While monthly breast self-exams are widely recommended to detect potential health issues, the practice of performing internal vaginal self-exams is less common and generally considered unnecessary by medical professionals. However, there are specific instances where these checks can provide useful information for individuals and their doctors.
Dr. Karyn Eilber, a professor of urology and associate professor of obstetrics and gynecology at Cedars Sinai Medical Center, stated that internal vaginal self-exams are typically not required. Unlike breast self-exams, which can help identify many breast cancers, the anatomy of the vaginal canal makes a thorough self-examination difficult. "It's very difficult for a woman to give herself a thorough vaginal exam because the vaginal canal is usually longer than any woman can reach, and you can only see the entrance of the vagina," Eilber explained. She also noted that self-exams are not effective for detecting sexually transmitted infections (STIs) or identifying early signs of HPV, which does not cause a lump unless it has progressed to cervical cancer.
Despite these limitations, some individuals, like Elana H., choose to perform internal self-exams to familiarize themselves with their anatomy, check the placement of an IUD, or monitor for any unusual sensations. While Elana acknowledged that finding anything significant is unlikely, she did once discover her IUD had been displaced. "I think everyone should be regularly checking in on the vagina for discharge, discomfort, patterns, etc.," she said.
When a Self-Exam Might Be Useful
There are limited scenarios where an internal vaginal self-exam might be beneficial. Eilber suggested that if someone experiences symptoms like localized pain or a sensation of something protruding from the vagina, such as a falling bladder common after childbirth, a self-exam could help pinpoint the location of the issue. This information can then be shared with a doctor to aid in diagnosis.
Dr. Christina Pardo, director of the women's health practice at Weill Cornell Medicine and NewYork-Presbyterian, identified other situations where self-checks are relevant. These include verifying the position of IUD strings, which may feel shorter or longer than usual, or might be undetectable if the IUD has shifted. Self-checks are also useful when inserting vaginal medications or contraceptive devices. Furthermore, external vulvar self-examinations can be helpful for individuals at higher risk for vulvar conditions to monitor for skin changes. In some cases, providers may offer self-sampling kits for various health tests.
Addressing Concerns About Lumps
If a lump is detected during an internal self-exam, medical experts advise against immediate alarm. Eilber noted that soft, fluid-filled lumps are often cysts that are not a cause for concern. However, Pardo emphasized that any lump that is hard, irregular, fixed, rapidly growing, or accompanied by bleeding or pain requires prompt medical evaluation. "While most lumps are benign, any new lump should be evaluated by your provider to determine the cause and whether treatment is needed," Pardo stated.
Both physicians stressed that most internal lumps and bumps are part of normal anatomy. Eilber advised that if self-examination is only being performed due to health information, it's important not to worry about minor findings, as they may have always been present but unobserved. When in doubt about any findings, consulting a gynecologist for a professional examination is the recommended course of action.