The challenging pelvic examination

J Gen Intern Med. 2011 Jun;26(6):651-7. doi: 10.1007/s11606-010-1610-8. Epub 2011 Jan 12.


While there is a large body of evidence on the effectiveness of Pap smears for cervical cancer screening and on screening for cervical gonorrhea and Chlamydia, there is sparse evidence to support other portions of the pelvic examination and little guidance on examination logistics. Maximizing comfort should be the goal; lubrication use and careful speculum selection and insertion can ease this intrusive procedure. This is particularly important in adolescent and menopausal women, sexual minorities, obese women, women with disabilities, and women with a history of trauma or prior instrumentation affecting the genitalia. We review the evidence and provide guidance to minimize physical and psychological discomfort with pelvic examination.

Publication types

  • Review

MeSH terms

  • Clinical Competence / standards*
  • Female
  • Gynecological Examination / methods*
  • Gynecological Examination / psychology
  • Gynecological Examination / standards*
  • Humans
  • Papanicolaou Test
  • Patient Education as Topic / methods
  • Patient Education as Topic / standards
  • Sexual Behavior / physiology
  • Sexually Transmitted Diseases / diagnosis
  • Sexually Transmitted Diseases / physiopathology
  • Sexually Transmitted Diseases / psychology
  • Vaginal Smears / methods
  • Vaginal Smears / standards