PSA: annual well-[uterus] exams have no medical basis

[untonuggan]

via Slate:

Just two years ago, the American College of Obstetricians and Gynecologists admitted that “no evidence supports or refutes the annual pelvic examination … for the asymptomatic, low-risk patient.” Nevertheless, ACOG reupped its endorsement of the exam, writing that it “seems logical.” The procedure—which is routinely initiated early in a woman’s teen years and conducted annually—can aid in “establishing the clinician–patient relationship” and provide “an excellent opportunity to counsel patients about maintaining a healthy lifestyle and minimizing health risks,” ACOG reported. In other words, according to ACOG, while the annual pelvic exam might not be worthwhile in and of itself, it can be a useful device for bringing a woman to her doctor every year to get some necessary information about her reproductive health.

These conflicting recommendations—one by internists, the other by gynecologists—speak to the effects of cultural shaming on women’s health.

...

In 2012, the United States Preventive Services Task Force and the American Cancer Society released new recommendations suggesting that women should undergo routine pap smear tests every three years, not once a year. In March, an Food and Drug Administration panel voted to replace the pap smear—in which a doctor scrapes cells from the cervix that are analyzed under a microscope for visual abnormalities—with an HPV test targeted at identifying the strains of the virus most likely to lead to cervical cancer.

***

Basically, it's your body and you can make your own decisions based on family medical history and your own risk factors. But if your doctor(s) have been giving you grief about needing to get a pelvic exam or pap smear and that's not something you're comfortable with, the article has good links to alternative recommendations about timing or different medical procedures that do the same thing and do not involve a speculum.

(YMMV, I am not a doctor, insurance coverage may vary, standard disclaimers apply.)

Comments

[kaberett]

(If you want more data to throw at them, here's the NHS schedule.)

[the_rck]

I'm likely to keep getting exams just because of the links between breast cancer and things like ovarian and uterine cancer (and the PBB exposure we had increases risk for all estrogen related cancers, so), but to really check for that, I'm going to have to request uterine ultrasounds which I really hate due to the discomfort.

[untonuggan]

ugh that sounds not good.

and yeah, thus part of the why "depends on family history."

:/

[pipisafoat]

except for the part where, if you want birth control, they don't give it to you without an exam.

my gyn was like "well, now that we've put the IUD in and confirmed that your pap is normal, just go see someone in five years to have the IUD replaced! unless you have issues, of course."

[redsixwing]

^ hormones, too.

Nothing makes me want to go to the doctor like making it so I can't have maintenance meds without my unnecessary, unpleasant* appointments. >.<

*uncomfortable to painful to I'll just stare at this wall for a bit, why don't I

[untonuggan]

wtf even is that.

i got my psych hormones without a pap magically. *clings to magical doctor* *clings to psych hormones that make life magical*

[shehasathree]

That is so bizarre - as far as I know it's not a thing at all here in Australia. (I'm 34 and I've actually never had a pap smear, but I am unusual in several regards. But certainly I am not aware of doctors refusing to prescribe birth control without a pap smear here; also, most people get birth control prescribed by their GP. Also probably a lot get a pap smear done by a GP, too, rather than a gynaecologist.)

[cadenzamuse]

Seriously? Seriously? Does ACOG not realize that they might have a chance at building relationships and rapport with patients if they suggested an evidence-based annual exam that didn't involve an uncomfortable, invasive, and potentially triggering manual exam?

*headdesks forever*

[untonuggan]

RIGHT? RIGHT?

my most headdesk moment is when they're all "well women expect it and it helps us build a rapport with patients" and I'm like: no. no. no NOPE NOPE RIDES NOPETOPUS INTO THE SUNSET.

[syntaxofthings]

*bookmarks* I've gotten out of those most of my life due to Congenital Anomalies™ but probably soon will need to have this with me at appointments.

[untonuggan]

<3

[lavendertook]

Thanks for this.

After my last experience with a gyn, I am done with pap smears. If I get cervical cancer, so be it.

[untonuggan]

<3

that is kind of where i am with this too.

[altamira16]

My current physician suggested the three year exams, and that is what we are doing. She has yet to give me a papsmear because I went to a gyn just before i saw her. Basically, she said that if we are not making babies, she can do the papsmear part of things.

[untonuggan]

my latest strategy is just to tell my GP that a GYN did a pap, and if I have to see a GYN for something (like the endo) I tell them my GP did a pap. then I "forget" to send requests to transfer records and no one needs to know because it's my damn body dammit.