Gynaecological examination: what happens and how it feels

A gynaecological examination usually has three parts: a conversation about your symptoms, an external assessment of your abdomen, and an internal examination with a speculum or an ultrasound. The whole consultation often takes no longer than fifteen to twenty minutes.

The tension is almost never in the examination itself. It is in not knowing what is about to happen.

So below is step by step what happens, what you are allowed to ask, and which part of your question needs no examination chair at all.

What does a gynaecological examination involve?

It starts with history taking: a conversation about your symptom, your cycle, previous pregnancies, medication and your history. That conversation steers the rest of the examination, so the more precisely you can describe things, the more targeted the look will be.

Then comes the physical part. That can stay external, such as feeling your lower abdomen, or become internal with a speculum or ultrasound. Not every consultation contains every element. For a conversation about contraception or hormone symptoms it sometimes stays at talking.

Does a gynaecological examination hurt?

Usually not, but uncomfortable is a more honest word than painless. A speculum examination feels like pressure. So does an internal ultrasound. Women who are tense experience it as painful more often, simply because your pelvic floor tightens.

You may say that you find it daunting. You may ask for a smaller speculum, to set the pace yourself, to have someone with you, or to stop. That is not a special favour, it is a normal part of good care.

How do you prepare?

Bring your cycle data: the first day of your last period, the length of your cycle and how heavy your bleeding is. Write your symptoms down with a date attached, because in the consulting room that detail is the first thing to vanish.

Practically: you do not need to shave or prepare in any special way. A skirt or dress is easier than tight trousers. If you are having a smear test, it is best not to schedule it during your period. More on preparing well for a medical conversation is in our article on preparing for your GP appointment.

What does a gynaecological examination not tell you?

An examination in the chair looks at structure. It shows whether there is a cyst, what your uterine lining looks like and whether anything visible is off. It says almost nothing about your hormone balance.

If you are wondering why your cycle is changing, why you are tired, or whether you are in perimenopause, that is a blood question and not an ultrasound question. You measure those values with a hormone test for women. For menopause specifically, our pillar on perimenopause describes which values add something, and the pillar on hormone testing in women sets out the full overview.

What happens after the examination?

What the doctor sees directly, you usually hear immediately. An ultrasound is assessed live, so whether a cyst or fibroid is visible is something you know while still in the room. Ask whether you can watch the screen, which is almost always allowed and makes the explanation far more concrete.

What goes to the lab takes longer. For a smear test or a culture, a wait of one to several weeks is normal. Ask three things on your way out: when the result is due, how you will receive it, and who to call if you hear nothing. That last question is the one most often forgotten and most often the one that goes wrong.

You also have the right to see your own file, including the written report of the examination. If you disagree with the conclusion or your symptom persists, you can request a second opinion.

Frequently asked questions

Is a smear test the same as a gynaecological examination?

No. A smear test is one action in which cells are taken from the cervix. In the Netherlands that runs for most women through the RIVM screening programme and is done by the GP practice, not by a gynaecologist.

Can I refuse the examination?

Yes, always. You give consent per element and you may withdraw it at any moment, including halfway through. Do ask what that means for the diagnosis, so you make an informed choice.

Can I be examined during my period?

For an ultrasound or a conversation that is usually no problem. For a smear test it is often advised against, because blood can make assessing the cells harder. Call the clinic if you are unsure and they will move it if needed.

References

• Thuisarts.nl, I am having an internal examination, 2026
• NHG, NHG guideline on vaginal bleeding, 2026
• RIVM, Cervical cancer screening programme, 2026

Every blood test result through Lunara includes a professional assessment by a BIG-registered doctor. For a physical gynaecological examination, discuss your symptoms with your GP or gynaecologist.