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In addition to an annual physical check-up with a doctor, it is a good idea for a person to examine their own body regularly, too. Health self-examinations will help them to learn what is normal, what is changing, and what is unusual for their own body. Early detection of any abnormalities can improve the chances of surviving a disease like cancer.
Centre for Sexuality does not provide health examinations like breast exams, pap tests, testicular exams, or digital rectal exams. Please contact a family doctor or go to a Sexual and Reproductive Health Clinic (for folks 29 years of age or younger) to schedule a health examination.
Pelvic Exam and Pap Test
When to Start Getting Tested
When a person with a cervix turns 21—or when they have been sexually active for three years (whichever is later)—it is important for them to start getting regular pelvic exams and pap tests, regardless of sexual orientation.
Pelvic exams and pap tests can detect early signs of health problems, including cervical cancer and sexually transmitted infections. Based on current health recommendations, pelvic exams and pap tests should be done by a doctor every three years for folks between the ages of 21 and 65, though a person might need to have more or less frequent tests based on their medical history and previous test results. The best time for a pap test is around five days after a person’s period has ended (i.e., five days after they finish bleeding).
What to Expect
Before a pelvic exam, the doctor will likely ask a person questions about their period, whether they are sexually active or not, what type of contraception they are using if they’re sexually active, and if they have noticed any changes in their body, such as pain, unusual discharge, or bumps. The doctor will ask the person to lie down on their back while they place one hand on their abdomen and then two gloved and lubricated fingers into their vagina. This is called a bimanual exam and helps the physician to feel the shape of the ovaries and the uterus inside a person’s body.
The Pap Test
After examining the vulva, the doctor will place an instrument called a speculum into a person’s vagina. A disposable, plastic vaginal speculum with two valves (or ‘beaks’) is often used in office gynecology.
Although it can feel weird or sometimes a bit uncomfortable for someone to have a speculum inserted into their vagina, it should not cause significant pain. The speculum allows the doctor to see a person’s cervix and to insert a small wooden spatula (which looks like a popsicle stick) inside the vagina to gently remove some of the cells from the cervix for testing. The cells are smeared onto a glass slide (a “pap smear”) and sent to a laboratory to test for abnormal cell growth and if requested, sexually transmitted infections (STIs).
If a person wants STI testing done during their pelvic exam and pap test, they usually need to ask for this specifically. Getting a Pap test is not the same as an STI test. Doctors cannot do this testing without a person’s permission.
The pelvic exam should not hurt, and if at any point it does, a person should make sure to let their health practitioner know. If they feel uncomfortable about having a pelvic exam done, they can ask that the doctor’s assistant be present in the room with them or even bring a friend along for support. If it helps, remember that the doctor has probably seen hundreds of vaginas (or more).
Around age 50, it is recommended that people with penises receive a digital rectal examination as part of their annual physical check-up to screen for prostate cancer. (In this case, digital means finger—not camera or computer!)
During the exam, a doctor will put a lubricated, gloved finger into a person’s anus in order to feel that their prostate gland is healthy and lump-free. The doctor is checking for growths on the prostate gland or to see if it is enlarged. They may use the other hand to press gently on the person’s lower belly or pelvis to check for any problems in this area. While it can feel uncomfortable, the exam shouldn’t take more than a few minutes or cause any pain.