Physical Exam

Female External Genital Exam

🎬

Video coming September 2026

How to Perform

With the patient supine in the frog-leg position, with the hips and knees flexed and the hips abducted, drape the patient to expose the external genitalia. Inspect the mons pubis, labia majora and minora, clitoris, urethral meatus, vaginal introitus, and perineum. Separate the labia as needed to inspect the vestibule and note any skin changes, lesions, swelling, or discharge. Palpate as indicated, including the Bartholin and Skene gland regions, for tenderness or masses. Ask the patient to bear down while observing the vaginal introitus for prolapse.

How to Interpret

Genital Herpes

Clinical appearance of a genital ulcer judged to be herpes

Rule in

Somewhat helpfulDerived CI

Rule out

Minimally helpfulDerived CI

Evidence:Strong

Primary Syphilis

Painless, indurated, clean-based ulcer (chancre)

Rule in

Very helpfulDerived CI

Rule out

Minimally helpfulDerived CI

Evidence:Limited

References

Loh AJW, Ting EL, Wi TE, Mayaud P, Chow EPF, Santesso N, Falconer J, Ofori-Asenso R, Ong JJ. The Diagnostic Accuracy of Syndromic Management for Genital Ulcer Disease: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2022 Jan 3;8:806605. doi:10.3389/fmed.2021.806605. PMID: 35071282.
Anum Q, Yossy V, Fonna N. Correlation between Acetowhite Examination, Dermoscopy, and Histopathology in Patients with Anogenital Warts. Iran J Med Sci. 2025;50(6):423-428. PMID: 40636952.
DiCarlo RP, Martin DH. The clinical diagnosis of genital ulcer disease in men. Clin Infect Dis. 1997;25(2):292-298. doi:10.1086/514548. PMID: 9332527.
Anderson MR, Klink K, Cohrssen A. Evaluation of vaginal complaints. JAMA. 2004;291(11):1368-1379. doi:10.1001/jama.291.11.1368. PMID: 15026404.
Pyle HJ, Evans JC, Vandergriff TW, Mauskar MM. Vulvar Lichen Sclerosus Clinical Severity Scales and Histopathologic Correlation: A Case Series. Am J Dermatopathol. 2023;45(8):588-592. PMID: 37462209.
Nam G, Lee SR, Kim SH, Chae HD. Importance of Translabial Ultrasound for the Diagnosis of Pelvic Organ Prolapse and Its Correlation with the POP-Q Examination: Analysis of 363 Cases. J Clin Med. 2021;10(18):4267. doi:10.3390/jcm10184267. PMID: 34575378.
Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.