What the New Pelvic Exam Guidelines Mean for You

Why you should talk to your doctor about annual visits

Old and New Way

Not every woman needs a pelvic exam every year, according to new guidelines from the American College of Physicians (ACP). However, you may want to hold off on canceling that appointment. Experts say skipping your pelvic exam could still have some unintended negative consequences on your health.

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The pelvic exam has important benefits, says OB/GYN Rebecca Starck, MD. “While this exam might not save your life, for asymptomatic women, it can reveal things to watch out for, such as uterine fibroids, irregular discharge or other ongoing, but not life-threatening, concerns,” she says.

Physicians shouldn’t offer routine pelvic exams to women who are average risk, have no symptoms and aren’t pregnant, the ACP says. The organization says that these exams rarely detect dangerous diseases, don’t reduce deaths and add unnecessary costs.

“The ACP evaluated things like mortality, pain and false positives in their review of 50 years of literature on pelvic exams. They concluded that the exam doesn’t significantly reduce mortality or aid in early detection of ovarian cancer,” Dr. Starck says.

Pelvic exams offer wider benefits to patients

In response to the new guidelines, the American College of Obstetricians & Gynecologists issued an advisory suggesting that annual pelvic exams still have value in keeping women healthy. And you and your doctor should decide whether you should have one or not.

“Women who see their OB/GYN yearly develop a comfortable relationship with the provider. This is important because with the relationship in place, women are more likely to bring up issues they might otherwise be reluctant to discuss, like urinary incontinence and sexual dysfunction,”  Dr. Starck says.

One concern, which many gynecologists share, is that women might decide that there is no value in the annual well woman visit altogether. But skipping the annual checkup has the potential to harm women. Many women view their OB/GYN physicians as their primary caregivers, making the annual visit critical for overall health maintenance.

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Dr. Starck says the yearly well woman visit gives the clinician the opportunity to screen for high blood pressure, cholesterol levels, excessive weight gain and sexually transmitted diseases. Your doctor can monitor your menstrual history as well. Menstrual history represents an important indicator of overall health, especially for younger women.

Doctors frequently use this annual visit to discuss immunizations and quitting smoking, as well as to give advice about preventive health practices to follow between visits.

The parts of the well woman exam can vary depending upon age, risk factors, symptoms and family history.

Annual Pap smear still critical

Do these new guidelines mean women can also skip that uncomfortable and awkward annual Pap smear? No, the Pap smear is not included in this recommendation.

Some women need a Pap smear and HPV test, and some do not. At the time of your well-woman exam, your doctor can determine whether  the Pap is needed, either with or without the HPV test.

The Pap smear tests for abnormal cells in the cervix that can develop into cancer. Two strains of human papillomavirus cause about 70 percent of cervical cancers.

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“My fear is that with the new Pap guidelines and now the ACP’s suggestion about annual pelvic exams, women might misinterpret the message as meaning they don’t need to see a doctor each year,” Dr. Starck says.

Women with abnormal cervical cells don’t typically have troubling symptoms. Missing the annual visit could prove life threatening in this case.

In short, Dr. Starck, like many gynecologists, believes in yearly well-woman visits with pelvic exams as appropriate – for evaluating symptoms and screening for asymptomatic conditions.

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