Do We Say Goodbye to Pelvic Exams?
After a review of studies conducted between 1946 and 2014, the The American College of Physicians (ACP) - which represents 137,000 internal medicine physicians and related s
pecialists - recently released new guidelines regarding an annual pelvic exam.
A pelvic exam consists of inspection of the external genitalia; speculum examination of the vagina and cervix; bimanual examination of the adnexa, uterus, ovaries and bladder; and sometimes rectal or rectovaginal examination.
Pap smears on the other hand is a method of cervical screening used to detect pre-cancerous and cancerous cells from the cervix and endocervix.
The new guideline concluded that the risks posed by pelvic exams may outweigh the benefits for most healthy women since they may result in false positives, leading to unnecessary tests and procedures. Also the ACP states that the exam "rarely detects important disease and does not reduce mortality." Having a pelvic exam can cause women discomfort, anxiety, pain and additional medical costs. Studies also showed little benefit in detecting ovarian cancer or other disorders.
As a result the ACP “recommends against performing screening pelvic examination in asymptomatic, non-pregnant, adult women” who have no elevated risk of cancer or other disease.
The American College of Obstetricians and Gynecologists, however, immediately responded in favor of doctors’ continuing to perform routine pelvic screening on healthy women. That group “continues to firmly believe in the clinical value of pelvic examinations,” it said in a statement, which helps physicians to diagnose incontinence, sexual dysfunction, and allows them to explain a patient’s anatomy.
This topic is still controversial among different organizations, therefore, you should discuss with your primary care physician or gynecologist if having an annual pelvic exam, in addition to pap smears, is appropriate for you.
Dr. Anele Manfredini is a family physician who specializes in women’s health, and she practices at the Dorothy Mangurian Comprehensive Women’s Center.