Does a Pelvic Exam Hurt? Understanding the Discomfort

Pelvic exams are a routine part of women’s healthcare. They help to detect abnormalities, diagnose medical conditions and ensure the overall health of a woman’s reproductive system. However, many women are anxious about the procedure, often wondering whether it will hurt. 

Understanding the pelvic exam procedure and what may cause discomfort can help you prepare for your appointment. This can include practicing relaxation techniques and asking your provider about using a more comfortable speculum like the Nella so your experience is less stressful.  

What is a Pelvic Exam? 

A pelvic exam is a routine procedure performed by a gynecologist to assess the health of a woman’s reproductive organs. During the examination, a healthcare provider inspects the external genitalia for any signs of disease, infection or abnormalities. 

A speculum is inserted into the vagina to provide a clear view of the cervix and vaginal walls. This allows the practitioner to check for unusual discharges, growths or other potential concerns. 

In some cases, the doctor might also perform a manual examination by inserting one or two gloved fingers into the vagina while using the other hand to press on the abdomen gently. This helps evaluate the size, shape and position of the uterus and ovaries and detects any tenderness or masses. 

What Causes Pain or Discomfort During a Pelvic Exam?

For most women, the pelvic exam is more about discomfort than actual pain. The sensation of the speculum being inserted and opened can feel foreign or unusual. However, some women may barely notice it, while others may find it slightly uncomfortable. 

The most common causes of pain or discomfort during  a pelvic exam include:

• Anxiety or stress: Nervousness or worry about the procedure can cause muscle tension and make the exam more uncomfortable.

• Menstrual cycle: Your cervix’s position and vaginal discharge vary during your cycle, influencing how the exam feels.

• Past experiences: Past trauma, surgeries or painful infections can lead to discomfort or sensitivity during the exam.

• Certain conditions: Endometriosis, pelvic inflammatory disease or fibroids can increase sensitivity and discomfort during the exam.

• Medical instruments: Using cold, metal medical instruments, such as a speculum, can cause pressure and discomfort.

Ensuring Comfort with the Right Equipment

A pelvic exam is a sensitive procedure requiring the right tools to ensure comfort. Given the intimate nature of the exam, using a medical tool, such as a soft, disposable speculum that prioritizes comfort, can improve your experience and reduce anxiety. 

• Ergonomic speculums: The design of the speculum, the instrument used to view the cervix, is vital. An ergonomically designed speculum minimizes discomfort, ensuring it aligns well with the body’s natural anatomy. Rounded edges and a smooth surface can prevent pinching and enhance patient comfort.

• Material matters: Using speculums made of body-friendly materials can reduce the cold sensation and discomfort. For example, some clinics offer plastic disposable speculums with a light that feels less cold than metal ones. These can be for patients sensitive to temperature.

• Lubrication: While not “equipment” in the traditional sense, using a water-based lubricant can ease the insertion of the speculum, making the process smoother and more comfortable.

• Gloves and texture: During the bimanual exam, the practitioner uses gloves. Using soft, well-fitting gloves can enhance patient comfort. 

• Positioning tools: Equipment like adjustable examination chairs or supportive cushions can provide proper support and allow for minor adjustments. These tools can ensure that you are in the most comfortable position during the exam.
  
  
• Ambient environment: While the focus is on equipment, the environment’s ambiance can also play a role in comfort. For instance, a well-heated room or wearing comfortable socks can make the patient feel more comfortable. 

Tips for a Comfortable Pelvic Exam

Consider the following tips for pelvic exams to create a less stressful environment, help you relax and discuss your needs with your provider.

• Relaxation techniques: Deep breathing exercises and relaxation techniques can help calm nerves. Try taking slow, deep breaths to relax your pelvic muscles before and during the exam.

• Open communication: Talk to your doctor about any concerns. They can offer reassurance, explain the process step-by-step and adjust their approach based on your feedback.

• Ask for a different speculum: Ask your healthcare provider if they have speculums in different materials. A speculum made of smooth polycarbonate materials instead of metal or hard plastic can cause less irritation if you have sensitive vaginal walls. 

• Consider the timing: Avoid scheduling the exam during your period if possible. Menstrual blood can interfere with certain tests and some women also experience heightened sensitivity during menstruation.

• Avoid intercourse before the exam: It’s generally a good idea to avoid sexual intercourse 24 hours before the exam, as semen, lubricants or other residues might interfere with the results of certain tests.

• Know you can stop at any time: If you ever feel too uncomfortable, remember that you can ask your physician to stop or take a break.

• Post-exam care: Some women might experience slight discomfort or spotting after a pelvic exam. Using a light pad or taking over-the-counter pain relief can help.

Prioritize Your Comfort When Getting a Pelvic Exam

Most of the discomfort and anxiety surrounding pelvic exams is due to the intimidating metal tools used for the procedure. Understanding what to expect during your exam and prioritizing your comfort when on the exam table can make your visit a less scary experience. 

At Nella, our speculum and comfort kits are designed by women for women. We want to change how women feel during their pelvic exams to feel more comfortable and confident before, during and after going to their gynecologist.