Today I’m getting a pelvic exam. Doctor
Blake gave us permission to film the whole thing so that you know how to
prepare, what to expect, and when to come back. In 2014 the American College of
Physicians determined that annual, once-a-year pelvic exams we’re
doing more harm than good. Their vote was appointment as needed, as
in if the person was pregnant or experiencing symptoms of a problem.
Whereas the the American Congress of Gynecologists and Obstetricians insist
that gynecology appointments are important because it allows them to connect to
patients on sexual challenges, STIs, birth
control, gender identity, and sexual orientation. Dr.B: Okay, Lindsay. We’re ready for ya’. Dr. B: Let’s see. Here for your pelvic exam today. L: Yes.
Dr.B: so normally I would get sexual history, past medical history, that sort of thing, but I know you’re just here for the exam so why don’t we just go ahead move on and do that. L: Okay.
Dr. B: So, I’m going to give you a gown. I’ll have you un-dress. Gown opens to the back.
Dr.B: And then there is a sheet right here. You can just unfold it and drape it across your lap. have a seat on the table and I’ll be back in
a couple minutes.
L: Awesome. I prepared for this. here’s how you would do it. Shower, groom
depending on preference, preferably schedule it when you’re
not menstruating but nothing in the vagina. No products, penises, toys, et cetera for 24 hours prior to the appointment.
Bring a list of questions to ask and a friend or relative for moral
support. One more thing you can do before the appointment is to masturbate. You can
also touch yourself during it, just don’t jostle things about. This is going
to open up the vagina, create more lubrication, and relax you. Dr.B: You ready?
L: Ready. Dr.B: Alright, so, feet there.
Dr.B: Which by the way, I don’t like to call them stirrups L: Oh, what do you like to call them?
Dr.B: Because you’re not a horse. I call them foot holders. L: Okay. So you don’t call them stirrups, you call them foot holders.
Dr.B: I do. L: Because I’m not a horse. Dr.B: Yes. Lots of people call them stirrups.
I will occasionally probably slip up and say that, but I try not to. L: That’s so nice of you.
Dr.B: Go ahead and lay down.
L: Scoot all the way down.
Dr.B: Scoot all the way down until it feels like you’re falling off the table. L: Success. Okay. Dr.B:I’m going to raise you up a little bit so I don’t want you to get off the table quickly because you’ll
be higher than you think you are. L: Okay. Whoo who. Dr.B: Alright, so i have the speculum Little light that goes inside of it.
Dr.B: Put a little bit of water base lubricant on it. This does not
mess up Pap results. Some people may say otherwise, but it’s
L: Okay. Dr.B: I’m just making it more comfortable for
you. So go ahead and lay on down. Just let your knees out to the side and
you’ll feel me touch. L: His hand is going down my thigh. And now it’s on-
Dr.B: Right. So I’m going to look at the outside here And you’ll just feel some pressure and
some cold. This is the speculum. L: Ah.
Dr.B: Doing okay?
L:Yeah. L: It’s odd. like somebody is flicking me. My vagina. and it’s a little, tiny bit cold. L: And feels like a tiny little pinch, like somebody is pulling on the leg hair or something like that.
Dr.B: So I can see your cervix and it looks healthy and normal. so this is our Pap brush and we
basically use it to scrape a few cells off your cervix. and see if there are any abnormalities.
L: Okay. Dr.B: Sometimes it feels a little crampy.
Dr.B: Ready? (quiet music) L: Crampy. Dr.B: Is it feeling crampy?
L: Yeah. Dr.B: Doing okay?
L: Uh huh. L: So, that feels like… L: A menstrual cramp.
Dr.B: Yeah. But not not super painful. L: No.
Dr.B: Yeah. L: Very localized.
Dr.B: And that’s it. L: Okay.
Dr.B: So then what I do is I stick it over here. Knock all the cells off. (stirring sound) And we send that to the lab.
L: Okay. Dr.B: And that’s it. Dr.B: So then-
L: The exam is over.
Dr.B: The exam is over. Dr.B: This comes out. Sometimes a little crampy. Dr.B: And you can go ahead and push yourself up. Don’t get off the table. L: That was so fast.
Dr.B: We can talk about this more in a little bit, but again, the only thing that potentially could happen is the bimanual exam which is two fingers in the vagina,
pushing on the abdomen. I don’t routinely do that. L: Because?
Dr.B: Because it depends on who you talk to but the American Academy of Family
Physicians and I’m a family physician, says that there’s not really any benefit
for just a routine screening. It’s not very sensitive in terms of finding
abnormalities and it’s uncomfortable and invasive, so why do if
it’s not going to help us. Now, if you’re having symptoms of abnormal menstrual cycles, pain, then it
may be worthwhile because then you’re actually looking if there’s something wrong with the uterus? is there a cyst on the ovary? But just as part of the routine
screenings, it’s not something I usually do. the other thing i would tell you is that when we scrape your cervix, sometimes there is a tiny bit of bleeding so you may have a little bit of spotting, but it should be very small. L: Okay Dr.B: I will step out and let you get dressed.
L: Awesome. The next episode I ask doctor Blake a
lot of your questions, So stay curious. Dr.B: You’re very small so we’re using a small speculum.
L: What if my vagina is big, though? Dr.B: Then I’ll go get a different size.
(Laughs) Dr.B: Its been known to happen.
L: Note: small person, potentially small vagina.