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If you dread the annual pelvic exam, there may be some good news for you: current guidelines suggest that yearly trips to the OBGYN aren't medically necessary and that healthy women only need PAP smears once every three years.

Lying on an exam table with our feet in stirrups and a speculum inside our vagina isn't exactly most women's favorite activity. Most women, I'm willing to bet, dislike having pelvic exams just as much as they do going to the dentist — even though pelvic exams done right do not typically hurt. Despite this near-universal dislike, many women, American women in particular, subject themselves to annual pelvic exams because they believe them to be an important part of preventative healthcare.

Are those yearly trips to the OBGYN really necessary, though?

What Usually Happens At A Routine Gynecological Appointment?

If you haven't been for a routine gynecological check-up before, you may wonder what actually happens during these appointments. Gynecological well-woman check-ups in the US traditionally, and often still do, involve the following aspects:

  • Recording basic information such as blood pressure, heart rate, and weight.
  • A chat about your personal and family medical history, if you are seeing a provider for the first time.
  • A chat about your reproductive life, menstrual cycle, and any strange symptoms you may have noticed.
  • An external genital exam followed by an internal exam performed with a speculum, during which the provider will take a look at your cervix. A bimanual exam may be performed, during which the provider uses their fingers and hands to get a general impression of the state of your uterus, fallopian tubes, and ovaries.
  • You may receive a PAP smear, which checks for abnormal cervical cells.
  • STD testing, where relevant.
  • A breast exam.

Who Can Perform A Gynecological Exam?

Besides obstetricians/gynecologists, family practice doctors, nurses, physician's assistants, and midwives may all perform pelvic exams of the type described above. In fact, nearly every healthcare provider will know how to perform a gynecological check-up, but that does not necessarily mean they provide that service. In the Netherlands, where I live, my family doctor's assistant usually does PAP smears, for instance, while my friend in England gets hers done by her general practitioner.

Are These Exams Unpleasant?

If you're going for your first gynecological exam, you are bound to be a little nervous. The good news is that internal pelvic exams do not hurt, and PAP smears should not produce anything beyond the mild discomfort you may experience when you have menstrual cramps. Routine gynecological check-ups do not typically take any longer than 15 minutes and are no big deal.

You do, of course, have to get yourself to a doctor for one, something that will likely cost you money as well as time, depending on where you live and what your insurance policy is like. Even experienced patients who know that pelvic exams don't hurt may still find the exams highly unpleasant as well, because they do involve taking your clothes off and having a medical professional interact with your most intimate parts.

If you hate annual pelvic exams, you may be wondering if you really need to be getting them every year at all. The simple answer, it turns out, is "maybe not".
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