Expert Panel Says Healthy Women Don’t Need Yearly Pelvic Exam

The annual pelvic exam often dreaded by women may be antiquated and now unnecessary.
Ask any woman about getting a pelvic exam and they will tell you that it is uncomfortable, embarrassing, and seldom yields any results that impact a woman’s healthcare. Now a recent report by the American College of Physicians suggests that the annual pelvic exam is unnecessary.

For decades, doctors have believed this exam may detect problems like ovarian cancer or a bacterial infection even if a woman had no symptoms. And sometimes it does. But recently experts have questioned whether the yearly ritual adds value to a woman’s health.

In the new guidelines, published in the Annals of Internal Medicine, an expert panel appointed by the American College of Physicians recommends that healthy, low-risk women not have routine annual pelvic exams. The panel based this advice on a systematic review of prior studies. They not only found no benefit from the annual pelvic exam, they found that it often causes discomfort and distress. Sometimes it also leads to surgery that is not needed.

The new guidelines only apply to the pelvic exam, and only in healthy women. The panel urged women to keep getting checked for cervical cancer. Also, the experts emphasized that pelvic exams remain a necessary part of the evaluation in any woman with symptoms that could be related to a problem with the vagina, cervix, uterus, Fallopian tubes, or ovaries.

A test women do need
Although seemingly healthy women may not need a pelvic exam every years, being tested regularly for cervical cancer can save a woman’s life. Here are the recommendations for women at average risk of cervical cancer:
• ages 21 to 29: a Pap smear once every 3 years.
• ages 30 to 65: a Pap smear every 3 years or a combination of a Pap smear and HPV test every 5 years.
• over age 65: routine Pap screening not needed if recent tests have been normal.
Keep in mind that these are guidelines. For personal reasons, you and your doctor may wish to choose HPV testing first or have more frequent Pap smears than recommended.
If during a routine appointment your doctor wants to perform a pelvic exam, and you aren’t keen on the idea, feel free to ask why you need it and what he or she is looking for. That’s not a challenge. Based on current evidence, there should be a reason for doing a routine pelvic exam.

Bottom Line: The annual pelvic exam should be a shared decision between doctor and patient. It is reasonable for women to ask their doctor whether a routine pelvic exam is necessary, and to ask for more information on the possible benefits and risks of the examination.

Medical Testing At Age 50-This Is Test You Can’t Afford to Fail

Most men and women do not need the services of the medical profession between the time they leave their pediatricians around age 18-20 until age 50. The exception is women who see their obstetrician for perinatal care and deliverying their children. Around age 50 you should start making regular visists to your doctor. This article will discuss the routine tests that you should consider when you reach middle age.

When you go for your annual physical, make sure your doctor performs or recommends these simple tests that may save your health — and your life — later. (Note that your doctor may recommend additional tests based on your personal health profile.)

Thyroid hormone test. Your thyroid, that innocuous looking gland in your neck, is the body’s powerhouse, producing hormones needed for metabolism. Aging (and an erratic immune system) can wreak havoc causing a variety of problems, especially in women. That’s why women should get a thyroid test at age 50 and then every 5 years.
The rectal exam. Dread it; hate it; joke with your friends about it: Just make sure you get one — every year. Along with other tests your doctor may recommend, it may give clues to treatable problems in your colon (think colon cancer) or prostate for men. Screening colonoscopy is recommended for everyone at 50 years old.
Stepping on the scales. This is the age when most people start gaining weight. Watch this weight gain carefully, and fight back with healthier eating and exercise. Being overweight puts you at high risk for developing a number of diseases — and studies show that weight loss can improve your odds.
Blood pressure. Untreated high blood pressure is an equal opportunity killer: It kills your heart, your brain, your eyes, and your kidneys. Don’t let hypertension sneak up on you. Get the test. It’s simple; it’s cheap; and it’s quick.
Cholesterol profile. Do you have high cholesterol? Find out — at least once every 5 years (more if you’re at risk for a heart attack). Controlling your cholesterol can add years to your life.
Blood sugar. Untreated diabetes can destroy your health, causing heart disease, kidney failure, and blindness. Don’t let it. Get a fasting blood sugar test at least once every 3 years and take control of diabetes early.
For women only: Pelvic exam and Pap smear. You may think you have suffered enough — at least 20 years of pelvic exams and Paps! But you still need these — especially if you’re sexually active. Ten minutes of mild discomfort once every 1 to 3 years pays big dividends in protecting you from cancer and sexually transmitted diseases.
For women only: Breast exam and mammogram. At this age, don’t ever let a year go by without getting a mammogram and having your doctor examine your breasts for any changes. Early detection of breast cancer can save your breast and your life.
Looking for moles: Love your skin. Check your skin monthly for any unusual spots or moles. Be sure to ask your doctor to check your skin once a year, as well.
Protecting your eyes. Vision-robbing diseases become more common as you age. Be sure to get your eyes examined regularly — every 2 years until age 60 and then yearly after that. Go more often if you have vision problems or risk factors for eye problems.
Checking your immunizations. People over age 50 should get a flu shot every year. And don’t forget, even healthy people need a tetanus booster shot every 10 years, and one of those should contain the pertussis vaccine for whooping cough. Be sure to ask your doctor to update any immunizations that you might need. Consider Hepatitis A and B vaccines if you haven’t already had them.

Use your birthday as a gentle reminder to schedule a visit to your dentist, and call your doctor to see if there are important tests you should take. By investing an hour or two now, you may be able to add years to your life.

Bottom Line: When you go for your annual physical, make sure your doctor performs or recommends these simple tests that may save your health — and your life — later. Remember of you don’t take time for your health, you won’t have time to enjoy life in your senior years.

For more information on women’s health, I suggest my new book, What’s Going On Down There-Everything You Need To KnowAbout Your Pelvic Health. the book is available from Amazon.com

New book on women’s health