Should you say goodbye to the annual pelvic exam?

The pelvic exam has been part of the "well-woman" visit for generations. According to new guidelines from the American College of Physicians (ACP), that ritual may be coming to an end. In the July 1, 2014, Annals of Internal Medicine, the organization recommends against pelvic exams for women who are neither pregnant nor have symptoms of pelvic disease.

The pelvic exam evolved over decades because it seemed a logical way to screen for fibroids and benign cysts as well as uterine and ovarian cancers. The term refers to the bimanual exam, in which the vagina is dilated with a speculum and the clinician places one hand inside the patient's vagina and the other on her abdomen to feel the ovaries, uterus, and other pelvic organs. The new recommendation was developed after a review of 52 studies found no evidence that pelvic screening reduced disease or saved lives. About 30% of the women in the studies reported some distress associated with the exam, including anxiety, embarrassment, and physical pain.

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