Do You Need That Annual Gynecological Exam?

The annual pelvic exam was a rite of passage all women living in the US — though not many other parts of the world — were encouraged to go through until very recently. By getting routine check-ups, it was thought, doctors would be able to catch problems ranging from cervical cancer to ovarian cysts (long) before women would begin suffering symptoms, thus opening the door for timely treatment.

However, the American College of Physicians introduced new guidelines in 2014 suggesting that healthy, low-risk women don't actually need annual routine pelvic exams at all. After looking at the currently existing body of scientific data, the panel that devised the new guidelines concluded that there is no valid medical reason for these routine check-ups. Indeed, the panel noted that pelvic exams often cause a significant amount of distress in individual patients, as well as that they can lead to surgery that wasn't really needed.

You Still Need PAP Smears (But Not Every Year)

There's a big "but" here, though: the American College of Physicians still fully recommends that women undergo PAP smears at regular intervals, as do physicians across Europe and the rest of the world. PAP smears screen for changes that can indicate cervical cancer, and can be life-saving.

Women should have their first PAP smear at age 21, and then repeat the procedure once every three years until they turn 29. Women aged over 30 may consider, in conjunction with their healthcare provider, having a PAP smear every five years as long as it is combined with a test for HPV. PAP smears are no longer generally necessary in women over 65.

These guidelines, it should be noted, apply only to women whose results have been normal. Those with risk factors such as HPV, previously identified precancerous cells, a weakened immune system or prenatal exposure to DES should have more frequent PAP smears.

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Is That It, Then?

Can you stop having annual pelvic exams, then? The American College of Obstetricians and Gynecologists still recommends them, unlike the American College of Physicians. Not all medical professionals agree, then.

Meanwhile, if you do decide to stick to PAP smears at the recommended frequency while skipping annual pelvic exams, don't forget that your health depends on your active participation as a patient a great deal. If you do notice pelvic pain, unexplained menstrual bleeding, or suspect you could have a sexually transmitted disease, it is your responsibility to make an appointment right away. You will also still need to see your OBGYN or another qualified healthcare provider for your birth control needs and during pregnancy.