Women undergo pelvic exam to have the doctor assess and look for signs of illness in their reproductive organs. The procedure is part of a woman's regular check-up or may be recommended because of pelvic pain, unusual vaginal discharge and other symptoms.
One problem with pelvic exam is that it is invasive. The procedure involves having the doctor visually examine the genitals, insert a speculum into a woman's vagina to examine the cervix as well as place two fingers into a woman's vagina to assess if there is anything wrong with the ovaries, uterus and other internal organs.
A new set of guidelines issued by the American College of Physicians (ACP), however, may bring relief to women who are not comfortable going through the procedure regularly as the doctors' group recommended that healthy women can skip the procedure.
The clinical guidelines, which were published on Tuesday, July 1, in the Annals of Internal Medicine, advised doctors to stop using pelvic exam as a screening tool as it poses more harm than benefits.
The recommendation was based on a review of studies from 1946 to January 2014, which showed no evidence that pelvic exam can identify ovarian cancer in a stage when treatment is most effective or detect other abnormalities in women who do not show symptoms of medical problems such as pain and bleeding.
"For any exam or intervention that a doctor does, we need to have evidence of benefit, and we couldn't find any," ACP director of clinical policy Amir Qaseem, the lead author of the new guideline said. "We did find some evidence that the exam caused fear, anxiety, embarrassment, and discomfort in women and may be preventing some from getting medical care."
The guideline also states that the procedure should only be performed on women with particular symptoms. Qaseem and colleagues advised that doctors quit the routine exam except when a woman experiences unexplained bleeding, pelvic pain, bloating, vaginal itching or discomfort during sex. The guidelines did not also change current recommendations on screening for cervical cancer.
"ACP recommends against performing screening pelvic examination in asymptomatic, nonpregnant, adult women (strong recommendation, moderate-quality evidence)," the clinical guideline concluded.
It isn't, however, certain if doctors and medical providers take heed of ACP's recommendation. The American Congress of Obstetricians and Gynecologists (ACOG), for one, still recommends that women who are at least 21 years old undergo annual pelvic exam.
