"The pelvic examination has held a prominent place in women's health for many decades and has come to be more of a ritual than an evidence-based practice," declared doctors George F. Sawaya and Vanessa Jacoby in an editorial published this week in the Annals of Internal Medicine.
Doctors who chose to continue employing the invasive examination must "clarify its goals and quantify its benefits and harms," argued Sawaya and Jacoby, both OB-GYNs at the University of California San Francisco.
But not all doctors are on board with abandoning the routine exam.
Though the American College of Obstetricians and Gynecologists has admitted the pelvic examination "lacks data to support a specific time frame or frequency," the group still recommends women above the age of 21 undergo a yearly exam after consultation with their physician.
On Monday, the group said it "continues to firmly believe in the clinical value of pelvic exams." Some doctors with the group say the intimacy and trust established during the exam enable women to feel comfortable sharing symptoms they might otherwise keep to themselves -- an openness that can help doctors detect problems before they increase in severity.
In this sense, the group says the exam acts as a prod towards more diligent care and good health; if taken away, the American College of Obstetricians and Gynecologists argues, women may be more likely to ignore symptoms and leave potential problems unaddressed for too long.
"It is the experience of the members of our practice committee and our executive board and those of us who created this guideline that, indeed, women coming to see us who are 'asymptomatic' often have issues that they want to discuss but don't raise them with us initially," said Dr. Barbara Levy, the vice president of health policy at the American College of Obstetricians and Gynecologists. "The pelvic examination creates an opportunity for us to raise those issues with a patient if we see something on the exam."
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