examination of anatomy
palpation of stomach area
test for cervical motion tenderness, as classically seen in pelvic inflammatory disease
palpation of adnexal structures
The exam should not be excessively uncomfortable, but a woman with a vaginal infection may feel pain when the speculum is inserted. During the bimanual exam, the palpating of the ovaries may be painful. The pap test may cause some cramping as well.
For educational purposes, trainee doctors have performed pelvic exams on unconscious women. The subjects are those undergoing surgery for unrelated causes, and they were rarely informed the examination had occurred. This practice was forbidden in the United States and the United Kingdom, which now require the patient to consent in advance. The practice still continues in Canada according to a study published in the Journal of Obstetrics and Gynecology.The director of the Medical Health program at the University of Manitoba claimed in response that the revised 2006 guidelines of the Society of Obstetricians and Gynecologists of Canada forbade pelvic exams without consent, though the original impetus for the study of pelvic exams and consent was an incident in 2007