It’s normal to feel uncomfortable when a doctor examines your private parts. However, there are good medical reasons why doctors need to do this. Understanding why doctors perform genital and rectal exams can help ease anxiety about having these exams done.
Doctors have specialized training to examine patients in a professional manner. They know these exams can cause discomfort. Their aim is to be as gentle and quick as possible during the exam.
Common Reasons for Genital and Rectal Exams
Here are some of the most common reasons doctors need to examine the genital and rectal areas:
During a routine physical exam
Doctors like to do a full-body scan during annual check-ups. This involves visually inspecting and palpating all areas, including private regions. They do this to check for any signs of problems like:
- Skin discoloration or irritation
- Damage to anatomy
- Abnormal discharge, odor, or secretions
- Hernias
- Hemorrhoids
- Growths or masses
A rectal exam allows doctors to assess the prostate in men. They also check sphincter tone and look for abnormalities in the lower GI tract.
To screen for cancers
Doctors can detect early signs of reproductive cancers like testicular, prostate, cervical, vaginal, and anal cancer from genital exams. Catching these cancers early greatly improves treatment success.
If you have symptoms in the pelvic region
Doctors will examine your private regions if you have any unusual symptoms like:
- Genital itching, pain, sores, or discharge
- Painful urination
- Bloody stools
- Constipation
- Diarrhea
- Hemorrhoids
These exams help them pinpoint the cause of your symptoms.
Before and after surgery
Doctors perform genital and rectal exams before any surgery requiring anesthesia. They do this to get a baseline assessment of your health.
These exams are also done after surgeries near the pelvic region. This allows doctors to check that everything is healing properly.
During pregnancy and childbirth
Obstetricians and gynecologists routinely check for cervical dilation and the baby’s position during vaginal exams. These help monitor the progress of labor.
After delivery, they examine the genital region to check for any trauma that may need repair.
What to Expect During the Exam
For a genital exam
You’ll be asked to undress from the waist down and lie on an exam table. Women are often given a sheet to cover the lower half of their body until the exam begins.
The doctor will visually inspect the vulva, penis, and scrotum for any abnormalities. They may gently palpate these areas to check for masses, pain, or tenderness.
In women, doctors often use a speculum to open the vagina and examine the cervix and walls of the vaginal canal. They take samples for Pap smears at this time.
For a rectal exam
You’ll be asked to take off your lower garments and lie on your side with your knees pulled up towards your chest. This position helps relax the anal sphincter muscles.
The doctor will separate the buttocks to visually inspect the anus for hemorrhoids, tears, and other problems. Then they will lightly lubricate and insert a gloved finger into the anus.
As they slide their finger in, they will feel around for any abnormalities in the walls of the rectum. In men, this allows simultaneous palpation of the prostate as well.
The doctor will quickly remove their finger once the exam is complete.
For comfort during the exams
Here are some things doctors do to make the exam as comfortable as possible:
- Explain what they are doing at each step
- Warm and lubricate any instruments before insertion
- Work gently and quickly
- Offer you a chaperone to be present during the exam
- Only perform what is medically necessary
- Ensure privacy during disrobing and dressing
Feel free to communicate any fears or discomfort you have. Don’t hesitate to ask questions about the exam at any time. A good doctor will listen and address your concerns.
Special Considerations
Children
Doctors avoid genital and rectal exams in children unless absolutely necessary. They are sensitive to how vulnerable children feel during physical exams.
However, if a child has problems like genital injuries, urinary issues, or chronic constipation, an exam may be warranted. Doctors are very gentle when examining children. A parent is also allowed to stay with the child for comfort and support.
Sexual trauma survivors
For survivors of sexual abuse or assault, genital and rectal exams can be very traumatic. If you have a history of sexual trauma, inform your doctor beforehand. They can take extra measures to make you feel relaxed and in control:
- Have a support person or chaperone present
- Let you insert the speculum or instruments yourself
- Offer anti-anxiety medication prior to the exam
- Talk you through the entire process and stop anytime you say
- Avoid holding you down or positions that make you feel powerless
LGBTQ patients
Doctors aim to provide a safe, judgement-free environment for LGBTQ patients during intimate exams. If you have any concerns related to your sexual orientation or gender identity, discuss them with your doctor. They can accommodate your needs by:
- Using gender-neutral terms
- Having a chaperone or support person present
- Explaining their actions clearly before touching you
- Providing gowns or draping to maximize privacy
- Positioning you in ways that minimize dysphoria
When to Decline an Exam
As a patient, you have the right to decline parts of the physical exam that make you extremely uncomfortable. However, there are some risks to declining recommended genital and rectal exams, such as:
- Missing early signs of cancer
- Delaying diagnosis and treatment of infections
- Problems related to pregnancy and childbirth going undetected
Discuss your concerns with your doctor so you fully understand the benefits and risks. If you are still uncomfortable, ask if there are any alternative detection methods available.
Coping with Discomfort
Having your private regions touched can be very distressing for some people. Here are healthy ways to manage feelings of anxiety and discomfort before, during, and after the exam:
Before the exam
- Give yourself positive affirmations like “this is for my health” and “I am in control”.
- Avoid catastrophizing. Remind yourself the exam will be over quickly.
- Try relaxation techniques like deep breathing, meditation, or listening to calm music.
- Have a supportive friend or family member come with you.
During the exam
- Focus on your breathing and try to relax your muscles.
- Tell the doctor immediately if you need them to pause, stop, or slow down.
- Close your eyes or look away from what the doctor is doing.
- Talk to the doctor to take your mind off the procedure.
- Remind yourself this is a medical professional doing their job.
After the exam
- Engage in self-care by doing something relaxing or enjoyable.
- Take a warm bath or read a good book.
- Confide in a trusted friend about your experience.
- Write down your feelings in a journal.
- Consider counseling if you experience depression or anxiety after.
Remember that these exams only last a few minutes, but detecting problems early has lifelong benefits for your health. The more relaxed you can stay, the easier the exam will be.
Conclusion
Genital and rectal exams can feel very invasive. However, doctors have legitimate medical reasons for performing them. Understanding why they are done and what to expect can help ease anxiety about these exams.
If you have any concerns, don’t hesitate to discuss them with your doctor. Clear communication ensures they take your comfort and dignity into account while still providing good care. Remind yourself that the brief discomfort of the exam is worth enduring to keep yourself healthy.
| Reason for Exam | What the Doctor is Checking for |
|---|---|
| Routine physical | Hernias, hemorrhoids, discharge, growths, masses, prostate health |
| Cancer screening | Early signs of reproductive cancers |
| Genital/pelvic symptoms | Infections, anatomical abnormalities, hemorrhoids |
| Before/after surgery | Baseline health status, healing after pelvic procedures |
| Pregnancy/childbirth | Cervical dilation, baby’s position, postpartum trauma |
| Tips for Patient Comfort |
|---|
| Have a chaperone present |
| Use positionings that feel less vulnerable |
| Offer medications to reduce anxiety |
| Go slowly and explain each step |
| Provide privacy while disrobing |
| Stop anytime patient requests |
| Warm and lubricate instruments |