New Pelvic Exam Guidelines: What Should You Do?

ABush Editor
  • What is a pelvic exam?

     

    When a doctor performs a pelvic exam, she is looking at and feeling the size and shape of the external and internal reproductive organs. These include the vulva (outside), and vagina, uterus, ovaries and fallopian tubes (inside).  

     

    Why do you need one?

     

    Though its efficacy and safety have recently been debated, doctors typically perform pelvic exams to make sure that your reproductive organs are healthy. A doctor will feel for masses, fibroids, cysts, and other unusual things. Many clinicians recommend that you have your first pelvic exam when you become sexually active or reach the age of 18 years.

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    Do you still need one even if you’re not sexually active?

     

    Even if you’re not sexually active, it is important to have a pelvic exam if you have not begun to menstruate around the same time as other young women your own age, or if you have had problems with bleeding, pain or discharge.

     

    What are the benefits of a pelvic exam?

     

    Occasionally, doctors will be able to feel a mass or cyst.

     

    What are the potential harms?

     

    Across eight surveys, anywhere from 11 percent to 60 percent of women called pelvic exams painful or uncomfortable. And, in seven studies, 10 percent to 80 percent of women cited fear, anxiety or embarrassment. Lastly, sometimes doctors may perform an unnecessary procedure, like an ultrasound, if they feel something suspicious.

     

    What is the new recommendation and why was it made?

     

    The recommendations, laid out by the American College of Physicians (ACP), advise against pelvic exams for women who aren't pregnant and have no symptoms of a potential problem. The ACP looked at 52 published studies from 1946 through 2014 and it couldn’t find any supporting evidence for routine pelvic exams. The possibility of finding cancer or other diseases in non-pregnant women without symptoms was very low. Also, the doctors found some harms, such as incorrect exam results that led to unneeded testing.

     

    The catch

     

    These recommendations come from the ACP, which covers U.S. internists, however most women get their pelvic exams from gynecologists, who are covered by the American College of Obstetricians and Gynecologists (ACOG). The ACOG says that all women age 21 and older should have an annual pelvic exam. The guidelines from the ACOG go on to acknowledge that “no evidence supports or refutes” the annual screening exam -- and that the decision is ultimately up to women and their doctors.

     

    The bottom line

     

    Speak with your own doctor and decide whether a pelvic exam is necessary. Of course, if a woman has a symptom out of the ordinary, such as persistent bloating or cramping, she should ask for a pelvic exam.

     

    Sources:

     

    NIH http://www.nlm.nih.gov/medlineplus/news/fullstory_147075.html

    ABC News http://abcnews.go.com/Health/wireStory/guideline-healthy-women-skip-pelvic-exam-24371758

Published On: July 14, 2014