Here's what informed consent means in gynecological care.
Ask for the specific reason for the exam, what it aims to find out, and how it will alter anything for your pregnancy or birth. If you aren't convinced there's a good reason for a pelvic exam, then you are within your rights to decline it, or to request a second opinion.
The takeaway for you: If you're not pregnant and don't have symptoms (such as vaginal discharge, abnormal bleeding, pain, urinary problems or sexual dysfunction), it's OK to skip your routine pelvic exam, Dr. Humphrey says.
The American College of Obstetricians and Gynecologists (ACOG) recommends women have pelvic exams only when they have symptoms or have a medical history that requires it. Ultimately, you and your ob-gyn or other health care professional should make this decision together.
All patients have the right to refuse an internal ultrasound. Unless the patient has never had sexual intercourse, we highly recommend the additional imaging, as it provides our radiologist and the doctor with as much information as possible for an accurate diagnosis.
However, some patients tell us they'd prefer not to have routine ultrasounds performed during their pregnancy. They cite a range of reasons, from not wanting to know if the baby might have a birth defect to concerns about the safety of ultrasound technology.
A pelvic ultrasound may be used to diagnose and assist in the treatment of the following conditions: Abnormalities in the anatomic structure of the uterus, including endometrial conditions. Fibroid tumors (benign growths), masses, cysts, and other types of tumors within the pelvis.
For example, 3D ultrasound is a less invasive tool for diagnosing pelvic pain than bimanual exams. Ultrasound is also superior in diagnostic capability and costs less than other imaging modalities such as MRI.
It's human reflex to tighten up when we're anticipating that something—like a pelvic exam—will hurt. But when our pelvic floor muscles contract and tighten, it can lead to more pain during the exam. A way to prevent this pain is to 'bear down' during the early part of the internal exam.
While pap smears are an important part of women's health, you do have the right to decline the test if you choose. Some women may choose to decline pap smears due to personal or religious beliefs, discomfort with the procedure, or other reasons.
To put things simply, you need both a pap smear and a pelvic exam. Contrary to popular belief, they are different.
While not the highlight of anyone's day, a pelvic exam can give your gynecologist important information about the health of your reproductive organs—even once you've passed the age of reproduction. For women 65 and older, a pelvic exam may not be necessary.
In fact, unless a patient has specific complaints or needs, I will not perform a pelvic exam until she needs a cervical cancer screening (PAP smear). According to ACOG guidelines, PAP smears should begin at age 21, regardless of when a girl becomes sexually active.
Unless there are health concerns or complications, there is no medical reason to have routine vaginal examinations as part of your regular pregnancy visits.
If you're uncomfortable with the thought of a pelvic exam during your period, you can reschedule your appointment. You should avoid some things beforehand. Two days before your Pap test, avoid intercourse, vaginal creams, suppositories, medicine and douches, as these may obscure abnormal cells.
Anxiety and fear are common before and during the pelvic examination. In fact, the pelvic exam is one of the most common anxiety-provoking medical procedures. This exam can provoke negative physical and emotional symptoms such as pain, discomfort, anxiety, fear, embarrassment, and irritability.
Why does a speculum hurt so much? Pain may be a sign that your muscles are overly tense or that you have a condition that's making the experience painful. To prevent pain, communicate your concerns and relevant health information to your provider. Let them know at any point if you're experiencing pain.
You may have a small amount of vaginal discharge or bleeding after the examination.
What an ultrasound allow us to see, often times cannot be detected by a regular pelvic examination also known as a well or annual exam. If you are having abnormal pelvic pain, experiencing heavy menstruation, and/or any other discomfort, it is important to speak to your gynecologist and request an ultrasound.
The only time a cervical check may be helpful is if you are over a week past your due date and your health care provider is trying to determine if induction is appropriate. If your care provider is requesting a cervical check, you have the right to decline the procedure.
To prepare for pelvic floor therapy, you should arrive dressed in comfortable clothes that allow you to move your legs freely without restricting your movement. Your exam includes an internal component, so make sure your groin and genital area is clean before your appointment.
You might have an external ultrasound of your lower tummy (pelvis) or a vaginal ultrasound to help diagnose ovarian cancer. Ultrasound scans use high frequency sound waves to create a picture of a part of the body. It can show the ovaries, womb and surrounding structures.
How long does the test take? A pelvic ultrasound can take 15 to 30 minutes.