Yearly Pelvic Exams: Not Anymore!
Are you still getting pelvic exams every year? If you dread the indignity and discomfort of pelvic exams, there may be some good news for you. Recommendations have changed recently. Read this to find out how often you should get a PAP smear or a pelvic exam.
This year, at least 3 major groups which advise doctors have changed their opinion on pelvic exams. The AAFP (American Academy of Family Physicians) and the ACP (American College of Physicians) now both recommend against routine pelvic exams in women. USPTF (US Preventative Task Force) also updated their recommendation though they felt more information was necessary for a definite answer.
New Recommendations for Pelvic Exams
Your first PAP should be at 21 years old. From then until 30, it’s every 3 years. HPV testing, which looks for the virus which causes cervical cancer, should not begin until you are 30 years old.
From age 30 to 65, if your HPV test is negative and your PPA is ok, you’ll only need a pelvic exam every 3-5 years. Some guidelines say 3 years and some say 5 years.
Many women ask, “Shouldn’t I have at least a pelvic exam?” The answer, according to these new guidelines, is that it is not necessary unless you are having unexplained or worrisome symptoms.
After the age of 65, if your PAPs have been negative up to that point, you can graduate and be done with pelvic exams forever. That’s the good news. The bad news is that ovarian cancer and uterine cancer are still a risk. But studies show that doing a pelvic exam, blood tests, ultrasound nor CT scan make any difference in the outcome.
It is very important to note that the new recommendations refer ONLY to routine pelvic exams for healthy women. These guidelines do not apply to women who are pregnant or those with existing conditions or symptoms that need to be evaluated.
Should I keep getting pelvic exams?
There is a lot of conflicting information right now. Although the USPTF recommends “more research,” many professors admit that this research is unlikely to occur. One physician, Dr. Michael Freedman of Evolve Direct Primary Care,”It allows doctors to spend more time focusing in on the more preventable causes of death women face.”
“With increasing evidence suggesting pelvic exams are not helpful, I’d rather focus on preventing heart disease, colon and lung cancer and all the other highly preventable causes of disease and death women face.” Michael Freedman, MD, Annapolis, MD.
To that point, 4 different ovarian cancer screening studies showed that 96% of the time doctors thought they found a cancer, they were wrong. The women in the “96% false positive” group ended up with unnecessary follow up procedures to rule out the cancer and spent weeks or months terrified they might have a deadly cancer.
New guidelines for pelvic exams and Pap smears
- No exam under 21 necessary.
- Ages 21 – 29: Pap every 3 years.
- Women 30 – 65: Pap plus HPV test every 5 years.
- Over age 65? If you have had regular cervical cancer testing in the past 10 years with normal results do not need further pelvic exams or PAPs.
- Please note that women with a history of a serious cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing goes past age 65.