1. Comprehensive physical examination

This involves assessing body temperature, heart rate, breathing rate, blood pressure, and if needed, height and weight measurements.

2. Evaluation of the abdomen

Observation of abdominal shape and presence of varicose veins.

Checking for tenderness, rebound pain or muscle tension. Palpating the liver, spleen and kidneys for any signs of enlargement or tenderness.

3. Assessment of the pelvic region

(1) Development of vulva and distribution of pubic hair. A normal vulva has downward-pointing triangularly distributed pubic hair with no ulcers, dermatitis or hypopigmentation in the perineal area. The mucosa around the urethral opening should be light pink without any growths. In married women, there may be old cracks in the hymen or perineum due to previous childbirth or episiotomy scars. If necessary, the doctor may ask the patient to bear down while observing for swelling in front and behind vaginal walls as well as signs of uterine prolapse or urinary incontinence. Any abnormalities will be documented in detail.

(2) Vaginal examination using a speculum: this procedure should be performed gently to minimize friction-related bleeding. Normal vaginal wall mucosa appears light pink with folds present; there should be no ulcers, cysts or congenital malformations such as vaginal septum or double vagina observed. Normal vaginal secretions are typically clear like egg white or have a white paste-like consistency with little odor; however, they may increase during ovulation and pregnancy. If there are abnormalities present (such as local itching), a sample can be taken at this time to check for trichomonas infection,candida overgrowth,gonococci bacteria,and clue cells among others; bacterial culture might also be necessary.The formation of leucorrhea is related to estrogen levels and it consists mainly from exudate from vaginal mucosa,cervical canal secretions,and endometrial gland secretions.