The Great Pelvic Exam Debate

Featured Article, Women's Health
on July 7, 2014
pelvic exams

Ah, the annual pelvic exam. It’s an unpleasant and decidedly uncomfortable ritual that every woman has woefully endured at several points in her life. For years, we’ve dutifully donned a hospital gown, climbed atop a medical table, placed our feet in stirrups, and pretended to act unfazed while a gyno poked and prodded our lady parts with a variety of metal utensils. Pelvic exams are no fun, to say the least. But they’re necessary, we are told—crucial to our overall health, the single best way to screen against medical problems like ovarian cancer, vaginal infections, or uterine cancers.

But how necessary are annual pelvic exams, really? And what if it was okay—encouraged, even—to skip the dreaded stirrups? Very soon, that possibility might become reality. In a new report issued in June, the American College of Physicians urged doctors to stop performing pelvic exams in healthy, low-risk women who aren’t pregnant and have no symptoms. The report argued that there is no evidence to suggest that routine pelvic exams are useful and that the procedure might actually do more harm than good by inducing unwarranted anxiety, dread, and fear in otherwise healthy women.

The report, which was published in the Annals of Internal Medicine, determined that pelvic exams are not effective diagnostic screening tests for ovarian cancer, as doctors previously thought. What’s more, many vaginal infections and sexually transmitted infections are now diagnosed via urine or blood samples rather than through a gynecologic exam alone. Additionally, the bimanual portion of the pelvic exam, in which a physician inserts two gloved fingers up the cervix, can prove to be so invasive and traumatizing for some women, especially victims of sexual abuse, that it deters them from visiting the doctor altogether.

Bottom line? These examinations, the American College of Physicians concludes, are a time-consuming and expensive procedure that costs the United State healthcare system more than $2.6 billion every year in unnecessary medical expenses.

It’s important to note, though, that the recommended guidelines apply only to asymptomatic, non-pregnant women who come to the office with no medical complaints. What’s more, women should still obtain regular Pap smears to screen for cervical cancer.

Still, this recommendation comes as a big—and controversial—change. For years, the annual pelvic exam has been the cornerstone of the annual women’s physical check-up. Many medical professionals are decrying the American College of Physicians’ new recommendations, charging that a thorough annual pelvic exam is important because many women with abnormalities don’t realize that they have symptoms. This is especially crucial when you consider notoriously difficult-to-detect gynecologic diseases like ovarian cancer.

Will annual pelvic exams ultimately be deemed pointless? Only time will tell. One thing is for certain, though: If you’re experiencing any weird symptoms “down there,” always play it safe and give your gyno a call. And don’t neglect those Pap smears, either!

What are your thoughts on this debate? Comment below: