Rectovaginal exam — purpose?

Dear Alice,

I would like to know what the rectovaginal examination is for. If you are under thirty, should the doctor perform it?

Dear Reader,

It's good to know that you are being proactive and inquiring about one of many important health screenings. The rectovaginal exam is one of the diagnostic tools at the disposal of a gynecologist or nurse practitioner. For many providers, a pelvic exam is considered incomplete without it, especially with a new patient. This is because the rectovaginal exam helps a provider understand your internal anatomy more fully and look for abnormalities missed by the bimanual exam (when two fingers are put inside the vagina and the other hand presses down on the abdomen, examining the uterus, ovaries, Fallopian tubes, and other internal organs).

For the rectovaginal exam, by putting one finger inside the vagina and another into the rectum, a provider can:

  • Evaluate the back side of the uterus and the wall between the vagina and rectum.
  • Check on the tone and alignment of the pelvic organs: ovaries, Fallopian tubes, and ligaments of the uterus.
  • Determine if the uterus is retroverted (tilted).
  • More thoroughly investigate complaints of pelvic or rectal pain.
  • Feel for rectal growths, check for blood in the stool, and look for other early signs of colon cancer, especially in women over the age of 40.

It's understandable that some women may feel a little uncomfortable with this type of examination. The sensation as the finger is withdrawn may feel similar to that of a bowel movement, but it will pass quickly. Providers aim to perform the exam with minimal discomfort to the patient and it's your right to express any concerns before or during the exam.

A discussion with a health care provider is the best way to determine the right age for this and other screenings.

Here's to healthy checkups,

Last updated May 14, 2015
Originally published Sep 10, 1999

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