It is being reported that new recommendations state that most women do not need to have a yearly pelvic exam done. The American College of Physicians is saying that the procedure has no known benefits when it is performed on women who are free of symptoms and who are not pregnant. The exam should be dropped from a woman’s yearly routine care, the internists group said on Monday.
They have based their findings on a review of evidence that did not find any studies which supported that the pelvic exam was finding ovarian cancer or any other type of severe disease. What the review did find was that having the test ended up causing distress in nearly 80 percent of women who had it.
The recommendation is already raising a lot of debate. Some doctors are applauding it while others feel it could easily set back preventive health care for females. It could also create confusion because it does not apply to women who suffer from abnormal bleeding, pelvic pain, sexual dysfunction or other such symptoms. This is also not about Pap smears, which is the screening test for cervical cancer where a physician collects a section of cells from a woman’s cervix. Every single major medical group continues to endorse and recommend having Pap smears performed, although no more often than every three years unless told otherwise.
What this does mean is stopping the visual inspection of female outer genitals, the placing of a speculum in order to look at the cervix and vagina and then a two-handed external and internal exam in order to feel for abnormalities in the ovaries and uterus.
However the American College of Obstetricians and Gynecologists, or ACOG, continues to vouch for an annual pelvic exam for every woman over the age 21 but also states that there is a lack of strong evidence either for or against the practice. It declares that the exam is not needed to monitor for sexually transmitted diseases or to prescribe for birth control.
The text has much value for many women who visit their gynecologists for their usual care, says Barbara Levy, who is vice president of ACOG. For one thing, she says, women often do not speak about having pelvic pain until a doctor ends up finding some sort of abnormality. Most women feel reassured when they are told that their genitals and reproductive organs appear normal and healthy.
Taraneh Shirazian, who is a professor of gynecology, obstetrics and reproductive science at Mount Sinai Hospital in New York, stated that disregarding the exam would mean giving women less comprehensive medical care and that is not good. However numerous gynecologists are questioning the exam. Some have declared that it has become more of a ritual than an evidence based practice.
Ranit Mishori, who works as an expert in family medicine and is a professor of medicine at Georgetown University in Washington, D.C., stated that she believes the basic pelvic exam does not have any value for patients so she does not offer it in her practice. She explained that there are numerous women that do worry about not having it done but most are extremely happy to hear what her belief system is. She said there are many women who even avoid going to the doctor because they do not want to undergo such an exam.
New recommendations have been released that state most women do not have to undergo a yearly pelvic exam. The American College of Physicians is saying that the procedure has no known benefits when it is performed on women who are free of symptoms and who are not pregnant. The exam should be dropped from a woman’s yearly routine care, the internists group said on Monday.
By Kimberly Ruble