Big news: Pelvic exams are no longer necessary for women who don't have symptoms and aren't pregnant, according to a new recommendation from The American College of Physicians out this week. It's a topic we covered recently in our April 2014 issue, but it's not an excuse to ditch your regular gyno visits altogether. Here's what else you need to know.
So Long, Stirrups! By Laurie Tarkan
Imagine going to your gyno and not spending the appointment staring at the ceiling with your knees in the air. “Until the Pap test was introduced, a woman didn’t go to the ob-gyn unless she was pregnant or had symptoms like pain or bleeding,” says Carolyn Westhoff, M.D., a FITNESS advisory board member and professor of obstetrics and gynecology at Columbia University Medical Center. When the Pap became standard in the late 1940s, so did the yearly gyno exam. But in 2012, based on new research, the American College of Obstetricians and Gynecologists (ACOG) told its members to dial back on the Pap test and give it every three years; for women 30 and older who combine it with a test for human papillomavirus (HPV), the recommendation is every five years.
The reason: Although the Pap can be a lifesaver, there is no benefit to screening on an annual basis, because cervical cancer is slow growing. “If you do Pap smears frequently, you’ll get some results that are ‘not normal’ but aren’t cancer,” says Miriam Alexander, M.D., the director of the general preventive medicine residency program at the Johns Hopkins Bloomberg School of Public Health in Baltimore. “Patients might then be ordered to have uncomfortable additional testing, which causes anxiety and can, in rare cases, lead to severe complications.” As for annual pelvic exams, women simply don’t need them, research has found. The exams are not necessary to screen for ovarian and uterine cancers or sexually transmitted infections, and they don’t need to be done before a woman starts taking oral contraceptives. “Gradually, more and more ob-gyns are realizing that the pelvic exam doesn’t have to be done so frequently,” Dr. Westhoff says.
The Bottom Line: The ACOG still recommends an annual gyno visit, but unless you have a medical problem or new symptoms, you probably don’t need a pelvic exam between Pap tests, Dr. Westhoff says.
So, how often should I get tested? Pap Test: Every three years starting at age 21. If you’re 30 or older, every five years if you combine it with a test for human papillomavirus (HPV).
Exception: More often if results are abnormal.
Pelvic Exam: Not necessary if you are feeling fine.
Exception: Unless you have symptoms such as bleeding, pain, urinary problems or new or unusual discharge.
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