Pelvic examination seldom causes complications. The most common complication is minor bleeding from irritation of friable mucosa caused by the speculum or cervical sampling instruments. Patients should be warned that spotting is normal following the pelvic examination (Lichtman).

Occasionally, a woman will have difficulty with the pelvic examination. She may not be able to tolerate insertion of the speculum because of severe anxiety, an intact hymen, or pain. Bimanual examination should be attempted. You may have to use one examining finger instead of two. If she still cannot tolerate the examination or if she has vaginismus, stop the examination.

This experience may uncover a psychosexual problem that needs to be addressed. Referral to the appropriate specialist is recommended. If the problem is a tight hymenal ring, there are exercises the patient may be taught to prepare her for later pelvic examination (Lichtman, Primrose).