What Is – and Is Not – Appropriate During a Pelvic Exam

For many women, seeing a gynecologist is not the most comfortable experience, but you should never feel unsafe or violated during a pelvic exam. With reports of sexual abuse at the University of Southern California and within the U.S. women’s gymnastics team, the Law Office of David A. Kates, PLLC wants women of all ages to know what is – and is not – appropriate during a gynecological exam.

What to Expect at the Gynecologist’s Office

When you arrive for your gynecology appointment, usually conducted annually and sometimes called a “well woman exam,” your medical team will check on your overall health. The nurse might take your height, weight, and blood pressure before guiding you into an exam room – just like they would during any other doctor’s appointment.

Unlike other doctors, however, gynecologists will ask you about any genital pain or problems, your menstrual cycle, sexual activity, and birth control. If you are sexually active (be honest), they will also screen you for sexually transmitted infections. You may be asked to remove your clothes and put on a hospital gown for certain parts of the exam.

Your gynecological appointment may include a Pap smear, a breast exam, and a pelvic exam. All these procedures are designed to assess the health of your reproductive system and screen for different types of cancer, including cervical cancer, ovarian cancer, and breast cancer.

Throughout your entire appointment, you should expect clear communication. Your doctor should never touch you without explaining what they are doing.

What Is a Pap Smear and When Is It Appropriate?

A Pap smear is a test for cervical cancer. In the past, doctors performed Pap smears once a year. Now, experts recommend them every 3 to 5 years for women 21 and older.

During Pap smear, you will lie on your back and place your feet on “stirrups.” Then, the doctor will insert a speculum into your vagina and open it slowly for access to your cervix. Next, the doctor will use a swab to scrape a small sample of cells from your cervix. Afterward, the doctor will remove the speculum and leave the room so you can get dressed.

To minimize your discomfort, your doctor will likely combine your Pap smear with your pelvic exam (if you need one).

Does Every Patient Need a Pelvic Exam?

No. According to The New York Times: “Women under 21 do not need invasive vaginal exams unless they have specific conditions or medical risks.” Although the American College of Obstetricians and Gynecologists (ACOG) recommends pelvic exams for women 21 and older, the organization says the exams are unnecessary to screen for sexually transmitted diseases and isn’t needed unless a woman has begun taking oral contraceptives, which can affect the linings of the vagina and cervix.

Like Pap smears, pelvic exams involve speculums. Your doctor will use the speculum to examine your vagina and cervix. In pelvic exams, your doctor will also place the fingers of one hand inside your vagina and press on your abdomen with their other hand. This process ensures your cervix, ovaries, and fallopian tubes are the correct size and in a healthy position.

While your doctor may want to perform a pelvic exam if you have multiple partners or engage in risky sexual behaviors, routine STI testing can be done with vaginal swabs and urine tests. Your doctor should only touch you as much as medically necessary, and pelvic exams are NOT medically necessary for all patients.

Should a Doctor Ever Use Their Hands Instead of a Speculum?

In some cases, doctors may need to use their hands to examine and care for a fragile patient, such as an older woman who struggles with bladder control or someone with a very sensitive cervix. Still, they should explain everything they are doing, and they should never make physical contact other than “physical contact required to obtain data for diagnosis and treatment,” per the ACOG.

Just like you don’t expect a shoulder massage when you get your hair cut, you shouldn’t expect any touching that goes “above and beyond” standard care. If you are uncomfortable or something feels off, you should not hesitate to communicate this and ask your doctor for an explanation.

Will Someone Else Be in the Room?

Ideally, an undressed patient should not be in an examination room alone, but this depends on the discretion of both doctors and patients – and the availability of staff. Some patients feel more comfortable talking to a doctor one-on-one, and others feel better when someone else is in the room during vulnerable situations.

If you want someone else to be in the room during your pelvic exam, you have every right to ask. In the same vein, you can request more privacy during your appointment. Your doctor should always try to accommodate your requests and make you as comfortable as possible.

How Should Your Doctor Communicate with You?

Your gynecologist is a professional and should communicate accordingly. As the ACOG explains:

Physicians should avoid sexual innuendo and sexually provocative remarks.” A physician may comment on your muscle tone or tell you that everything looks normal, but they should not editorialize or give you “compliments.”

When you are naked, your doctor can tell you everything looks “normal” or “fine,” but they should not comment on your physical appearance, make “jokes,” or say anything remotely inappropriate.

In fact, aside from communicating what they are doing, your doctor shouldn’t say much at all while you are naked. Most gynecologists are trained to do most of their talking when patients are sitting up and fully clothed.

What If My Doctor Makes Me Feel Uncomfortable?

Gynecological exams are inherently uncomfortable, but if you feel especially uncomfortable or believe your doctor is out of bounds, speak up right away. Document your complaint at the doctor’s office or hospital.

If you believe you have been sexually harassed or assaulted, you can also report the doctor to the state licensing board and local authorities. Anytime you need to go above your doctor’s head with a complaint, you should also hire an attorney.

At the Law Office of David A. Kates, PLLC, we are here to protect your rights. Attorney David Kates has been fighting for those who have been harmed by negligent medical care for more than 20 years, and he can help you file a medical malpractice lawsuit against your provider.

Do not let gynecologists and other doctors take advantage of you. Instead, call our firm at (718) 866-3664 or contact us online to discuss your legal options during a free consultation.