Women’s Wellness Check
A women’s wellness check-up is an important part of preventive healthcare at every stage of life. The American College of Obstetricians and Gynecologists (ACOG) recommends that women have a routine wellness visit at least once a year.
This visit provides an opportunity to review both physical and emotional health, address any gynecologic concerns, and focus on prevention. During your appointment, your doctor may discuss topics such as menstrual cycle abnormalities, pelvic pain or other gynecologic symptoms, screening for sexually transmitted infections, contraception, fertility and preconceptional planning and menopausal health. It is also an opportunity to discuss general health concerns and lifestyle concerns.
Depending on your age, medical history, and symptoms, your visit may also include a pelvic examination and cervical cancer screening (Pap smear and/or HPV testing). Read more about cervical cancer screening here.
What Is a Pelvic Exam?
A pelvic exam is a physical examination used to assess the health of the female reproductive organs, including the vulva, vagina, cervix, uterus, and ovaries. It may be recommended as part of routine screening or to evaluate specific symptoms.
During the exam, you will be asked to undress from the waist down and to change into a gown. Then, you will be asked to lie on an examination bed with your feet supported. During this examination, in addition to your doctor there is generally a third person in the room, likely a nurse or an assistant.
During the pelvic exam, the doctor will first examine the external genital area for any skin changes, irritation or abnormalities. A speculum is then gently inserted into the vagina to visualize the vaginal walls and cervix. Here, a swab may be taken for cervical cancer screening (pap smear and/or HPV testing) or for sexually transmitted disease (STD) testing, if indicated.
After the speculum is removed, the doctor will perform an internal examination to assess the size and shape of the uterus and ovaries, as well as assess for any pain.
It is completely normal to feel anxious about a pelvic exam. Your comfort and dignity are a priority, and you are encouraged to discuss any concerns with your doctor before the examination.
When Should I Have a Pelvic Exam?
A pelvic exam is recommended when a woman has certain symptoms, including pelvic pain, severe menstrual cramps, abnormal vaginal discharge, irregular menstruation, or vulvar irritation or genital lesions. A pelvic exam is also typically performed as part of cervical cancer screening, and before inserting certain forms of contraception, such as an intrauterine device (IUD).
For women without symptoms, routine pelvic exams may offer the potential benefit of detecting some gynecologic conditions early. The decision on whether to have a pelvic exam should be made after discussion with your OB-GYN.
When Is a Pelvic Ultrasound Indicated?
A pelvic ultrasound is a non-invasive imaging test that allows your doctor to visualize the uterus, ovaries, and surrounding pelvic structures. It provides information that cannot be obtained from a physical examination alone.
A pelvic ultrasound may be recommended if you have symptoms such as pelvic pain, abnormal menstrual bleeding, irregular cycles or bleeding after menopause. It is also indicated when an enlarged uterus or a pelvic mass is found on examination, or with symptoms suggestive of ovarian cysts or fibroids.
A pelvic ultrasound may also be indicated to evaluate suspected conditions such endometriosis, fertility concerns or for assessment of early pregnancy or pregnancy related complications. Furthermore, it is used to clarify suspicious findings from a pelvic exam.
Pelvic ultrasounds can be performed via the abdomen, or transvaginally, or both, depending on the clinical situation. Your doctor will recommend the most appropriate approach based on your symptoms, comfort, and medical needs.
Importantly, not every pelvic exam requires an ultrasound. Imaging is ordered only when it is likely to provide helpful information to complement the pelvic exam. Your OB-GYN can discuss the reasons for the test and explain the findings in detail.
References
1. American College of Obstetricians and Gynecologists. The utility of and indications for routine pelvic examination. ACOG Committee Opinion No. 754. Obstet Gynecol. 2018;132(4):e174-80. doi:10.1097/AOG.0000000000002895.
2. American College of Obstetricians and Gynecologists. Well-woman visit. ACOG Committee Opinion No. 755. Obstet Gynecol. 2018;132(4):e181-86. doi:10.1097/AOG.0000000000002897.
Maternal–Fetal Medicine Specialist in Bangkok
Dr. Narisra Srikureja Firer (Dr. Niti)
Dr. Niti is a Bangkok-based OBGYN with subspecialty training in Maternal–Fetal Medicine (MFM). She provides comprehensive care for women across all stages of life, including pregnancy care, deliveries, and general gynecological conditions.
She dedicates her time to private practice at Ruamjairak Hospital and Mission Hospital, and serves as a Maternal–Fetal Medicine Consultant at a large government tertiary care center.
To read Dr. Niti’s full bio, click here.
