Pap Smears and Pelvic Exams

Pap Smear

The Pap smear is a screening test for cancer of the cervix, and for changes of the cells of the cervix that could lead to cancer.

When: Routine screening is done every 3 years, beginning at age 21 and going until age 65.

How: Please see below under Speculum exam.

Pelvic Exam

A pelvic exam is performed to do a pap smear, prepare for some types of birth control, or to evaluate a problem. The pelvic exam may have three main parts — inspection, speculum exam, and bimanual exam –which take a total of 3 to 10 minutes to complete.

Inspection

When: Inspection is done any time you are having a speculum exam for a pap smear, an infection check, or if you notice unusually symptoms such as a bump or a sore or a change in your skin that you want checked out.

How:  First, the clinician will do a visual inspection for unusual lumps, moles, or sores. The clinician will look at the vulva (outside of your vagina) and anus while separating the labia (lips of the vagina) and butt cheeks. She will also inspect the area of pubic hair.

Speculum Exam

When: Speculum exams are used to perform pap smears, check for vaginal infections, put in an IUD, or perform other procedures inside the uterus.

How: The clinician will insert a speculum into the vagina. Once it is in, she will open the spoon shaped ends of the speculum to be able to see the cervix. This action may put pressure on the rectum or urethra, but only for a moment. Once the cervix is located, she will secure the speculum in its place. It may cause a clicking or spinning sound. (If you want to look at your cervix, now’s the time!) While the speculum is inside the vagina, the clinician will collect the cells for the pap smear, any discharge for an infection check, or evaluate a problem. You may feel a little cramp or twinge during the Pap smear. You also may have a little bleeding – it’s normal.

Bimanual Exam

A bimanual exam – or exam with the clinician’s hands to feel the cervix, uterus, and ovaries – is done only in certain circumstances.

When: It is part of the exam if you are 1) interested in having an IUD placed for birth control 2) wanting to be fit for a diaphragm or cervical cap to use for birth control , or 3) if you are having symptoms such as pelvic pain.

How: To do a bimanual exam the clinician will place two gloved, lubricated fingers into the vagina and another hand on your belly above the pubic bone. She will wiggle the cervix with her two fingers and feel the uterus and ovaries between her outside hand and inside fingers. During this exam the clinician can tell you the position of your uterus.

Abnormal Results

If you have had one or more abnormal Pap smears, we perform a colposcopy as a second, routine diagnostic procedure.