Exams for Internal Genitals (vulvas, vaginas, uteri, fallopian tubes, and ovaries)

Sexual health exams for Internal Genitals (vulvas, vaginas, uteri, fallopian tubes and ovaries)

At Island Sexual Health, our job is to give you up-to-date, clear information that helps you better understand your sexual and reproductive health and make the best choices for your wellness.

We offer annual sexual health check-ups including pap exams and STI/STD tests, at all of our clinics in Greater Victoria, BC.

All services are confidential.

Here is what to expect during your annual exam at our clinics.

Make an appointment, or read more about what to bring to your appointment.

What should I know before an exam?

Sexual health exams usually do not hurt. They may be less comfortable than other types of exams. Please let us know if we can do anything to make the exam process more comfortable for you.

Don’t put anything in the vagina for 48 hours before the exam (contraceptive jellies/foams aka spermicides, douching, sex)
Pap tests are not recommended during your period. A mid-cycle test is best.
When you arrive to our clinic, you will be asked to complete a written health summary that asks questions about your health. It is not meant to be intrusive but to give the healthcare provider a clear picture of your health when they see you. If you would like to print the form ahead of time and bring it you are welcome to.
You will be asked the date of when your last menstrual period (lnmp) began if applicable. knowing this date when you come in can be helpful.

Who is in the room during exams?

You are welcome to bring a support person (partner, parent or friend) for any part of your appointment including the exam. We have both male and female doctors; clients have the option of having a trained assistant in the room during exams. If you have a preference in health care provider, you are welcome to specify when you book your appointment. If you have any special needs, please do not hesitate to ask our clinic staff.

Medical and sexual history

The doctor/nurse will need to assess your wellness including sexually transmitted infection risks, sexual health, and risk factors for any birth control you may be using. You will be asked personal questions about:

your sexual history (information about partners, type(s) of sex, past testing results)
family medical history
any symptoms or discomfort
existing medical conditions or medications (including prescriptions, supplements and recreational drugs)
birth control or safer sex methods you are using (if applicable)

The more information we have about you, the better care we can give you.

The doctor/nurse may also take your blood pressure and listen to your heart.

Pelvic exam (internal exam) including a pap exam

**Following this paragraph is a diagram that illustrates internal and external genitals**

A pelvic exam is an internal exam intended to ensure that your sexual and reproductive organs (including labia, vagina, cervix, uterus, ovaries) are healthy and normal. Usually at ISH, a pelvic exam includes screening for cervical cancer (Pap test) as well as sexually transmitted and vaginal infections.

You will have privacy while you get undressed from the waist down. The doctor/nurse will ask you to lie on the exam table and cover yourself with a paper drape and put your legs up in the foot rests at the bottom of the table. The doctor or nurse will return to the room when you’re ready to proceed with the exam.

Breathing deeply and letting your knees flop wide apart at the knees can help relax your muscles and make the exam more comfortable.

The pelvic exam takes about 3 – 5 minutes.

Wearing gloves, the doctor/nurse will first look at and touch your outer vulva area to check for infection or sores.
Next, the doctor/nurse will gently insert a plastic speculum (a special tool used to hold the vaginal walls open) for the internal exam. It may feel slightly uncomfortable at first but it shouldn’t be painful. If it feels uncomfortable, please let your nurse/doctor attending.
The doctor/nurse will use a wooden Pap stick (like a small tongue depressor) to collect some cells for the Pap test, which checks for early cell changes that could lead to cervical cancer.
The doctor/nurse may use a swab (like a Q-tip) and collect a specimen for chlamydia and gonorrhea tests (all ISHS clinics include these tests, but it is not standard everywhere).
The doctor/nurse will then gently remove the speculum and throw it away.
The doctor/nurse will insert two gloved fingers into your vagina (inside canal) and with the other hand will press down on your abdomen to check your ovaries and uterus, to make sure they are a normal size and that you are not in any pain or discomfort. This is called a bimanual exam.

That’s it! The doctor/nurse and assistant will leave the room while you get dressed.

The results of your exam and infection tests will be kept in your file. We recommend scheduling a follow up appointment for 12 weeks after the test was performed to review your results.

If you have a cervix and have been sexually active (including oral and digital sex), BC Cancer Agency recommends that you should start having PAP tests at age 25. You should continue with PAP testing every 3 years (or as advised by your healthcare professional) until age 69. Please note, PAP tests are a cervical screening tool not a diagnostic test for sexually transmitted infections.

Through regular sexual health exams, we can help you ensure that all components of your sexual and reproductive system are healthy and happy! Illustration by Rita Wakelin, one of our amazing youth committee members!

Full infection screening

We recommend that everyone have a complete screening for sexually transmitted infections yearly or before each new sexual partner. We include all of the necessary swabs and blood tests to ensure you have a complete overview of your sexual wellness. We typically send most of our patients for blood testing to the lab with a requisition.

You should start having regular sexual health exams when you become sexually active, and should continue yearly even if you don’t have sex anymore. We recommend regular check-ups for those who are currently and/or have been previously sexually active. We recommend that everyone have a complete screening for sexually transmitted infections yearly or before each new partner. Generally, a full STI screen will include testing for chlamydia, gonorrhea, HIV, syphilis, and hepatitis.

Please note: To receive results of testing, you need to make a follow up appointment or make alternate arrangements with us to receive your results. We do not provide results for STI testing over the phone.

Your questions and concerns

You will have time to ask the doctor questions if you would like. You may wish to write down questions ahead of time so you don’t forget. If you have had any changes in your sexual wellness or function, please make sure you mention it so we can make sure all of your concerns are followed up. You are always welcome to book another appointment if you have additional questions/concerns.

Call us 250-592-3479 to make an appointment to get a sexual health check-up including sexually transmitted infection screening and genital exams at any of our clinics in Greater Victoria, BC.

All services are private and confidential.