Annual Pelvic Exams Don’t Do Much Other Than Make You Uncomfortable

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Photo: Angela Wyant

A group of health experts said Tuesday that there is not enough evidence to recommend annual pelvic exams in healthy women who aren’t pregnant or who don’t have gynecologic symptoms.

Stat describes the pelvic exam as “an internal and external inspection by sight and touch,” which is code for when your gyno sticks their gloved fingers inside you and prods your lower abdomen with their other hand to feel your reproductive organs. (The Pap smear is a separate test involving the god-awful speculum and a swab of your cervical cells.)

The pelvic exam makes sense on its face as it can help doctors diagnose problems like ovarian cysts, uterine fibroids, and pelvic inflammatory disease, and the American College of Obstetricians and Gynecologists (ACOG) has defended the procedure in the past.

But the U.S. Preventive Services Task Force, which advises the government on health-care practices, conducted a review of studies and gave the exam a grade of I, for “indeterminate” because they couldn’t determine the benefits and harms of the pelvic exam for four conditions: ovarian cancer, bacterial vaginosis, genital herpes, and trichomoniasis.

Not only can pelvic exams lead to false positives and cause unnecessary stress, alternatively, they can give women a false sense of security. Another medical group, the American College of Physicians, says that finding and treating conditions like cysts or fibroids before a woman has symptoms isn’t any better than treating them once she develops symptoms.

ACOG said it’s reviewing the draft recommendation and will decide if it needs to update its own pelvic-exam guidelines (which call for yearly exams in women 21 and older), but stressed that, either way, women should see their gynos “at least once a year.” To be clear, the USPSTF says women 21 to 65 still need a Pap smear every three years (though some doctors do those annually) so the speculum isn’t going anywhere.

The recommendation is open for comments from the public and from doctors until July 25. After reviewing the comments, they’ll issue a final recommendation, which some insurers can use to decide what procedures to cover.