A new draft recommendation statement concerning pelvic exams is being discussed.
A new draft recommendation statement concerning pelvic exams has been widely reported, yet some of the reporting has not made important points clear.
The statement from the U.S. Preventive Services Task Force concludes that for asymptomatic, non-pregnant adult women, “current evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations.”
In response, some media have used headlines like, “Task Force says women may not need pelvic exams,” but that’s misleading, said Mona Afrassiab, D.O., FACOG, a board-certified obstetrician and gynecologist at Lake Regional Health System.
“The Task Force is not recommending women skip these exams,” Dr. Afrassiab said. “Unfortunately, I think that’s the message some women are getting. The real point of this new draft recommendation is that more research is needed to assess the benefits of pelvic exams. Meanwhile, the American Congress of Obstetricians and Gynecologists continues to recommend annual pelvic exams for most women.”
It’s also important to note that the Task Force recommendation is not a final recommendation, Dr. Afrassiab said.
“This recommendation statement is still in the draft stages, which means it could change,” she said. “We don’t know what the final recommendation will be.”
What is a Pelvic Exam?
According to the American Congress of Obstetricians and Gynecologists, the pelvic examination includes an external examination, a speculum examination of the vagina and cervix, and an internal examination. When indicated, a rectovaginal examination also should be performed.
The pelvic exam is not the same as a Pap test, which is done to screen for changes in the cells of the cervix.
What Do Women’s Health Experts Recommend?
The American Congress of Obstetricians and Gynecologists recommends an annual pelvic exam of patients 21 years of age or older. However, it also recommends that “the decision whether or not to perform a complete pelvic examination … for the asymptomatic patient should be a shared decision after a discussion between the patient and her health care provider.”
“Each patient should be individually evaluated,” Dr. Afrassiab says. “In my opinion, no blanket statement on female care is adequate. Those with complete hysterectomies, who have no vaginal or perineal issues, can skip this exam. Women with no vaginal or perineal issues who have ovaries remaining still need ovaries palpated but can skip the speculum exam. Monogamous women who have no issues, with intact pelvic organs, need an exam at least every two years. Women who have frequent partner changes, even if they have no known issues, need a full exam every year. Any woman may decline a pelvic exam if she feels uncomfortable.”
To make an appointment with Dr. Afrassiab at Lake Regional Obstetrics and Gynecology, call 573-302-2764. To view her bio, visitwww.lakeregional.com/physicians.