The annual exam includes a breast exam and pelvic exam.

Pelvic Exam
The pelvic exam is performed to assess the position of the uterus and ovaries.The routine pelvic exam has three main parts — inspection, speculum exam, and bimanual exam –which take a total of 3 to 10 minutes to complete.

Inspection
First, the clinician will do a visual inspection for unusual lumps, moles, or sores. Here, 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
Next, the clinician will insert a speculum into the vagina. It may be plastic or metal, and hopefully warmed and lightly lubricated on the outside. While she inserts it, be sure to take big breaths in and out to allow the vagina to relax and open. 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 and any discharge for a STI check or to 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.

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.

Bimanual Exam
After she takes the speculum out, the clinician will do the bimanual exam. She 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. You can ask her to show you where your organs are - and even feel them. She may ask you to do a Kegel exercise (squeeze her fingers with your vagina), then she’ll take her fingers out - and that’s it!

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