Gynaecological Examination

The Gynaecological examination includes three components- abdominal examination, bimanual examination, and examination using a speculum.

You should perform an abdominal exam, looking for:

• Masses
• Tenderness

Ask about any soreness or vaginisthmus

• Part the labia to minimise discomfort
• Insert your lubricated middle and index finger into the vagina up to the cervix
• Put your other hand on the pubic symphasis, rocking the uterus against your fingers
• Feel the uterus for its size, shape (should be the size and shape of a small pear) and if it is tender
• Palpate the fornices feeling for ovarian enlargement
  Cervix
  • Position
  • Size
  • Tenderness
  • Brush against the cervix for cervical excitation, warn the patient first

Steps of speculum examinations:

1. Part the labia to minimise discomfort
2. Insert the speculum sideways first, then rotating it into the correct position.
3. Open the blades of the speculum carefully
4. Inspect the cervix looking for any tears, polyps, bleeding, discharge or warts
5. Perform any swabs or sweeps that you need to do
6. Carefully withdraw the speculum

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