ve had it once, it gets a whole lot easier the next time.
