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
This Test At Your Gyno’s Office Is Painful And A Waste Of Time