Your guide to pelvic exams

For decades, Australian women have counted a regular pelvic exam as a routine part of their healthcare. In the past, this important test was carried out at the same time as their Pap smear. However, since 2017 the two-year Pap test has been replaced with a five yearly Cervical Screening Test. Ever since, women have been confused about when to have their pelvic exam or if they really need one. You too? To put you in the know, here’s the latest:

Is it true that I don’t need a pelvic exam if I don’t have any specific problems?

“No complaint” does not mean “no problem”. Many conditions don’t have symptoms in their early stages or mild symptoms may be disregarded as unimportant. Women many not recognise that vulvar discoloration can be a sign of vulvar cancer or may not mention vaginal dryness because they don’t realise that treatments are available, from lubricants to hormone therapy. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) recommends that women have a pelvic exam as part of a regular two-yearly general health check. “Meanwhile, if you have any symptoms or concerns about your gynaecological health between pelvic exams, see your GP as soon as possible to rule out underlying causes,” suggests Dr Alison De Souza, urogynaecologist and spokesperson for RANZCOG.

If I’m up to date with cervical screening, why do I need a pelvic exam?

The new Cervical Screening Test only checks for cervical cancer, while the pelvic exam checks for other gynaecological cancers or conditions. “A two-yearly pelvic exam is different and starts with a visual inspection of the external skin of the genitals to check for growths or abnormal skin changes on the vulva,” explains De Souza. “It uses a device called a speculum to help look inside the vagina and check for abnormal discharge, abnormal growths on the cervix, and changes such as thinning or dryness of vaginal walls.” During the pelvic exam your doctor will also place one or two fingers into the vagina while applying pressure on your abdomen in order to feel your reproductive organs. “This is to check your ovaries, uterus and pelvis for tenderness, growths such as fibroids or lumps or masses, which could indicate cancer,” De Souza adds. The list of conditions that can be detected during this exam includes vulvar disorders, uterine or bladder prolapse, cervical polyps, ovarian cysts, fibroid tumours and sometimes even colon cancer. “If you have any concerns or questions about sexual function or gynaecological issues or changes, jot them down and ask them before your pelvic exam,” De Souza suggests. It’s not easy but it’s important to feel as relaxed as possible during pelvic exams. And if you feel any discomfort at all, talk with your doctor.