Here at Sex, Etc., we hear this question a lot, probably because it’s not something that people talk about openly. As with anything that is new or unknown, going for a pelvic exam for the first time can feel scary for some people. A great way to ease some of that anxiety is to know what to expect so you feel more prepared and in control. Here are some things that you might find helpful as you prepare for your visit.

Many health care providers will meet with patients first in their office, before going into the exam room. This is particularly true for patients who’ve never had a pelvic exam. By meeting first, you get a chance to ask any questions that you have about what to expect. You can tell your health care provider you’d prefer this approach when you call to set up your appointment.

When you get into the exam room, you’ll be left with privacy to take off your clothes, including your underwear, and put on a paper or cloth gown before the health care provider joins you. When you’re ready and sitting on the exam table, the health care provider will come into the room. If you would prefer someone of a particular sex, you can make that request ahead of time. Many offices have a female nurse in the room during the exam regardless of the gender of the doctor. Be sure to ask for this if it would make you more comfortable.

You’ll be asked to lie on your back on the exam table and to slide down to the edge of the exam table and place your feet in what are called stirrups so that your legs are spread open. This position makes it easier for the gynecologist or health care provider to examine the vulva and check both inside and outside the vaginal area. She or he will use a bright light to see better. Usually, the health care provider will check the labia and vulva for the general health of the skin.

Next, the health care provider will insert a metal or plastic device called a speculum into the vagina. The speculum holds open the vaginal walls so the gynecologist can see the cervix, the tip and opening of the uterus, inside of the vagina. Specula come in a variety of sizes and your practitioner will use the one that is most suited to your body.

For those who are 21 or older, the health care provider will insert something similar to a tongue depressor (but smaller) into the vagina until it reaches the cervix. Gently rubbing the cervix with the swab allows the practitioner to collect some of the cells near the opening to the cervix. These cells are placed on a slide and examined under a microscope at a lab. This is called a Pap test, and it tests for irregular cells on the cervix that could indicate a pre-cancerous condition. The American Congress of Obstetricians and Gynecologists recommends a first Pap test at 21.

After the Pap test, the health care provider will remove the speculum and insert a gloved, lubricated finger into the vagina while gently pressing on the abdomen with the other hand. This is called a bimanual, which means “two handed,” exam. This exam allows the practitioner to check for the position and size of the uterus and ovaries.

The pelvic exam should not cause pain, but some parts of it can feel a little uncomfortable. Try to relax and breathe deeply. If you feel any pain, tell the health care provider so they can work with you to make the exam as comfortable as possible.
Along with the pelvic exam, many health care providers will also do a breast exam to be sure there are no abnormal lumps in the breasts. This is a great opportunity for you to learn how to do this important self-exam every month. The exam doesn’t hurt and generally takes just a few minutes.

After your full exam, you’ll be able to get dressed and then ask any other questions that you have. This is also when the health care provider can prescribe birth control or any other medications you might need and address any of your health concerns.
Doctors recommend that you first visit the gynecologist (or health care provider who deals with these types of exams) when you are between 13 and 15 years old. Your first visit may not involve a pelvic exam; it might just be a conversation with the health care provider, who can answer any questions you have. These visits should continue every year of your life to ensure good health, although you may not need the entire exam every year.

To find a health care provider, check out this FAQ.