Truth
About Pelvic Exams
Many healthy women undergo unnecessary
pelvic exams each year. Studies have showed that there are no
benefits of pelvic exams on healthy women without symptoms.
The US Preventive Services Task
Force, which advises the federal government on preventive care,
concluded that there is not enough evidence to recommend the
procedure for healthy women. Studies have not shown that pelvic
exams decrease a woman’s chance of developing illnesses
such as ovarian cancer or of dying prematurely, the task force
said.
The task force finding is the
latest reminder that many seemingly sensible procedures have
little basis in science and fewer clear benefits than once thought.
In recent years, procedures such as screening mammograms and
PSA tests for prostate cancer, and even annual physicals, have
turned out to be of questionable benefit.
Its conclusion applies only to women who are not pregnant and
who do not have pelvic symptoms, such as pain or unusual bleeding.
It gave the pelvic exam a grade of “I,” for “indeterminate,”
meaning “we don’t have enough evidence to determine
the benefits and harms,” said task force member Dr.
Maureen Phipps, professor of obstetrics and gynecology at
the Warren Alpert Medical School of Brown University and chief
of OB-GYN at Women & Infants Hospital of Rhode Island.
The exams can also cause harm
(in addition to discomfort, for some women), said Phipps. Their
rate of “false positives” — finding an apparent
problem that isn’t there — ranges up to 46 percent.
For instance, when a pelvic exam “detects” ovarian
cancer, the chance that the woman actually has that often-fatal
disease is 0 percent to 3.6 percent. But a woman given that
frightening news, or the less dire news that she has a less
serious condition such as ovarian cysts or fibroids, will typically
undergo additional, sometimes risky, tests, including biopsies
and even surgery for something that might never have affected
her.
Pelvic exams can also give false reassurance. When an exam finds
no sign of ovarian cancer, for instance, there is a chance the
woman actually has it, according to studies reviewed by the
task force. Such “false negatives” can cause a woman
to ignore early symptoms of a potentially deadly disease, Phipps
said.
An estimated 76 percent of preventive care visits to OB-GYNs
include a pelvic exam, and US physicians performed 62.8 million
of them in 2010, the last year for which the task force had
data. Insurers typically reimburse doctors about $35 for them.
Ovarian cancer is extremely rare
and the most reliable way to diagnose ovarian cancer is through
an ultrasound or blood test — not a pelvic exam.
You can have an urine test for
STDs rather than a pelvic exam.
Medical Disclaimer: The
information on this web site is for educational purposes only.
It is not intended in any manner as professional medical advice.
You should consult a healthcare provider to determine the appropriateness
of the information on this article for your own situation, or
if you have questions or issues regarding a medical condition.
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Sources:
Pelvic
exams for healthy women have no proven benefit, U.S. panel says
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Test At Your Gyno’s Office Is Painful And A Waste Of Time
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