Should You Skip Your Annual OB/GYN Exam?
by Anna Maltby
It seems like a given that women should get a pelvic exam every year, right? Well, a surprising new research review and practice guideline suggests that it might actually not be a great idea.
According to a new American College of Physicians systematic review of published literature on human subjects, routine pelvic exams do not benefit asymptomatic, average risk, non-pregnant women--and might even cause more harm than good.
For those women, pelvic exams, the guideline co-authors say, rarely detect important disease, don't reduce mortality and may lead to false positive or false negative results and unnecessary cost. Plus, they make many women uncomfortable. (Ya think?)
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Note that this only applies to the pelvic exam--i.e. the super un-fun part of the appointment where your ob/gyn performs a manual examination with her hands in your vagina (and sometimes rectum). The ACP findings and guidelines do not suggest changing current U.S. Preventive Services Task Force recommendations for Pap tests (where your doc inserts a speculum and collects cervical cells to test for abnormalities) and visual inspections for cervical cancer. Those recommendations are a little complicated, but basically for women between 21 and 65, they say you should get screened every three years. (You can read more about that at uspreventiveservicestaskforce.org.)
Ok, but isn't it better to be safe than sorry? It can be hard to understand the drawbacks of overtesting, but in this case they really do seem to outweigh the benefits, Dr. Linda Humphrey, a co-author of the guideline and a member of ACP's Clinical Practice Guidelines Committee, told SELF.
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"In the case of the pelvic exam harms include discomfort associated with the exam, fear, anxiety or embarrassment associated with the exam--and anticipation of it--the potential to put time into conducting the exam and not into doing other things that do help patients (for example, counseling about smoking), concern about diagnosing problems that don't matter (such as fibroids in the absence of symptoms) and concern about false reassurance (for example, delaying care when symptoms are present because one just had an exam and it was 'OK'--this issue applies to all screening test," Dr. Humphrey says.
The takeaway for you: If you're not pregnant and don't have symptoms (such as vaginal discharge, abnormal bleeding, pain, urinary problems or sexual dysfunction), it's OK to skip your routine pelvic exam, Dr. Humphrey says.
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