Study: Women’s vaginas don’t need yearly supervision after all

Research-savvy women who avoid doctors and forgo birth control prescriptions in order to escape pelvic exam coercion have recently been handed additional evidence to support their decisions.  A study looking at the pros and cons of pelvic examinations found that routine screening exposes women to unnecessary and avoidable harms with no benefit (reduced mortality or morbidity rates).  In a nutshell, the findings from the study support the following conclusions:

  • Pelvic examinations in asymptomatic women do not reduce morbidity or mortality rates
  • Many false-positive findings are associated with pelvic examinations
  • Harms include unnecessary laparoscopies or laparotomies, fear, anxiety, embarrassment, pain, and discomfort, psychological and physical harms, as well as harms associated with the examination itself
  • Studies that tracked the misdiagnosis rates and the unnecessary procedure related harms were conspicuously absent in the reviewed literature – and the researchers reviewed literature dating back to 1946 (in other words, no one is keeping track of the extent of these unnecessary harms)
  • No evidence was found that pelvic examinations in asymptomatic women provide any benefit

As a result of the study findings, the American College of Physicians (ACP) strongly recommend that doctors stop performing routine pelvic examinations.

Different versions of this news were recently splashed all over mainstream media and many not-so-mainstream media venues such as Slate.  It would have been difficult to miss the news that doctors have been advised to stop performing routine pelvic exams. However, given the backlash from ob-gyns and those women who believe they have been protected by routine exams one is left wondering if any changes will take place.

 

About forwomenseyesonly

Hi. My name is Sue and I am interested in promoting holistic and respectful health care.
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18 Responses to Study: Women’s vaginas don’t need yearly supervision after all

  1. cindy knoke says:

    yep read this earlier and thought of you!

  2. Alex says:

    Why is it “strongly suggest”? Don’t these doctors get TOLD something? What’s the idea? That they’re taught a variety of medical procedures & cobble together whatever agenda they want?

    Instead of it being a “Hey, do whatever you want” situation, it should be a “You have no option for including attack in your methods of practice” situation. Where do they get the notion that they have some kind of right to defend incompetance?

    P.S.- I know there’s no way to say anything so that someone else can’t lie or twist your words, but they’d be trying to pull the same things whether someone argued with them or not.

  3. Elizabeth (Aust) says:

    http://www.forbes.com/sites/peterlipson/2014/07/03/should-you-get-an-annual-pelvic-exam/

    This male doctor says:
    “There is no magic to the pelvic exam. Since the vagina is part of the body, it gets examined. Skipping the genitals seems about as smart as skipping the lung exam. What is so special about the genitals that we should skip them?”

    Actually he should skip the lung exam as well, the whole annual examine-everything exam is not evidence based either and leads to over-investigation etc. Also, I don’t buy the vagina and ear are viewed in the same way argument. Yeah, sure….

    “I find the “emotional” component idiotic in this sense: it assumes that women are too psychologically fragile to have their genitals examined, and it assumes that gynecologists have no training or common sense in dealing with survivors of abuse, assault, and rape. This is an argument for better doctoring, not for abandoning an exam altogether.”

    This doctor doesn’t get it, does he?
    Why on earth would anyone want their genitals examined for no good reason and when that practice exposes you to risk? Many women find this exam difficult for all sorts of reasons, it should not be performed unless it’s absolutely necessary and the woman provides informed consent. (symptomatic cases and even then it’s so unreliable it may be better to use other diagnostic tests, like the ultrasound)

    “I find the recommendations put out by internists to be paternalistic and premature. The data aren’t sufficient to draw conclusions. It seems arbitrary to leave out a particular body part from a physical exam. If good studies are done in the future, ones designed specifically to evaluate the best way to approach women’s health, we should use that data to change our practices. For now, I see no good reason to eliminate the female genitals from the physical exam”

    No, the recommendation is based on the evidence. Poor clinical value and the exam carries risk. No, the research is clear and that’s why other countries ditched this exam many years ago.
    HE sees no good reason, his patients might though, some may choose to use the services of someone who follows the evidence in the future…and who puts the interests of his patients first.

    Some doctors will say anything to hang onto this exam.

    • Karen says:

      Oh the ship is sinking, and the rats are squeaking… music to my ears! Especially this one: “The data aren’t sufficient to draw conclusions. ” Yes, all SEVENTY YEARS of it. The one about women being too “psychologically fragile” to be coerced into quasi-sexual acts could be said by a paedophile too.

    • Karen says:

      “How many pelvic exams does it take to diagnose one patient with ovarian cancer? How many does it take for a patient to disclose to her doctor a history of unsafe sexual practices, difficulties with intercourse, or a history of rape?”

      It is useless in detecting ovarian cancer. Regarding the torture, ie penetrating the sexual organs in order to extract information, said information is NONE of their business. If someone would say they were a rape victim, what on earth this paternalistic male doctor would reply back, or could do for them? And unsafe sexual practices, what are these smoking????

    • Mint says:

      The genitals are not “another part of the body”. If this was the case, there wouldn’t be laws regarding indecent exposure. For example, my husband cannot walk up the high street exposing his genitals without risking an arrest. However, I can fearlessly walk up the high street exposing both ears!

    • Heather says:

      Right, Elizabeth!
      It feels at times that doctors will keep insisting on pelvic exams even if the exams are proven deadly. It’s like waiting for a car salesman telling you not to buy a car and ride a bike instead, isn’t it?

      Elizabeth, you are doing such a heroic job of educating women around the world! I’m proud to be from the same country as you — Australia. I prefer to think of it as the country where Elizabeth lives, not a country of arrogant doctors, ignorant women and medical malpractice.

      I probably have to thank you for now my happy life. I’m pretty sure that it was one of your posts years ago, somewhere in a blog about useless pap smears that made me think and start my own research.
      Me and my partner have never been with anyone else in our lives, and I absolutely trust this man that he will never cheat. Nevertheless, we had all the tests done, including HPV — all negative. And yet doctors in every medical practice we go to when we move were treating him like an able human being, and me — as someone who has to be told to undress, spread my legs and let my genitals poked and probed no matter what the reason of my visit was. And of course, all that bull$hit about life-saving cervical screening was poured into my ears every time I tried to question doctors’ orders.

      Thanks to one of your old posts, I realised that no screening can possible be beneficial for me, and only risks me to suffer unnecessary ham. I said bold and fat NO to all intimate exams, and don’t say yes to any tests before I do my own research. I simply don’t trust doctors anymore. I guess what: a feel much better, happier and healthier now than ever.

      Thank you!
      It was great to find this blog and to see you here.

      • Elizabeth (Aust) says:

        Heather, welcome to the forum, you’ll enjoy it here, full to the brim with informed women.
        Now that’s (sadly) still a fairly rare thing, but we’re moving in the right direction.
        It warms my heart to hear one of my posts prompted you to take a closer look at this “life-saving” and “simple” test. I’ve always felt if my rantings helped a few people, it was worth the exercise, and the abuse that sometimes comes my way. I have to say though, the abuse, editing, being banned from sites etc. has dropped dramatically in the last 3 years, change is in the air!

        I despair for Australian women, (well, all women really) when I read the NY Times it now seems like lots of Americans are questioning the value and need for these exams, yet I’m not sure the same can be said for us.
        Americans now are being fed a steady stream of articles critically examining these tests and exams, while the crickets are still chirping here. Papscreen is rarely challenged even though I believe they give women BAD medical advice and have no respect for informed consent. (or consent itself, “offer her a pap test on the spot”) IMO, their mission is coverage, their survival, and meeting a govt target, they couldn’t care less about women. So women here get one message: get screened or die an early and preventable death! (and that’s been the case for decades)

        Thanks to Robin Bell from Monash University we’re now hearing about the risks and uncertainties with breast screening. (that only happened about a year ago, even though concerns about mammography have existed within the profession for many years)
        Dr Alex Barrett has joined them and I hope as time goes by, more will find a conscience and join these brave advocates prepared to stick their heads over the screening parapet.
        (or give women the NCI summary on breast screening, enabling them to make an informed decision)

        I think we’re miles behind as far as awareness of risks and ACTUAL benefit (if any) and critical discussion is concerned. (compared to the UK and the States) The States has Dr Gil Welch and the team at Dartmouth, Dr Carolyn Westhoff, IBIS (pushing for OTC access to the Pill etc.) and others, the UK has the fearless and persistent Prof Michael Baum, Margaret McCartney, Hazel Thornton, Angela Raffle and many more.
        I attended the Evidence Live Conference in Oxford last year and there were speakers from Australia, I wouldn’t call them advocates though, I’ve never once heard them publicly challenge screening in this country…the non-evidence based program, no respect for informed consent/consent, misinformation, the unethical tactics used to get women screened, the harms of screening/excess biopsies/over-treatment and over-diagnosis, the ethics of hidden target payments. There is a LOT they could talk about and challenge. I left feeling we have few in this country fighting for our rights, protecting us from these programs, challenging the outrageous etc.

        I think the States may see the Pill off-script before we do, the AMA should hang their head in shame, their conduct has been disgraceful, they’ve sided with these programs, still link the Pill and pap testing and will fight to maintain control over women…so no OTC access to the Pill and no self-testing. (and probably the introduction of a call and recall cervical screening program…why? Greater control over women)

        Our new program (if it’s approved) has excess built in to keep vested interests happy, we’ll use HPV primary testing FROM age 25, when we know women under 30, (about 40%) will be HPV+, transient and harmless infections that will clear by age 30. I’ll bet these poor women will be sent for immediate colposcopy and biopsy. No HPV self-testing will be offered unless you decline the invasive version of the HPV test for 6 years. (that gives them plenty of time to hassle you)
        AND, HPV primary testing will continue until an absurd 74. (not 60)
        (and we’re extending the breast screening program to include those up to age 74, why? There is no evidence of benefit, but it’s political brownie points and more joy for vested interests. I see more false positives, fear, anxiety, excess biopsies, over-diagnosis and over-treatment. (that will harm many women and take some lives)
        We had an opportunity to put women first, but once again, vested interests came first, they KNEW they had to change our pap testing program, it’s harming huge numbers of women that’s getting harder to hide, but had to keep all those who feed off this program happy so they didn’t scare the herd. A problem when you’ve deliberately misled women over decades and denied them a right to choose, to make an informed decision.

        It seems to me many or perhaps, even most, women here don’t question cancer screening and we do that at our peril. These programs expose us to serious risk for no, little or uncertain benefit.

        So pleased you found the information you needed to make an informed decision. Yes, lifetime mutually monogamous partners are never mentioned by this program, we’re told, “if you’ve had sex, even once, you’re at risk”…THEY feel it’s safer to assume all men are unfaithful. Of course, if they respected women as competent adults, they’d give us real and complete information and allow us to make that assessment.
        They don’t have the right to keep us in the dark, make decisions for us, make assumptions about us and our partner or accept risk on our behalf.
        I look forward to reading more of your comments.

    • Heather says:

      Elizabeth, thank you so much!
      I can only guess how much of your personal time you dedicate to this noble mission of educating women and revealing the truth, and how much of insult and mistreatment you receive along the way. This makes you literally a hero.
      You saved me years of disgusting tests, pain, anxiety and possible harm. You gave my partner a happy, confident woman. You made both of us question every doctor’s “recommendation”, and as a result our health improved. You empowered me to pass the information to my family and friends, and many of them done the same further.

      I won’t be wrong to assume that you might’ve saved thousands of women around the world. If the “Australian of the Year” award wasn’t so politically-brownie-point-ed, you should’ve been one of the nominees at the very least.

      It is just very unfortunate that Australian health care, as a system, is an utter disgrace: infection rates of the third-world magnitude; misinformation, misogyny and paternalism of the early last century era; doctor’s incompetence not deserving of that of a developed country; the usage of womens health care in political and monetary gains; and almost total inability to put the patients’ interest above everything else. Every year, when I’m lodging my tax return and filing the Medicare and PHI section, I’m disgusted and ashamed to think of what we are actually paying for.

      Australian medical system works along two lines:
      1. To gain for itself (power, money, influence, etc).
      2. To protect itself (to be able to keep doing the #1 indefinitely).

      Any questions, challenges and free-thinkers are ignored, ridiculed or silenced.
      And that is why I admire you so much Elizabeth! You dare to question, you find the truth, and you selflessly share it with others. And you give people a chance for a happy and healthy life. I know that for sure, from my personal experience.

      Thank you for being you!

  4. ADM (Canada) says:

    I cannot figure out the medical system. They hold on tight to ideas from bad or outdated or misunderstood science such as the link between cholesterol and heart disease and drink eight glasses of water a day. The research linking cholesterol and heart disease was found to be wrong when it was replicated and yet Dr’s still prescribe mediation to lower cholesterol in the effort to prevent heart disease. They ignore current research showing a link between vitamin D and many illnesses and cancer. But when a seventy year longitudinal study clearly shows that the pelvic exam is of low clinical value they cling to it. Looking at the picture in the linked article I can clearly see that they couldn’t feel anything. The DRE was dropped from medical practice on much less evidence. The Dr’s are all panicking and saying must protect income. The medical system claims it’s based on science but it’s really based on protecting income which is why many Dr’s to not follow evidence based practice.

  5. Jola says:

    A friend of mine went to a gyno once a year to have an exam just because she thought it was ”necessary”. She told me that every time she’d had the exam, she’d experienced some infections. The infections were troublesome so she went again to get a prescription for an antiseptic, but to get it, she ”had to” have a exam, which obviously caused another infection. The antiseptic ointments didn’t work too much. Her grandma advised her to make irrigations of CAMOMILE, MARIGOLD, NETTLE AND SAGE – normally bought as tea bags and they did work. Since she made a couple of irrigations, she hasn’t been at a gyno at all and hasn’t had any infections – magic?

    • Anonymous says:

      Yeah and doctors will tell you NEVER to douche. If women healed themselves with herbs and nutrition how would they ever make any money?

      Even having sex ONCE is a risk for HPV? They sell that hogwash to the lesbian community with anything in the vagina, a finger, a toy, a tampon and they all need Pap tests even if they or their partners never had penis in vagina sex.

      I am waiting to see what the new Ontario health minister, a male doctor responds to pressures about the every three year Pap test rule passed by his predecessor. They still do not fund the HPV. It is recommended but has to be paid for by the patient, $70 and it is only available with a Pap test and pelvic exam.

  6. Article re: $190 million settlement on lawsuit concerning Dr. Levy and the more than 8,000 women he filmed while performing pelvic exams http://www.cbc.ca/news/health/johns-hopkins-to-pay-out-190m-to-settle-lawsuit-over-secret-video-recordings-1.2713649

    From the article: “Some women told of being inappropriately touched and verbally abused by Levy, according to Schochor. In some cases, women said they were regularly summoned to Levy’s office for unnecessary pelvic exams.”
    Well, it turns out that almost ALL pelvic exams are unnecessary. Also from the article it states many women ” were so traumatized that they dropped out of the medical system, and some even stopped sending their children to doctors“. Women don’t have to have been filmed in order to “drop out of the medical system” – the exam on its own is traumatic enough. Especially when coerced or bullied into it. When will there be some recognition or transparency about what occurs on a daily basis in women’s “health care”?

    • Moo says:

      More about this case.

      The doctor was fired but committed suicide some days later. The hospital her worked for has the pay the settlement. It is doubtful that most victims will get any money because most of the photos did not include their faces, only their genitals. How are these women going to have get their compensation and go through having their name in public and possibly photos as evidence in public court. The dmage is huge.

      How this man abused women verbally and touched them inappopriatey. Was there any record of complaints agianst this doctor or were his victims to afraid or embarrassed to come forward? Among his patients were also girls, 62 numbered in the article I read. He also circumvented the policy of having a chaperone in the room at all times. How ,any times was he alone with a patient/victim?

  7. Alex says:

    I’ve got a question: What, if anything IS a regular pelvic exam useful for? Apparently, the pap test portion that tends to get included, but isn’t terminologically linked, doesn’t work as advertised & can cause serious problems on its own or serve as a catalyst for other things that do.

    I was wondering if it was just an added poke for its own sake & for sake of having something to connect false indications to. Can’t say “Well, we think you have this because of our blind assumption.”

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