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

Testing Yourself for STDs at Home or at the Doctor's Office

Young woman bent over on bed, clutching stomach.
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Going to the doctor can be difficult. That's particularly true if you're dreading the visit. For some people, it's the dentist that scares them. For other people, it's the thought of having to undergo a pelvic exam. It can be emotionally intimidating to put your feet in the stirrups at a gynecologist's office. Some individuals are also afraid that a pelvic exam will hurt. It can be an uncomfortable experience—particularly if you are tense or afraid.

Concern about needing to undergo a pelvic exam can make people reluctant to seek out STD testing. Fortunately, there are several options for those who are interested in STD testing but don't want to have a doctor performing an exam that they perceive as intimate. One of those options is self STD testing, and you can do it at your doctor's office.

What Is the Purpose of a Pelvic Exam?

There are several reasons why doctors perform pelvic exams. First and foremost, the exam is used to check on gynecological health. During the exam, the doctor can 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, if you are having pelvic pain or unexplained bleeding. Then a doctor might use a pelvic exam to try to understand the cause of your symptoms. 

STD testing is often done during a pelvic exam. Before or after your gynecologist does your Pap smear, she may take additional swabs to test for various STDs. She may also perform a wet mount. This test involves putting a vaginal sample on a slide to look for conditions such as trichom oniasis and bacterial vaginosis. However, if the thought of undergoing a pelvic exam is preventing you from getting an STD test, there are other ways to get the information you need to stay healthy. 

Types of Samples for STD Tests 

There are several types of samples that can be used for STD tests. Not all sample types will work for all STDs, but there are generally tests that will help people avoid a pelvic exam if they are very concerned about one. There are some STDs where visual inspection is the best method of diagnosis, but there are usually other ways to test for the presence of an STD. (One exception to this is genital warts. They are always diagnosed by visual inspection of the growths. The same is true for molluscum contagiosum.) Types of samples include:

  • Blood, 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 general herpes. However, many doctors will only use a blood test for herpes in the presence of symptoms. 
  • Urine tests for STDs are growing in popularity thanks to the development of molecular amplification tests that detect very small amounts of bacterial DNA. They are most commonly used to detect chlamydia and gonorrhea, although there are also urine tests for trichomoniasis.  These tests have some disadvantages when compared to swab tests, which will be discussed below. 
  • Vaginal swabs can be performed by a doctor in order to collect samples for STD testing. These swabs can be used to test for a wide variety of bacterial STDs. However, importantly, it is also possible to take a self-swab for STD testing. Even when vaginal swabs are the best option, they don't necessarily require a doctor. Patients can take them, successfully, themselves. 
  • Urethral swabs can also be performed by either a doctor or patient. They have similar usefulness to vaginal swabs but are used to test the penis. 
  • Throat and rectal swabs can be used to identify infections transmitted by oral sex and anal sex. Blood tests can 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 people with penises than those with vaginas. Why? Because urine passes through the major site of infection, the penile urethra. However, it doesn't pass through the vagina or the cervix, the major sites of infection. In such cases, a vaginal swab may be a more effective option. And sometimes a urethral swab is the only option available. 

Unfortunately, the thought of having a doctor 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. Still, some patients and doctors question whether self-swabs are as effective as doctor-collected swabs for detecting STDs. By and large, the answer seems to be yes. In fact, some research suggests that self-collected swabs are the better option. 

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. Most people are willing to swab themselves if given the option. It's both easy to do and easy to do right. 

Studies have also shown that the self-swabs are at least as good at detecting bacterial STDs as urine and cervical swab. In fact, multiple studies have suggested that they're actually better. They're also cheaper and easier to implement than physician swabs. There's no reason why they can't be widely implemented to make STD screening more accessible to all. 

A Word From Verywell

Your doctor may or may not be aware that self STD tests are an option. Therefore, if you're interested in exploring self-swabs as a replacement for a doctor swab, you may need to ask. If you do, and your doctor is reluctant, don't give up hope. Show them the citations at the bottom of this article, and ask them to do some research on their own. A self STD test is a reasonable thing to ask for. Don't be afraid to do so, if it's something that's going to help you get the testing you need. The best testing option won't do you any good if you're not willing or able to use it. 

If you're not willing to go to the doctor at all, no matter who does the swabbing, you might want to consider online or home STD testing. The best of the online options use the same tests that you'd find in your doctor'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 care 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 doctor 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.  

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