Do Healthy Women Benefit from Routine Pelvic Exams?

Posted by Admin on September 10, 2015
The pelvic exam is a routine part of a women's gynecologic examination, but a new review performed by the American College of Physicians demonstrates that for healthy women it is likely doing harm rather than good. The doctor's group is now issuing new guidelines that advise against it.

The authors of the review note that the new guideline only applies in the case of pelvic exams and does not apply to Pap smear screenings for cervical cancer. The American College of Physicians recommends that such screenings should be restricted to a visual inspection of the cervix and taking cervical swabs to test for cancer and in some cases HPV.

For several decades, the pelvic exam has been a routine aspect of preventive care for women in the US, where 63.4 million exams were performed in 2008. However, some in the research community have started to question whether this regular function of a woman's routine checkup is medically justified.

Drawing on 52 published studies, the American College of Physicians analyzed the evidence to date and found that the routine pelvic exam has a low rate of success as a means of identifying gynecologic cancer or infections.

However, in instances where women have symptoms such as pain, urinary problems, abnormal bleeding, vaginal discharge, or sexual dysfunction, the pelvic exam is then the appropriate screening measure to take. However, in healthy women with no symptoms and only average-risk, the study investigators found no evidence supporting the use of pelvic examinations.

Immediate past president of the American College of Physicians, Dr. Molly Cooke, explains that the findings demonstrate that pelvic examinations expose healthy women to unnecessary and avoidable harms, including anxiety, discomfort, and embarrassment, and may even prevent some women from needing medical care. She also warns that false positive findings can also lead to excessive and unnecessary screenings that add extra costs to the health care system.

 

Written by Stuart Diamond

Empowered Doctor Editor-in-Chief

 

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