Task Force: Pelvic Exam Harm Outweighs Benefits

Holy Hormones Journal: Pelvic exams – the annual we go trotting off to a doctor every year have been found to have few benefits?  In the past few years, we have found out that the risks of HRT, synthetic hormones, mammograms, mastectomies, Gardasil the HPV vaccine and hysterectomies outweigh the 07.02.16 female-832266_640benefits purported by the pharmaceutical and medical industries. And now to find out that that in addition to the shame, embarrassment of thrusting your pelvis up in front of doctors who may also bring in a team of medical students prodding around your inner sanctum – a violation I might add, we find out that the rate of “false positives” which leads to more prodding and testing and prodding and diagnosis – and even more prodding ranges up to 46%? How many women have had to endure the unnecessary removal of their reproductive organs because of a false positive?

Pelvic exams can find endometriosis, ovarian cysts, uterine fibroids, warts, herpes, pelvic inflammatory disease, and cervical polyps. But research has not shown that detecting and treating these before they produce symptoms is better than waiting for early symptoms to appear, said Dr. Amir Qaseem, vice president for clinical policy at the American College of Physicians. “You want to find things before they cause symptoms only if you have treatments that will keep full-blown symptoms from appearing,” he said. “We don’t have those for the conditions pelvic exams find.”

BY Sharon Begley, STAT
June 28, 2016 at 12:09 PM EDT

Millions of healthy women undergo routine pelvic exams every year, but on Tuesday a panel of physicians and other medical experts cast doubt on this longstanding pillar of women’s preventive health care.

The US Preventive Services Task Force, which advises the federal government on preventive care, concluded that there is not enough evidence to recommend the procedure for healthy women. Studies have not shown that pelvic exams decrease a woman’s chance of developing illnesses such as ovarian cancer or of dying prematurely, the task force said.

Doctors who perform routine pelvic exams have vigorously defended their worth against previous criticism, but on Tuesday their organization, the American College of Obstetricians and Gynecologists, backed away from that firm stance, acknowledging there is little to no evidence that the exam benefits asymptomatic women.

The task force finding is the latest reminder that many seemingly sensible procedures have little basis in science and fewer clear benefits than once thought. In recent years, procedures such as screening mammograms and PSA tests for prostate cancer, and even annual physicals, have turned out to be of questionable benefit.

Its conclusion applies only to women who are not pregnant and who do not have pelvic symptoms, such as pain or unusual bleeding. It gave the pelvic exam a grade of “I,” for “indeterminate,” meaning “we don’t have enough evidence to determine the benefits and harms,” said task force member Dr. Maureen Phipps, professor of obstetrics and gynecology at the Warren Alpert Medical School of Brown University and chief of OB-GYN at Women & Infants Hospital of Rhode Island.

The public can comment on the draft recommendation, which was accompanied by a 71-page review of the scientific evidence, through July 25. After considering the feedback, the task force will issue a final recommendation, which the federal government and some private insurers can use to decide what procedures to cover.

The recommendation is unrelated to screening for cervical cancer, which the task force highly recommends. But that can be done without a pelvic exam, an internal and external inspection by sight and touch.

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Author: Leslie Carol Botha

Author, publisher, radio talk show host and internationally recognized expert on women's hormone cycles. Social/political activist on Gardasil the HPV vaccine for adolescent girls. Co-author of "Understanding Your Mood, Mind and Hormone Cycle." Honorary advisory board member for the Foundation for the Study of Cycles and member of the Society for Menstrual Cycle Research.