The cold exam table with its crinkly paper. The cold speculum and even colder lube. The cold stirrups that you are convinced you’ll slip out of. And let’s not forget the fact that your vulva, vagina, and rectum are literally on display for the whole world to see (or at least a doctor or two).
I don’t think anyone looks forward to their annual pelvic exam. And in fact, many women find it downright traumatizing. I know I did when I first started getting them at the ripe age of 16. It’s definitely gotten better over the years, especially as I’ve found medical providers whom I truly feel comfortable with. But it’s never fun, and like most women, I still pretty much dread it.
Of course, just because you don’t like a medical procedure doesn’t mean you should skip it. No one likes most medical procedures, but we do them because, duh, we’d rather not drop dead of a preventable illness. In terms of pelvic exams, though, there is some new evidence emerging that they might actually not prevent illness — and in some cases, do more harm than good, especially for healthy, non-pregnant women.
In early March of this year, a US Preventive Services Task Force panel released a recommendation regarding the practice of annual pelvic exams, published in the latest issue of JAMA, the journal of the American Medical Association. Their conclusions? They don’t see enough evidence for or against pelvic exams, and further research needs to be done. They recommend that the practice of annual pelvic exams for healthy women needs to be reevaluated STAT.
According to NPR, the panel recommends that as of now, women should confer with their doctors on a case-by-case basis as to whether the exam would be beneficial to them based on their health history, age, and other health concerns.
NPR explains that the original purpose of the annual pelvic exam was to check for the overall health of a woman’s reproductive system, including vagina, uterus, fallopian tubes, ovaries, and cervix. Dr. Kirsten Bibbins-Domingo, the doctor who chaired the US Preventive Services Task Force, tells NPR that the main reason physicians cite for the annual exam is to detect ovarian cancer.
But NPR points out that the claim that pelvic exams are useful in the detection and prevention of ovarian cancer has recently been called into question by the American College of Physicians (ACP), who published guidelines in 2014 challenging the idea of the exam as a useful tool for detecting ovarian cancer. The ACP say that pelvic exams not only aren’t the best way to detect ovarian cancer, but they have a high rate of false positives, leading to unnecessary stress and possibly unnecessary invasive procedures for women (um, no thank you on that one).
Of course, all of this is still in the beginning stages of being evaluated (although the American Congress of Obstetricians and Gynecologists still recommends annual pelvic exams for women 21 years and older, NPR reports that they too are in the process of reevaluating this).
But if it’s true that annual pelvic exams might not be necessary for the majority of healthy, non-pregnant women, I think a whole bunch of us will be rejoicing — at least in the days leading up to our annual gyno appointments. Not only do we all want to be spared the discomfort and mortification of sitting there with our feet in stirrups and our vulvas on display, but none of us should have to deal with the potential for false positives, stress, and unnecessary medical procedures.
As Dr. George Sawaya, a medical researcher and OB-GYN from the University of California, tells NPR: “We live in an era where it’s really important to make sure we have really excellent evidence when it comes to prevention. We don’t want to harm well people in our pursuit of trying to make them more well in the future.”
Hell yeah. I think we can all get behind the idea that our lady parts should only be meddled with if there is just cause to do so, amiright?
Keep in mind whatever happens with annual pelvic exams for healthy women, there will always be women for whom these exams will be useful and life-saving. The US Preventive Services Task Force panel recommends that anyone who has unusual pain, bleeding, or signs of infection be examined by a doctor ASAP. And the potential elimination of annual pelvic exams would not affect Pap smears, which are recommended every 3 to 5 years for women ages 21 to 65 as a highly effective screening for cervical cancer.
I mean, Pap smears are no walk in the park either (ouch!), but I can brace myself for one every few years, especially if there is good proof that it could potentially save my life. But I’ll be super-duper psyched if doctors indeed come to the overall conclusion that the spread eagle annual exam should be a thing of the past.