Pelvic exams and cervical cancer screenings are among the most important preventive healthcare tools available for women’s health, yet many patients still feel uncertain, anxious, or uninformed about the process.

Cervical cancer is highly treatable when identified early, making regular screenings like Pap smears, HPV testing, and follow-up cervical exams a critical component of preventive care. Yet online searches for topics like “what is a pelvic exam” and “bleeding after cervical check” and even myths like “can you feel cervical cancer with your finger” reflect ongoing confusion about routine gynecologic care and cervical cancer detection.

In Florida, access to preventive women’s healthcare is especially important, from young adults starting routine gynecologic care to busy working professionals who may delay preventive visits to retirees and seasonal residents who round out the state’s diverse population.

As the need for cervical cancer screenings and trusted women’s health providers in Florida continues to grow, TopLine MD Alliance Network is here to address common patient questions and misconceptions about pelvic exams, Pap smears, HPV testing, cervical biopsies, and more. Because early-stage cervical cancer rarely causes symptoms, these services can all save lives.

Why cervical cancer shouldn’t be ignored

Cervical cancer is the fourth most common cancer in women worldwide, with over 600,000 new cases diagnosed each year.

Cervical cancer starts in the cells of a woman’s cervix – the lower, narrow part of the uterus that connects to the vagina – and develops slowly over time. Cervical cancer is most frequently diagnosed in women between the ages of 35 and 64, with the average age being 50.

Many older women don’t realize they are still at risk of developing cervical cancer as they age. More than 20% of cervical cancers are found in women over age 65. However, according to the American Cancer Society, these cancers rarely occur in women who get routine cervical cancer screenings during their 20s, 30s, 40s, and 50s.

The medical community now knows that the human papillomavirus (HPV) causes most cases of cervical cancer in women, leading to significant changes in how women are screened for cervical cancer as they age. Today, women get HPV testing in addition to Pap smears – both of which are conducted as part of a pelvic exam.

What is a pelvic exam?

A pelvic exam, sometimes referred to as a gynecologic exam, is a routine exam that health providers use to check for any signs of disease in a woman’s reproductive organs. The word “pelvic” refers to the location of the reproductive organs in the pelvis.

During a pelvic exam, your TopLine MD Alliance Network gynecologist will check the following organs:

  • Vagina
  • Vulva
  • Cervix
  • Uterus
  • Ovaries
  • Fallopian tubes

Women should have their first pelvic exam by age 21. (In some instances, your gynecologist may recommend getting a pelvic exam before age 21.) Pelvic exams then become part of every woman’s routine preventive care. Most women have a pelvic exam every 1-3 years, depending on their age, health risks, and other factors.

Your gynecologist or other health provider may also recommend a pelvic exam for reasons like:

  • Family history of cervical cancer
  • Family history of ovarian cancer
  • Pelvic pain
  • Pain during sexual intercourse
  • Irregular bleeding
  • Unusual vaginal discharge
  • Concerns about sexually transmitted diseases (STDs) or uterine infections
  • Checking for uterine fibroids or ovarian cysts
  • Fitting an intrauterine device (IUD)
  • Pregnancy

What to expect during a pelvic exam

It’s normal to feel anxious about a pelvic exam, especially if it’s your first. Ideally, the health provider performing the exam should be someone you feel safe and comfortable with. If you prefer to have a female gynecologist, let the office know when you schedule your visit. All TopLine MD Alliance Network gynecologists are trained to guide you through the process with care and ease.

You don’t have to do anything special to prepare for a pelvic exam. It is generally a good idea to avoid inserting anything into your vagina for 24 hours prior to the exam, including sexual intercourse and tampons. If you are menstruating on the day of the exam, contact the office to find out if you will need to reschedule.

When you arrive at the office, your gynecologist may ask for a urine sample before the exam. Otherwise, the exam will begin with a discussion of your health history and an assessment of your specific symptoms or concerns. After talking, the gynecologist will give you a gown and sheet, then leave the room so you can undress in private.

Once you are in the gown and the sheet covers your lap, you will lie back on the exam table, slide your hips to the edge of the table, and place your feet into stirrups. Let your knees fall outward and relax your legs, buttocks, and abdominal muscles as much as you can.

Most gynecologists will tell you exactly what they are going to do before they do it. If not, you can ask them to tell you where they will be touching you as they perform the exam. There may be a chaperone in the exam room (such as a nurse), or you can ask a family member or friend to accompany you if you need extra support.

A pelvic exam typically includes:

  • External exam – The gynecologist visually inspects your vagina and vulva, looking for any signs of infection.
  • Manual exam – The gynecologist places one or two gloved fingers inside your vagina, using the other hand to gently press down on parts of your abdomen. During this portion of the exam, they feel the size and shape of your uterus and ovaries, checking if any areas are tender or enlarged.
  • Speculum exam – The gynecologist places a metal device called a speculum inside your vagina. The speculum widens your vaginal wall, making it easier for the gynecologist to view your vagina and cervix.
  • Pap smear – While the speculum is inside your vagina, the gynecologist uses a small brush to take a sample of cells from your cervix. The exam may also include an HPV test, which checks for high-risk types of human papillomavirus.
  • Rectal exam – Depending on your health history and symptoms, the gynecologist may insert a finger in your rectum to check for tumors or other abnormalities behind your uterus.

Most pelvic exams also include a breast exam, where your gynecologist visually inspects and manually presses your breast and armpit tissue to check for lumps and other signs of breast cancer.

A pelvic exam typically takes about 10 minutes. You may experience slight discomfort during a pelvic exam, but you should not feel pain. If you do, notify your gynecologist right away.

Light bleeding after a cervical check is normal

Light bleeding or spotting after a cervical cancer screening (including a Pap smear or HPV test) is very common and usually harmless. The bleeding occurs because the gynecologist must gently brush the delicate lining of your cervix to collect a cell sample.

To avoid irritating the cervix further and to minimize bleeding, continue to avoid sexual intercourse and tampons for the next 24-48 hours. If you experience heavy bleeding (similar to a menstrual period), pelvic pain, or the bleeding does not stop after 2-3 days, contact your gynecologist.

How often do you need a cervical cancer screening?

Some women think they need a Pap smear every year, while others believe they only need to see their gynecologist every 3-5 years. Then some women have gotten the HPV vaccine, which offers extra protection against cervical cancer. Do these women even need to get screenings?

The answer is yes. The American College of Obstetrics and Gynecology recommends an annual wellness visit for all women of reproductive age. The inclusion of a pelvic exam at this visit should be a shared decision between the patient and the gynecologist, after reviewing the patient’s health risks and symptoms.

Despite the myth, you cannot feel cervical cancer with your finger during a self-exam. Cervical cancer begins as microscopic changes on the surface or inside the lining of the cervix. You can locate your cervix by gently inserting a finger 3-5 inches into your vagina, but there is no way to accurately diagnose cancer by touch alone – and it’s simply not worth the risk.

Not all pelvic exams will include a Pap smear or HPV test, but your TopLine MD Alliance Network gynecologist will tell you whenever they are necessary. Most women with an average cervical cancer risk are tested every 3-5 years, but you should still never skip your annual wellness visit.

What if the screening results are abnormal?

There’s a wide variety of reasons why women get abnormal Pap smear results – it does not necessarily mean that you have cervical cancer. The same goes for HPV, which is a very common virus. In most women who have HPV, their immune system clears the infection from their bodies without leading to cancer.

However, it’s important to talk to your gynecologist so you understand the screening results and what they mean for you. To ensure any cancer is caught early, your gynecologist may recommend repeating the Pap smear and/or HPV test.

Or you may need to undergo additional diagnostic tests, such as a cervical biopsy. During this procedure, the gynecologist scrapes cells or tissue from the cervix to be examined under a microscope. The cervix may be numbed or you may be put to sleep with anesthesia, depending on the type of biopsy you need.

Once your gynecologist has the biopsy results, they will contact you with the results. The vast majority of cervical biopsies are negative for cancer, with only 4-5% of all cervical biopsies performed after an abnormal screening resulting in a precancerous or cancerous diagnosis. However, regular cervical cancer screenings save thousands of lives by catching precancerous cells and early-stage tumors before they become life-threatening.

Connect with Florida’s top gynecologists today

The TopLine MD Alliance was created by physicians who came together to make healthcare experiences better for patients. We help patients navigate the complex healthcare system, connecting them with top-tier healthcare providers, practices, diagnostic centers, and imaging centers we trust.

The TopLine MD Alliance brings together high-quality care, exceptional service, and compassionate support while ensuring that you are always satisfied with your choice of health providers. Our women’s health specialties include gynecology, gynecologic oncology, urogynecology, obstetrics, maternal fetal medicine, and more.

To get started, find a provider near you today.