How a Self STD Test Can Reduce the Need for Pelvic Exams

Concern about having a pelvic exam can make some people reluctant to seek out testing for a sexually transmitted disease (STD). While having pelvic exams is a necessary part of the recommended screening for cervical cancer, there are several other options for STD testing, including self STD testing, and you can do it at your healthcare provider's office.

What Is the Purpose of a Pelvic Exam?

There are several reasons why your healthcare provider might do a pelvic exam. First and foremost, the exam is used to check on gynecological health. During a pelvic exam, your practitioner would look for signs of ovarian cysts, fibroids, STDs, or even early stage cancer. Some gynecological health conditions can only be identified during a pelvic exam. Furthermore, a pelvic exam is needed to perform a Pap smear. (It is important to note that a Pap smear is not an STD test. It looks for potentially pre-cancerous changes to the cervix.)

Pelvic exams may also be needed to diagnose certain health conditions. For example, it can help in assessing what's wrong if you are having pelvic pain or unexplained bleeding.  

STD testing is often done during a pelvic exam. A swab sample can be used for a wet mount. This test involves an examination of a vaginal sample that's placed on a slide to look for conditions such as trichomoniasis, yeast, and bacterial vaginosis.

However, lthough wet mounts may still be used, swabs are often now sent for Nucleic Acid Amplification Testing (NAAT) which has emerged as a more reliable test for these infections.

If the thought of undergoing a pelvic exam is preventing you from getting an STD test, it's important that you know that there can be other ways to find out if you have an STD. 

Types of Samples for STD Tests 

There are several ways to test for STDs, including blood tests and urine tests. Each type of test is used for some STDs, but not others.

Some STDs can only be diagnosed with a visual inspection—like genital warts and molluscum contagiosum. 

Types of tests include:

• Blood tests, which can be used to detect STDs that are present in the blood (i.e. HIV.) Blood samples can also be used to detect antibodies against various STDs. There are blood tests for syphilis that are very effective. There are also type-specific tests for oral herpes and genital herpes. However, many healthcare providers will only use a blood test for herpes in the presence of symptoms. 
• Urine tests for STDs are becoming more widely available with the development of molecular amplification tests that detect very small amounts of bacterial DNA. They are most commonly used to test for chlamydia and gonorrhea, although there are also urine tests for trichomoniasis. These tests have some disadvantages when compared to swab tests. 
• Vaginal swabs can be performed by a healthcare provider in order to collect samples for STD testing. These swabs can be used to test for a wide variety of bacterial STDs. However, it's also possible to take a self-swab for STD testing. Even when vaginal swabs are the best option, they don't necessarily require a practitioner. You can take it by yourself.
• Urethral swabs can also be performed by either a medical professional or patient. They have similar usefulness to vaginal swabs, but they are used to test for infections on or in the penis. 
• Throat and rectal swabs can be used to identify infections transmitted by oral sex and anal sex. Blood tests can sometimes identify infections at these sites. However, urine, vaginal swabs, and urethral swabs would not. 

Self Swabs vs. Other Types of Samples 

Urine tests work really well for a number of STDs. However, they're fundamentally more effective for testing for an infection in or around the penis because urine passes through the penile urethra, but not the vagina or the cervix. A vaginal swab may be a more effective option than a urine test.

However, sometimes a urethral swab is the most reliable option. And the thought of having a healthcare provider take a vaginal or urethral swab can be quite off-putting for some. Many people, given the option, would prefer to take those samples themselves. This may be particularly true for individuals with a history of sexual trauma or those with gender dysphoria that makes genital exams uncomfortable.

You might wonder whether self-swabs are as effective as healthcare provider-collected swabs for detecting STDs. By and large, the answer seems to be yes.

A number of studies have found that people are more willing to get STD tests if they can take their swabs themselves. This is true for people of a variety of ages and sexes. It's also true for not just vaginal and urethral swabs but also rectal and throat swabs. It's both easy to do and easy to do right. 

A Word From Verywell

Your healthcare provider may not routinely suggest self STD tests. If you're interested in exploring self-swabs as a replacement for a practitioner's swab, you may need to ask. Don't be afraid to do so, if it's something that's going to help you get the testing you need.

If you're not willing to go to a medical professional at all, no matter who does the swabbing, you might want to consider online home STD testing. The best online options use the same tests that you'd find in your healthcare provider's office. However, online and home testing requires you to do your homework. You need to make certain that the company you choose is using appropriate tests and testing for all the STDs you're concerned about. You also need to make a plan for seeking care if your results do turn out to be positive.

Asking for a self STD test at the healthcare provider may be a better choice for many people. That's particularly true for anyone who either doesn't want to do the research needed to find good testing options or who wants to have an easy connection to STD treatment.