A Pelvic Exam is Not Necessary to Test for Sexually Transmitted Diseases

There is a growing number of women who are declining routine pap tests and pelvic exams, but Doctors have found a way around this.  Doctors are now promoting yearly sexually transmitted disease (STD) testing together with a pelvic exam they claim goes with it.  While many women are  saying no to STD testing, there are some who agree to testing and who are also willing to tolerate the pelvic exam that Doctors are including.  However, a pelvic exam is not necessary to test for STD’s.  Blood and urine is all that is required to test for STD’s, the same way in which men are only required to supply blood and urine for the exact same tests.

Most Doctors will not offer a choice, so women who are asymptomatic/who do not wish to undergo a pelvic exam but who still want to be tested for STD’s will need to speak up.  If your Doctor wants to conduct a “whiff test”/”pH test”, which requires taking a swab from your vagina, you should know that these tests merely indicate bacteria and pH level of your vaginal secretions – they do not test for STD’s.  Both vaginal pH and presence of bacteria are often transitory meaning they will fluctuate depending on your time of the month, whether or not you have recently taken a bath, engaged in intercourse, used a tampon, etc.  You do not need a whiff test or a pH test to test for STD’s.

Doctors have recently added a test for Trichomoniasis to the list, an STD that causes itching/burning/odor.  If you suspect you have this and want to include it in testing, you will need to ask to perform a self vaginal swab.  However, Trichomoniasis is difficult to diagnose due to the poor sensitivity of the tests.  Both men and women can contract this STD but doctors do not usually bother to test men for it.  If you do not wish this test included you have the right to decline.  Do your research, protect your healthy mind and body.

A number of web sites reveal urine and blood tests are not only much less invasive to test for STD’s, they are also more accurate.  Excerpts and links to sites with more information:

Private Testing Center provides affordable testing for HIV and STDs, including herpes, chlamydia, gonorrhea, syphilis and hepatitis b & c. All of our HIV testing and STD testing is done through the blood and urine. No pelvic exams, painful swabs or embarrassing visual exams are necessary as blood and urine testing is the most accurate.

via http://info.stdtestexpress.com/metro/losangeles/how-it-works-177T-13751N.html

Guidelines from laboratory: Send 5-10 cc of first void urine for gonorrhea and chlamydia NAT.

For Syphilis draw blood in purple or red top tube.

std_testing.pdf application/pdf Object.

For chlamydia and gonorrhea “you can request the new urine tests instead of having to undergo an uncomfortable swabbing of your urethra.”

via Which STD Tests You Should Get and Why – MSN Healthy Living – Health and Wellness.

There is a quick and easy test for chlamydia and gonorrhea that can be done without a pelvic exam and without swabs. It simply involves urinating in a cup and the office sending the urine sample to a lab to test for these STDs. . . Testing for other STDs, including HIV and hepatitis B, is from blood tests.

via STD Testing – Tests for STDs.

Should You Get a Herpes Blood Test? If your doctor is unable or unwilling to perform a blood test for herpes, and you want to get screened, I highly recommend visiting your local STD clinic. STD clinics often have better resources for comprehensive STD screening than doctors in private practice. However, since some areas have formal guidelines that recommend against generalized testing for herpes antibodies, you may need to argue for why it is important to you to receive a herpes blood test. A known exposure is generally considered an acceptable reason to want to be screened for herpes, even when the desire to inform yourself and your partner(s) is not.

via STD Testing – Is There a Herpes Blood Test?.

The following methods can be used to detect Trichomoniasis (T. vaginalis):

  • In men a urethral swab and in women a high vaginal swab (can be self-collected) can be sent to the laboratory for culture of the organism. It is harder to detect T. vaginalis in men and false negatives are common. Reliability may be improved by combining a urethral swab with a urine sample for culture. It is often recommended that male sexual partners of infected females receive empiric treatment (without relying on culture results); however a full STI screen is still recommended due to the increased likelihood of co-infection with other STIs.
  • Wet mount microscopy – a small amount of vaginal discharge is placed on a slide with a few drops of saline and immediately examined under a microscope. The organism may be visible, but only for 10 to 20 minutes after collection of the sample. Excess white blood cells may also been seen in this fluid and indicates accompanying inflammation.
  • Cervical smear tests sometimes note the presence of trichomonads, however false positives can occur (less likely with liquid based cytology) so this should be confirmed with culture. A cervical smear test cannot be used as a screening test for trichomoniasis, due to the high number of false negatives.



  1. I thought readers might be interested in this piece about the Contagious Diseases Acts passed in Britain during the 1860’s and 1870’s, which allowed for any British woman to be forcibly escorted to the nearest police station to have a pelvic exam. A forerunner of our call and recall system for our cervical screening programme!

    • Honestly, that sounds a lot like the cops now. Things aren’t quite as broad as that, but more & more they’ve been directing things like that at people.

      I’ve got to ask: Why is the complaint always that it’s a MALE doctor doing something? Every time something creppy goes on, there’s always the distinction made between male & female. What’s the argument? That when a woman does something to another woman it’s the same as her doing something to herself? Or just that it’s not an attack?

      I get that there’s more likelyhood for a male involved in that situation to get aroused by it, but that’s also potentially true for women & gratification of an assailant isn’t the primary factor- it only adds to things. The problem is the act occuring, in itself.

      • Yes, these are my feelings exactly. A former GP of mine was a lesbian, and harrassed me at every visit for a smear test. When I had my first child, she got her way, and pressured me into 2 very painful ones, which I’ve made sure, ever since, were my last ever. She would also do pelvic exams at the drop of a hat, and being female, didn’t seem to require a nurse to be in attendance either. On another visit for a different matter, she suggested a breast examination. Needless to say, I’ve got a new GP now, but dealing with a lesbian, who can by-pass having another female in the room, is sometimes more dangerous and embarrassing to deal with.

      • Your intelligence in these matters is reflected best in your comment here and the further comment below. If we ever get together and print up a screen of items, things to watch for that commonly occur, alternatives to pap (which we successfully use), etc, your two comments here must be included.
        I have read in places where women will return to a female doctor that molests or brings them to orgasm. Why? Some have said they were flattered at being chosen. Others had so much trust in the doctor’s ability they would return. Regardless, these both reflect something going on mutually which is an extra doctor-patient relationship.
        Then these practitioners misread other patients who object to the sudden affection. It does not help that these exams, by design, stimulate our nipples, and then also stimulate every erogenous zone we have externally and internally. We experience the full feeling, involuntarily lubricate, and during the process we engorge and re-engorge (clitoris and labia) every couple minutes w/o realizing it.
        Then we go home trying to rationalize what just happened. These are medically condoned rapes. Our spouses end up being the therapists, the targets of our anger, and these issues complicate in the delivery room. The worst time for a husband to be excluded, or made to feel like he’s not welcome, are during these exams and during deliveries. Divisions in the relationship widen, and divorces germinate during and after these events involving stirrups.
        It’s almost as if husband is being forced off his wife in the jungle. Hate to say it that way b/c it may over generalize. But there’s many hormones involved, and the bonding instinct may shift. After all, husband is watching while doctor is, involved so to speak.
        A woman who carefully preps herself for the doc, excluding her husband from the exam, then refusing to discuss anything afterwards…it happens. A husband we conversed with felt very estranged afterward. Eventually he pressed the issue. His wife admitted to receiving a very thorough rectovaginal and would say nothing more. What’s worse, both parties live close to each other. In Texas. The older doc with his wife and the younger couple, wife being very attractive. Not a good situation.

  2. So why can’t you bring your partner or a friend to spend there while you get your exams? The chaperone is supposed to be the patient’s advocate so they do not have to be an employee of the doctor. If the advocate has a relationship with the patient then somehow they are a legal problem for the doctor?

    • This was some years ago when I was pregnant, and my husband didn’t attend all my visits, as they were during the day and he was working. Other than this, we don’t have regular “well-woman” exams here in the UK. Just the smear test every 3 years 25-50, then five yearly 50-65. I’ve only had 2 in my lifetime and that was bad enough.

    • When that’s the case, it’s time to find a new doctor. There’s something brewing between doctor and patient.
      An amazing thing re these doctors. They insist in being the medical care providers of their female employees. Years ago we read of this, where the doctor performed the exam and sparks flew. He then began working at separating the employee away from her husband. The husband worked in the medical field and somehow discovered things and intervened. Through therapy, the couple reconnected. The wife admitted within another short period she would’ve have left her husband for the doctor.
      The couple filed a complaint against the doctor, had him transferred, hopefully lived happily ever after. Hope doctor didn’t.

    • I agree. Some of us are getting on in years and my personal experiences are very dated. There have been some changes in recent years as dissatisfaction with cancer screening programmes has grown, and women are getting better informed about their limitations. I would like to see a lot of the issues discussed here being given a much wider hearing, but I’m not on FB.

      • There are numerous issues that you find in some places more than others:

        (1) Not thinking compositionally. Properties don’t change by designation. Just like if a doctor poisons someone with a needle, it’s still murder. A situation is what it consists of, but some people make an argument that functionally amounts to “what happens ISN’T what occurs.” Don’t know if these people really have this mindset, but when someone says “It’s not like that, it’s a doctor” it pretty much makes this exact point. It’s not like what? Reality?

        (2) Having an issue with fighting back. Don’t know where it comes from, but it’s a pretty common thing among men AND women in America as far as I’ve noticed. Not a complete & total thing, but widespread. Also, it seems like people worry about if something “counts” as

        (3) Coercion. Backing people into corners. Pretty simple: “You don’t get this without that.”

        (4) Guilt. Acting like somoene comporting their own medical situations is an act of tyranny. Also like they’re going to die & that’ll hurt the people they leave behind.

        (5) Impressions of defectiveness. Being defective by not allowing these tests to be performed on them, as well as general physical defectiveness. Their body is made out to be a ticking time-bomb, whether directly or subtlely. Constantly mentioning ailments as if it’s in response to constant occurances. It also comes off like a woman is likely to get a problem that only a woman can get just because she is a woman.

  3. It is beyond infuriating that women are deceived and harassed into any invasive, abusive exam that is completely unnecessary for STD testing. It absolutely is NOT. The current CDC recommendations strongly advise against pelvic exams for STDs. They have little to no clinical value. Anything any doctor “claims” they check for can be done via some other reliable diagnostic assay. For example, NAATs, which is SELF collected, is the gold standard for chlamydia and gonorrhea. Syphilis, HIV/AIDS, HBV, and HCV require blood tests. Trich is also SELF collected. I’m absolutely fed up with the abuse women face at the hands of doctors. Are these idiots going to claim they can feel bacteria and viruses? The only two that require visual checks and biopsies are genital warts and herpes. Lesions MUST be present for the tests to work, though. Its not worth the trauma when asymptomatic and no other reason exists for such an invasive exam. And I’ve heard that women are forced to submit to breast exam for STD checks. WTF???? Boobs don’t get STDs. I’ve only ever used Planned Parenthood for STD checks, and the always used urine, blood, and saliva (for HIV). Thank god for PP!

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