Why Pelvic Exams are Not called Vaginal Exams

The term “pelvic exam” is a bit misleading.  A woman who didn’t know better might think it meant having her pelvic bones examined.  Imagine her shock when she discovered that the doctor did not want to see or touch her pelvic bones at all, and instead headed straight for her vagina.  But to name the exam in a more accurate and descriptive way would be leading people down a path they are not supposed to go.

Naming the exam a “pelvic” exam leads people down an appropriate but rather deceptive path, and also accomplishes a number of different goals.  One goal is to allow everyone to safely ignore the fact that the vagina is being examined at all.  The doctor or nurse will not have to say to a woman, “I will need you to take your cloths off and spread your legs now so I can look at/in your vagina”.  Instead, the doctor or nurse can simply say “let’s get you ready for your pelvic exam”.

Another goal is to medicalize what is being examined.  Examining the vagina can be a bit dodgy after all.  Vaginas can be viewed as secretive, suspicious and dark places.  They can also hold the power to captivate, enthrall, incite, tempt and seduce.  To even say the word out loud can take courage for some.  The term “pelvic exam” sounds much more sterile and scientific than the term “vaginal exam”, and is much more suitable to a medical environment.

Medicalizing the exam also accomplishes the goal of desexualizing the exam.  A woman’s vagina magically becomes . . . something else.  I’m not exactly sure how it happens, but suddenly it becomes acceptable to put a woman’s vagina on display for public viewing.  And it is okay to look at it . . . in a ‘nonsexual’ way.  For example, when a pubescent boy is found watching an educational YouTube video of a birth or a pelvic exam, the boy can safely say “no, it’s not porn, it’s okay to watch”.

Ignoring the sexual nature of the exam also helps some medical students and instructors in teaching hospitals to convince themselves that it is acceptable to practice the exam on anesthetized women without the women’s knowledge or consent.  It helps to allow the exam practice to be viewed as something other than medically sanctioned gang rape.  Desexualizing the exam also lessens the effects of convictions when doctors are caught doing something “naughty” while conducting the exams.  Imagine if the headlines read something like: “Doctor So and So convicted of sexual assault when examining a woman’s vagina”.  This headline sounds a bit redundant, since examining a woman’s vagina sounds a little like sexual assault just on it’s own.  Instead, the headlines usually say something like: “Doctor So and So convicted of sexual assault while conducting a pelvic exam”.   This headline sounds less redundant and also less severe.

I am in favor of changing the name from “pelvic” exam to the more accurate and descriptive name of “vaginal” exam.  This might help to give the exam more recognition for the effects it can have on women, for the effects it can have on men, and for the effects it can have on pubescent boys.

index.jpgplv

38 comments

  1. That happen to me when i was 17. i thought they were going to check my hips but when they brought out the speculum i was ni shock. i feel doctors almost always mislead woman if its not about pelvic exams its about pap smears.

    • Thanks for sharing this Anonymous. Your comment helps bring to light how women are not having the procedure explained beforehand. Drs should explain, in detail, what happens beforehand. Especially in your case as it was your first time. They should also provide information about why the test is being done and explain the risks. Then they should ask for consent before going ahead. When women aren’t offered informed consent before such an invasive exam it can have devastating effects. It is awful that it was done to you that way, and I don’t think they could get away with it today since the age has been raised. Although some are still ignoring guidelines.

      • I whould also like to add that I have a problem with the way paps and pelvics are presented to woman, in a way that we have no choise as tho its so ruten and normal doctors think all woman are excepting this test. The way the doctor said he was going to do a pelvic. doctors need to be taught to explan exams and get concent first. and respect any refusel.

  2. A pelvic exam is not a misnomer. The exam observes the external features of the pelvis, along with external and internal reproductive anatomy. You give the impression that the exam is all about the vagina, because that is where the speculum rests, but that is simply not the case. The doctor is examining muscle tone and skin externally. The speculum is placed so that the physician can observe the cervix and take a pap smear if needed. The digital exam is utilized to palpate the ovaries and uterus. In fact, very very little of the exam is devoted to the vagina. Why, then, would it be more appropriate to call this a vaginal exam?

    • DIT, thank you for your question: “Why, then, would it be more appropriate to call this a vaginal exam?”. My purpose in writing this post was to help raise awareness about the harms being caused by the lack of information and choice being offered to women. When a woman is unaware of the invasive nature of the exam, and is not given a choice prior to the doctor going ahead, it can have devastating effects. Please open your mind and read about some of the experiences and trauma being done to women – all in the name of “health care” of course.

      Given the exam’s invasive nature and the way women are often aggressively pressured into the exam, the after effects can be similar to having been raped. Although in some ways and some instances worse, because it is medically sanctioned and socially accepted. Perhaps reading this post: https://forwomenseyesonly.com/2013/01/02/psychological-harms-of-pelvic-exams/ and the comments made by many of the women on this and other posts will help to educate you regarding the devastating effects this exam can have on women.

    • You cannot be serious. How can it be “very very little” about the vagina when that is where most of the “action” occurs?! Trust me. When you’re getting it done, it is VERY much about the vagina when you have a cold metal object shoved up there and stretching you so the doctor can “observe”.

    • No time is spent on pelvic structure. It’s a genital exam and a pointless one at that (in asymptomatic)

      It is next to impossible to palpate a normal woman’s ovaries (and medically pointless to do so at best…false positive waiting to happen).

      And how do you get the the cervix and uterus but through the vagina?

      Pelvic exam is a marketing term…that simple.

  3. When I was in my early twenties, I was told that I needed a “pelvic ultrasound” to look at my ovaries. Now, they did legit need to look, because I was showing every symptom of having PCOS. But imagine my shock when I was made to strip, had the nurse yank my legs apart, and start lubing me up. And when I expressed distress and horror, I was told that “this is what you consented to” and the nurse proceeded to shove the ultrasound wand into my vagina without further preamble – or express consent.

    I was never informed of the realities of what would be done to me. My doctor made it sound like they’d just be doing an external scan. And I was never given the chance to say “no” before the procedure was forcibly done to me.

    The tests did reveal that I have PCOS. To this day I’m not sure whether what happened qualified as assault or rape, or nothing at all because I had been scheduled for a pelvic ultrasound (even though it was clearly not with my INFORMED consent). Every time that I’ve ever mentioned the incident to someone, I have been told that “it was just a medical test” and that I’m “overreacting, you asked to have it done.”

    I do know that the experience, combined with my distrust of men and awareness of the power play/sexual nature of vaginal exams, is why I have never had a full exam performed. I’ve looked into it but no one has been willing to respect my request for a female doctor at the very least.

    Once burned, twice shy.

    • I was given a bogus pregnancy test in my early twenties – which was in the late 1980s. I went to see a male Dr. he asked me to remove my clothing then did an internal exam and breast fondle – then when I asked the results – he said leave a urine sample and call back for the results in about a week. I realised the whole naked exam was pointless and I had just been abused. This has given me a phobia of male gynecologists and doctors – I will not see them for any intimate exams

      This has proved very useful – because my female Dr referred me for a full scan when she was taking me into her patient list. It was at a seperate centre – when I arrived the male Dr asked me to undress, including my underwear/nickers.

      I put the gown on but didnt remove my pants or bra – he asked me why I didnt do as asked, that he needed to do a pelvic scan with the vaginal probe. I refused and he said he would do the rest of the scan and tell me if it was necessary. I thought this was a very arrogant statement – since I just made it clear, it wasnt going to happen

      My approach is always to read up on any medical procedure – especially if it is remotely connected to the reproductive system. I did a lot of reading regarding fibroid tests and learned that an abdominal scan can be assisted by drinking plenty fluids – it aids what they can see using the external scanning device and can avoid the vaginal probe. Doctors wont tell you this – they just assume it doesnt matter or make a difference. I will do anything to avoid future medical trauma and abuse.

    • It has now become somewhat “standard” to perform this kind of ultrasound in early pregnancy to “date” the pregnancy–even though if a woman knows the date of her last menstrual period, research has shown that to be more accurate than the ultrasound. Now I had opted out of OB care before this became standard, so I was never “offered” one of these ultrasounds…but my impression from talking to other women is that they do not know, prior to the ultrasound tech pulling out the wand and the condom, that this is how the ultrasound will be done. And by then they feel they “have” to get the exam done, they don’t have time to think about it. They are emotionally excited to see their baby, and they have scheduled the appointment and thus feel obligated to follow through. I feel that this is coerced consent, and the doctors rely on women feeling guilty that they “wanted” to see the baby so they don’t complain. But really, if the doctors were honest and said “well you know your LMP, so that is more accurate, but we still want you to get an ultrasound wand stuck in your vagina because it is our routine, all you will see is a little bean shape and a slight flicker of a beating heart…” how many of the women would not schedule the appointment?

      • I find this very disturbing that these internal vaginal scans are done in early pregnancy. I had my kids in 1997 and 2000 and I can remember going for the scans (external ones that is) and it being a very happy occasion, with husband in 1997 and in 2000 with a small child also looking on. How on earth could this possibly be a happy family occasion with you lying there naked and this instrument shoved up between your legs? Surely, they must give you a choice?

      • Anonymous- I’ve got to ask: what country did you do this in? You’re instincts are correct, but in America (and the America-esque countries, it seems) they’re very dictatorial & assaultive. Most of the time (typically through subtle methods like coercion or deception) they force women into internal testings. Properties don’t change because of designation, but in this country it seems to be long-standing tradition to act like this isn’t the case- causing a very severe self-defense concern.

        This is called “iatrogenic attack” (just like if a doctor poisons someone with a needle, it’s still murder). That’s not a very common term in America, but it definitely conveys things clearly. In this part of the world, it’s very common for someone to functionally argue that whatever a doctor does is not a problem (much like saying: “what a priest does isn’t wrong”- I’ve heard this called Thinking By Analogy, but I’m not exactly sure why).

        Up here they frequently make a “you don’t get this without that” situation with birth control & they figure anything goes when someone’s pregnant. This goes for any of the risks that come with these situations. Reproductive endangerment is something doctors get applauded for here. Completely antithetical to medical assistance, I know- but that’s what they are.

    • You express an issue with all this & that one thinks to argue with it? What a horrible “person”! If someone has to do something to counteract what someone else is doing, they know it’s an issue. Something ceases to exist despite its existance? You didn’t know what the situation consisted of, so as far as you knew, that wasn’t what you consented to. This was sequenced to preclude any capacity on your part to refuse. It’s kind like talking too fast so someone doesn’t have time to think. There was no space for argument. I’m sorry that happened to you. Dynamics don’t change because standards do, and third-party orchestration is an assault. I don’t mean to rub it in, but I don’t want to camoflauge there antagonism, either. I doubt I’m letting any cats out of the bag, but I’m sorry if I’m coming off insensitive.

      By-the-way, any interface (visually or physically) with sexual areas as a product of someone else’s decision-making is an attack (someone puts a camera in a bag at the store, gropers on the subway, two guys in a prison cell, etc…). If it’s a penetrative one, that is rape (whether by medical methodology or more conventional methods). Circumstances constitute the situation. If a doctor poisons someone with a needle, it’s still murder- so too with any attack. It’s just an iatrogenic variation. I’ve heard it called “thinking by analogy” to think like that (same idea as thinking it’s not wrong if a priest does it, or that wearing someone else’s clothes will give you their abilities). I don’t know why someone thinks reality takes a coffee break for doctors. Someone says you’re “overreacting, you asked to have it done”- and that you don’t stop these actions at your discretion? That your reaction to this situation isn’t conveying refusal? It’s a pretty damn obvious sign you’re not on board with the situation if you’re expressing distress and horror. The medical personnel are not supposed to be mindful of extant circumstances?

      Also, these medical personnel don’t tell people about the risks, inaccuracies, or alternatives to these “suggested” exams (or that there’s a massively low risk factor for the type of cancer they scare everyone with- about 0.5%). Medical quality is determined by patient satisfaction, anyway- not academic value. Once again, I’m so sorry that happened to you.

  4. Thats the problem I have with theses tests. No one ever explanes what the exam involves to the woman. they should not just asume the woman knows. I also notice the way doctors expect woman to just be okay with these exams. the thing is they are trained to see these exams as just meadical. but how can they expect all woman will feel the same. its as tho they hid every thing from woman and prevent informed concent out of fear that alot whould refuse if they new the test was vaginal or that there is a high false positve rate and the follow up are extreamly invasive. i do think its a male domenated field. and there is no way a man whould ever go for what woman are expected to go thru.

  5. I dont like the way doctors hide things like high false positve rates and how invasive the follow up are from woman. There is a attitude that woman dont have a right to say no to these exams and that we dont need to know the risks. its very disrespectfull that woman are treated like meat.

  6. if i were a Woman I would never go to a male doctor for such an exam. It’s ridiculous that they have pulled the wool over so many peoples eyes for as long as they have. Female and Male.

  7. I studied Latin, and thought I understood what a transvaginal ultrasound would be. Boy! was I in for a surprise! I was 62 at the time, and it was not painless. I could have used some long-lasting lubrication the night before if I had known what I was facing. It’s clear to me that doctors purposefully mislead us with terminology. Among themselves, they don’t call it transvaginal, they call it endovaginal (I might possibly have figured that one out). I think a better term is intravaginal (as in intramural basketball-played within the walls of the school). That I would have understood. If a doctor tells you you need a transvaginal ultrasound, ask if (s)he means an intravaginal one instead. That will get the doctor’s attention.

    • Anon, I’m mid-50’s and I was equally caught out by not understanding what this was before turning up to a hospital appointment. At my doctor’s I heard the words ultrasound and thought “Oh that’s OK, I’ve had that when I was pregnant and it’s where they put the gel on your stomach”. Easy peasy. Doc mentioned that they would put something up inside me, but I thought I’ll refuse that when it gets to that part and just get the results of the ultrasound. Of course, when I got to my hospital appointment I was aghast to discover that it wouldn’t be an outside ultrasound but one put up inside my vagina. As this consultation took place in a separate office I had no idea what this gadget looked like and the size of it was causing me great anxiety. I kept asking the gyn what did it look like and he was getting more and more cross with me. I’d seen the blacked out ultrasound room next door, all dark inside and this freaked me out even more. I never went into a dark room like this when I was pregnant. The whole experience was a terrible shock, that I walked out of this appointment. I did, in fact have cancer at the time, and it was another 3 months to get another hospital appointment. If only doctor and gyn had taken the time to explain things to me, taken me into the ultrasound room and shown me the gadget, and explained why the internal one was necessary, and that we could stop at any time, I am sure things would have turned out differently.
      I wrote to the hospital and complained that I had had a bad experience in the past and this appointment was totally unsympathetic. A few months later I noticed someone post on their website that the gyn dept at this hospital had been exceptionally kind and caring towards her, when they were notified that she had had a bad experience in the past, and had done everything possible to put her at ease. Maybe my letter had taught them a lesson.

    • my cusin said she cryed in pain when they did one on her pregnant. they didnt stop. she thought she had to have it. I remember a girl when i was in high school say that her doctor didnt tell her and just stuck her whole hand in side her and she was in shoke. i dont know why she did that but the girl said she was having trouble sitting down the next day. seems like doctors think vaginas are a free for all and were just supose to take anything they come up with.

      • I keep saying it: subjugation of the profession would likely knock a lot of that shit off.

      • A dr did this to me recently too. She stuck her whole hand in me and was pushing my organs towards the ceiling. Then put her hand directly behind my abdominal wall and pushed upwards again. I had bleeding and awful pain the next day and bulging urethra. i was at this dr because another doctor in her network had caused problems inside me. possible uterine or bladder prolapse. i did not know this dr knew the dr that hurt me. She did not return my calls for two weeks. I was told to go to ER. I did and they said it was period. IT WAS NOT MY PERIOD. DRS ARE DANGEROUS

  8. I agree Alex docs are way out of control they are leeches and suppository merchants made good.

    Kleigh that experience sounds awful im angry for your cousin.

    Hi Ada my research now makes me believe keeping patients in the dark is deff a ploy used by docs. In the past i have just let them get on with it now i will question everything and be deliberately annoying but not to the point they throw me out. It will be more like a game for me. Keep well.

  9. I had stopped getting exams yearly a few years after having my kids. I was healthy and my paps were always fine. frankly I was quite tired of being poked and prodded and felt up constantly. I can do my own breast exam. I went in to my doc for a car accident and she asked if she could do a pap. This was my first and very dangerous life changing mistake. I was not sexually active but was told I had hpv. After this day for four years I would be bullied and frightened into colposcopies and paps ( which were always fine) my gynecological and overall health was very good. But I continued to be bullied about paps. I was now 46 years old and started missing periods and having shorter ones so I thought I should at least get hormone testing done. I went to the gyno and they would not test my hormones but insisted on an endometrial biopsy. I respectfully declined. Why cut and invade a perfectly healthy uterus. She always tried to scare w me hpv. This did weigh on my mind and cause stress for many years. They eventually refused to be my doctors as i would not do biopsy. They said it was because i missed to many appts. It was truly because I called and asked them to stop sending letters and calling about biopsy. I was not going to do it. Anyway they sent to dr michael Ira Reich, Salem ma. They said he would test my hormones if I would submit to a routine pap smear. This was my second biggest mistake and changed my life forever. He performed unconsented damaging procedure. Would not let me speak. He made me answer questions about my childrens ages, WHERE THEY WERE, and how they were doing. He told me to lay back as he was starting exam. I very quickly felt pain that i have never felt before and i have had a colposcopy. I jumped up in pain and he or his nurse did not acknowledge my pain or the fact i was crying. They waited til i laid back down as i was afraid to move with speculum inside me for fear of hurting myself more. I saw a VERY LARGE piece of pink bulbous tissue dropped in a wide cup the nurse was holding. I got very frightened. He then stepped far back from me and told me to repeatedly cough with speculum inside me.
    I suffered terrible pain the next day dropping burning releasing sensation causing me to double over in pain. Bleeding started. Burning genitals and down my legs and back. Heavy low abdomen overall ill feeling. five months later i have all these symptoms still a vagina that hangs open and insides that will never b the same. I suffer everyday

    • Ruined, that is a horrifying account, I’m so sorry you went through such an ordeal.
      It sounds like he did a biopsy without your consent, you were there to have your hormones checked…right? I’d be lodging a complaint and possibly, seeking legal action.
      Has there been any further contact with this “doctor”? Has he provided you with results which confirm he took an endometrial biopsy? (or was it a cone biopsy?)
      It sounds like you were misled into attending the appointment and perhaps, some discussion had taken place between the doctors. Maybe your refusal was discussed; some doctors are perfectly happy coercing and misleading women into procedures and tests they don’t want. Ambushing and capturing women is almost a sport.
      The days of doctor knows best are over…he shouldn’t be allowed to get away with it. It is so upsetting to hear account after account of women being abused by the medical profession, what part of NO don’t they understand.

    • Ruined. I am so sorry this happened to you. You don’t deserve this awful pain ,the physical as well emotional. Please read all the posts on this site and gain strength from the fact you are not alone. We are here for you. What you need to know is that periods change towards the meno, they become lighter, heavy, more, sometimes less, frequent. The most dangerous thing a woman can do is go running off to the doctors. From now on i suggest you try a wait and see approach. Get info off the internet and use your own judgement about how to heal youself from now on. It doesn’t take much to learn and know more than your average doctor. Remember this they have only written a few essays and sat a few exams and attended some lectures any intelligent person undertaking their own research could surpass this in no time.

      Iam thinking about you sister. Linda xxx

  10. I also, wonder if they’re more likely to do biopsies on women who’ve chosen not to have pap tests, they know you won’t come back so decide to take a sample “just in case”. I’ve heard from a few American women over the years who were cornered into a pap test, it came back mildly abnormal and they were rushed in for a cone biopsy, “because we have no pap test history”. You’d think we were dealing with an epidemic, all of this carnage caused by screening for an always-fairly-rare cancer. It just horrifies me, no consent for the pap test, no consent for biopsies…well, how can that be anything other than an assault?

    • If you look at some of the treatment protocols of various gynocologist associations, when a woman is determined to be “noncompliant” or “at risk of not following up” or “has not have regular screening” then there is all the most pressure to do LEEP, cone biopsy or hysterectomy. “Wait and see”, alternative therapies or informed consent are thrown out.

      If any woman is worried about cervical cancer so much she can get a hold of a self HPV test and get her own results. Another alternative is to purchase a package of plastic speculum and look at her own cervix with some vinegar swabbed in it. Google cervix inspection with acetic acid. This is done in some low resource countries that do not have access to cytology labs to process pap tests. It is also the first step in colposcopy. If a woman sees anything she is concerned about she can go on some antiviral herbs and take vitamins for a few months.

  11. saw this article just saw this article
    ‘Surprising gaps’ in ovarian cancer research: US report
    ‘Surprising gaps’ in ovarian cancer research: US report
    Yahoo News · 1 day ago
    Ovarian cancer, often called the “silent killer,” is poorly understood by researchers and often does not even arise in the ovaries, a US panel said …
    
    'Surprising gaps' in ovarian cancer research: US report .
    View photo
    ‘Surprising gaps’ in ovarian cancer research: US report
    Ovarian cancer, often called the “silent killer,” is poorly understood by researchers and often does not even arise in the ovaries, a US panel said Wednesday.

    With no cure in sight, no reliable early screening tests and a lack of effective treatments for the cancer, the National Academies of Sciences, Engineering and Medicine called for a series of steps to close what it said were “surprising gaps in the fundamental knowledge about and understanding of ovarian cancer.”

    “The committee concludes that a substantial proportion of carcinomas labeled ‘ovarian’ may actually originate outside the ovary or arise from cells that are not considered intrinsic to the ovary,” said the 377-page, congressionally mandated report.

    Many of these cancers “arise in other tissues besides the ovary, such as the fallopian tubes, which eventually metastasize to the ovary.”

    Ovarian cancers kill about 14,000 women each year in the United States, where some 21,000 women are diagnosed annually with what is the nation’s fifth most common cancer.

    Early symptoms may include bloating, pain while urinating or abdominal discomfort; but often, no early symptoms are detectable.

    About two in three women who are diagnosed with the cancer learn of it only once it is already advanced and has spread beyond its initial site.

    Fewer than 30 percent of women who receive these late diagnoses will survive beyond five years.

    Overall, fewer than half (46 percent) of all women diagnosed with ovarian cancer live for five years.

    – Opportunities to improve –

    But there are research opportunities “that, if addressed, could have the greatest impact on reducing the number of women who are diagnosed with or die from ovarian cancers,” said the report.

    These include placing a priority on research into high-grade serous carcinoma (HGSC), the most common and lethal subtype of ovarian cancer.

    A better understanding of the range of other subtypes is also needed, the report said.

    Women with mutations in their BRCA1 or BRCA2 genes are known to face a higher risk for ovarian cancer — along with breast cancer.

    “Despite this important discovery of a major ovarian cancer risk factor, genetic testing and counseling for families at risk has not been universally adopted,” said the report, calling for more widespread genetic testing.

    But since most women who get ovarian cancer have no family history of it, the report also called for a fresh effort to understand the risks of developing ovarian cancer, “including hormonal, behavioral, social and environmental factors.”

    Another challenge involves the relative rarity of ovarian cancer.

    Although it is the seventh most common cancer in women worldwide, clinical trials may enroll fewer participants than breast cancer trials, for instance, so researchers must get the most out of their data.

    There is a “need to develop new clinical trial designs that are information-rich in terms of molecular characterization and metadata so that clinically useful conclusions can be drawn quickly from smaller study enrollments,” said Jerome Strauss, chair of the committee that carried out the study.

    Treatment is also a major obstacle. Most women with ovarian cancer are initially treated with platinum-based chemotherapy.

    While many respond well at first, “virtually all recurrent ovarian cancers ultimately become resistant to current drug therapies,” said the report.

Speak your mind

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.