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In the last few years, the guidelines on the required frequency of cervical cancer screening (Pap smear) have changed, and more recently, even the importance of your Yearly/Annual Pelvic exam has been up for debate amongst established medical societies. The American College of Obstetricians and Gynecologists, ACOG, recently released their rebuttal statement, reconfirming their support for the importance of the Annual Pelvic Exam. Their statement was made in response to the recently released article from the American College of Physicians supporting the contrary, recommending against the annual pelvic exam in asymptomatic women, thus bringing into question the utility of the exam.
It already feels strange to me as an Ob/Gyn, to have to re-learn and re-teach against the age old adage of ‘have your pap smear done every year smear’. But now as well, as a Women’s Reproductive Health professional, I feel placed in a position of having to defend the importance of having the yearly pelvic exam performed by a gynecologist.
So I’ll just make it plain. While the study notes that the pelvic exam does not decrease mortality from ovarian cancers, with all due respect, screening for ‘death by ovarian cancer’ isn’t the only reason for the pelvic exam. There is plenty of other information that we as gynecologists are assessing with the exam. A thorough inspection of the your female anatomy, including the outer vulva and inner vaginal tissues, assessment of infection, moles, warts, polyps, bladder/genital/rectal prolapse, detecting sources of pelvic pain, urinary incontinence, and the presence of ovarian cysts and fibroids, would be just a few.
Until we as women are able to become the contortionists that we’d need to be in order to examine ourselves (or trust our ‘untrained’ partners to do the exam), why would we want to omit the pelvic exam?
If concerns of anxiety, fear, or pain are the reasons for omitting the pelvic exam, let’s at least make that a shared decision for discussion between you and your healthcare provider…before opting for ‘No Pelvic Exam’ as a standardized guideline.
Find here ACOG’s statement on the Annual Pelvic Exam:
Suzanne Hall, MD, FACOG
Eastside Gynecology Obstetrics, PC