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5 Ways To Prepare For Your Pelvic Exam


Guest post by Erica Robinson, Registered Holistic Nutritionist, Certified Kinesiologist, and student at the Canadian College Of Naturopathic Medicine.

I always jokingly said I’d have to spread my legs for money to pay my way through medical school.  I just never guessed it would actually come true!

Now entering my second year of naturopathic medicine, I work as a medical model helping the upper-year students learn how to perform a safe and effective gynecological exam, which is a Controlled Act only performed by Medical & Naturopathic Doctors in Ontario.

First off, I want to share with you the three parts of a proper gynecological exam:

  • The visual exam: Your doctor visually inspects the vulva (external genitalia) looking for any lesions and signs of uterine prolapse
  • The speculum exam: a metal or plastic speculum is inserted into the vagina to visually inspect the cervix (entrance to the uterus) and walls of the vagina.  A swab test is done for bacterial cultures and sexually-transmitted infections, a pH test is used to assess if the vagina is acidic enough to ward off pathogens, and a pap test is done to detect cancerous cells of the cervix.
  • The bimanual exam: one hand rests on the abdomen, and two fingers of the other hand are inserted vaginally, so your doctor can palpate the uterus and ovaries to assess their health

Top 5 Ways to Prepare for the Exam

  1. Arrive Clean: Your doctor is trained to perform the exam regardless of hygiene levels, but this can help you personally feel more comfortable.  Remember to avoid douching or using any soap internally, as this will alter the pH of the vagina and can lead to increased risk of infections.
  2. Plan your appointment at a time when you aren’t menstruating: Blood will alter the pH test as it is alkaline and the experience will likely add to your personal discomfort.
  3. Avoid sex for 24 hours before your test: I’ve been told this isn’t such a big deal these days, but I once got a false positive for having malignant cells of the cervix because of it.  The pressure on the cervix caused by sexual intercourse can cause normal cell death, which then leads to increased cell growth: a potential red flag on a Pap test.  If having sex without a condom, semen will also alkalize the vagina and alter the pH test.
  4. Avoid foods that you know cause gas: though a great everyday tip, it’s especially uncomfortable when you have gas and someone is pressing down on your abdomen.
  5. Most importantly: Choose a practitioner you trust and feel comfortable with.  I’ve never been a fan of the wham-bam-thank-you-m’am approach of my MD, so I now see an ND for my annual gynecological exam because I feel the exam is more thorough, I am more of an active participant in the process because I get to ask questions and receive feedback, and I leave feeling a lot more dignified and a lot less invaded.  Find a practitioner you work well with.

Question Of The Day: What’s the most embarrassing that’s ever happened to you or ‘a friend’ at the doctor?

Erica L. Robinson is a second-year student at the Canadian College of Naturopathic Medicine in Toronto, ON, as well as a Registered Holistic Nutritionist and Certified Kinesiologist. She is also the founder of Whole Life Health Services:

9 responses to “5 Ways To Prepare For Your Pelvic Exam”

  1. Kate says:

    My humorous story was that my former doctor (unfortunately, she took a job out of state so she isn’t any more) was so intent on having a good “bedside manor” that she would pause during the exam to raise her head up to make eye contact with me as we were talking about things going on in our lives. I was thinking, um, just get this over with, I know you’re listening to me even if you’re not making eye contact with me!

    • Meghan Telpner says:

      I was just saying to someone that the most uncomfortable bit is the extra efforts that are way overdone to make us comfortable

  2. Peace says:

    Nurse Practitioners too!

  3. Peace says:

    (can perform the pelvic exams)

    • Erica says:

      Oops! Forgot to mention :) thanks for adding it. I don’t have reliable access to the chart of practitioners that can engage in the Controlled Acts, unfortunately, but my primary concern is when practitioners of various physical medicine disciplines (chiropractors, osteopaths, etc) are “inserting a finger or instrument beyond the labia majora” to do an adjustment, which is actually completely illegal in Ontario! So that’s my main goal of mentioning who can be doing so.

  4. Anna B says:

    1) Assistant left the door open when she went to get something. Legs spread facing the door.

    2) Doctor’s tie was found to be the cause of the mysterious tickling sensation going on while he was fiddling with his tools. He tucked it into his shirt and kept going.

  5. Cathleen says:

    A midwife is also a qualified practicioner to see for annual exams, any kind of well-woman care (including birth control), pregnancy care, as well as for gyn concerns/issues.

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