Are Pelvic Exams Really Necessary?

Two national physician groups are at odds now that a new study has found that annual pelvic exams aren't actually necessary.

According to the findings of the American College of Physicians (ACP), published this week in the Annals of Internal Medicine, women who aren’t pregnant and show no signs of a medical problem (abnormal bleeding, pain, urinary difficulties, sexual dysfunction) don’t need an annual exam, due to a lack of evidence that the screening (usually done for gynecological cancers and abnormalities such as ovarian cysts) is actually necessary.

The report could be good news for women, many of whom call the procedure everything from "embarrassing" to "painful," and for the 1.5 percent who have unnecessary surgery as a result incorrect findings. Often, women schedule a checkup with their gynecologist to refill a birth control perscription and end up getting the pelvic exam as part of the visit, not because they have any health concerns.

But the new recommendations differ from what the American College of Obstetricians and Gynecologists (ACOG) advises: that women 21 and older should have an annual pelvic exam. "We leave the decision to get an annual pelvic exam to the patient and her doctor but we do believe the exam should be annual," Barbara Levy, MD, appointed vice president for health policy at ACOG, tells Yahoo Shine. "That way, we can screen for cysts and other abnormalities and examine the position of the bladder, the tone of the muscles and vagina, and the hormonal environment."

Researchers still strongly encourage the Pap smear, however, which screens for cervical cancer. ACP advises visual inspection of the cervix and vaginal swabs to test for cervical cancer and human papillomavirus (HPV). However, medical experts don’t require yearly Pap smears for women who are not at risk for cervical cancer (average-risk women can undergo them once every three years, beginning at age 21). And women can still be screened for sexually transmitted diseases with a urine test or vaginal swab.

As for ovarian cancer, Levy admits that skipping the pelvic exam would not put women at higher risk for the disease. Since there is no way to test for the rare cancer, a pelvic exam would not detect its signs. The exam, however, still has other benefits, she says. "In general, women should take advantage of their yearly pelvic exams to open a dialouge with their doctors about their overall gynecological health."

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