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Regular pelvic exams, are they necessary?

image courtesy Alex E. Proimos via flickr

Pelvic exam. Just the thought causes women of all ages to shudder. Yet, year after year, ladies make pelvic exam appointments because it’s the right thing to do.

What if it wasn’t necessary to endure the awkward and often uncomfortable procedure?

Susan Perry of MinnPost challenged the tradition in an article citing the New York Times, which said:

An increasing number of experts now challenge the value of this time-honored practice, which is done as a matter of course when women come in for routine gynecological checkups or Pap smears.

To clear up some questions, Health Talk turned to Carrie Ann Terrell, M.D., director of Obstetrics, Gynecology and Women’s Health at the University of Minnesota Medical School and director of the Women’s Health Specialists Clinic.

Health Talk: How often should women have pelvic exams? What does a “regular exam” mean?

Carrier Terrell: The data is not clear on this topic. There are several national committees evaluating when and how often a routine screening pelvic exam is indicated.

HT: Why do women have pelvic exams?

CT: Historically, we cited multiple reasons requiring women to have annual pelvic exams. The most common was due to annual Pap smear screening, but with the new ASCCP guidelines we no longer routinely perform annual pap smears on many women. Other reasons that have been stated include: cancer screening, screening for ovarian masses, screening for STDs, screening for abnormal skin lesions.

HT:  Do you feel regular pelvic exams are necessary?

CT: The data suggests routine screening pelvic exams do not yield improved outcomes or reduced disease. At the same time, they are often anxiety provoking and uncomfortable for patients. In general, physicians are often opposed to performing exams that are uncomfortable if no proven clinical benefits have been shown.

HT: How likely is it that the regular pelvic exam will eventually go the way of the pap?

CT: Very likely.

HT: Would losing the regular pelvic exam minimize the necessity of the annual exam?

CT: We are already reconsidering how we label and characterize preventive care. We see our role evolving into being a team member to help women maximize their health rather than a point person screening for disease.

HT: Are there other reasons for an annual?

CT: Preventive care guidelines for women vary by age group. Not all preventive tools are needed annually. I do believe most women benefit from regular communication with their health care team (which may include a physician, midwife, advanced practice nurse, and/or complementary health provider such as TCM, acupuncture, chiropractor, etc.).

While it seems annual pelvic exams may eventually become a thing of the past for some women, it’s good to remember annual appointments with your clinical provider are still important.

Check out why taking some annual “YOU” time should be regularly added to the to-do list: here.


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