The doctor generally feels around your belly and pelvic area while also having their fingers inside you. It’s generally uncomfortable (as is the entire pap smear process), and occasionally even unpleasant. But like so many other things in life, it’s something women put up with because we know that it’s good for our health.
Except… it might not be so good for our health after all. In fact, pelvic exams have been making headlines for some time now, with various studies suggesting that the entire exam process is actually relatively useless.
And last week, the American College of Physicians – America’s largest medical-specialty organisation – released new guidelines that give a “strong recommendation” against performing pelvic examinations on women who are not pregnant and have no symptoms.
The ACP reviewed published literature from 1946 through to 2014 to determine just how useful the pelvic exam is when screening for pathology. They examined accuracy of the screening pelvic examination in detecting cancer, pelvic inflammatory disease and other gynecologic conditions. They also examined issues relating to overdiagnosis and overtreatment, with false positives being very common.
The result? The “diagnostic accuracy of the pelvic examination” was very low – in other words, it did little to detect any problems. 96.7% to 100% of abnormal pelvic examinations did not identify ovarian cancer, and there was no reduction in cancer mortality rates that could be associated with the pelvic examination.
However, significant harms were found through the study – including “fear, anxiety, embarrassment, pain, discomfort and urinary tract infections and symptoms, such as dysuria and frequent urination.” 10% to 80% of women who experienced a pelvic exam reported feeling fear, embarrassment, or anxiety, and some even experienced pain – as a result, they were less likely to return for another exam.