Many Young Women Could Be Receiving Unnecessary Pelvic Exam

“Many young women associate the examination with fear, anxiety, embarrassment, discomfort, and pain.”

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New research, published in JAMA Internal Medicine, has found that many teenage girls and young women are getting invasive gynecological exams, in spite of guidelines against the practice.

The authors of the study found that a vast majority of women between the ages of 15 and 20, who had an invasive pelvic exam during an OB/GYN visit, did not need one.

Study author Dr. George Sawaya at the University of California, San Francisco, said, “There are very few indications for a bimanual pelvic examination in girls and women.”

Pelvic exams typically involve applying mild pressure on the abdomen while inserting two fingers into the vaginal tract to determine any signs of infection or unusual growths.

The American College of Obstetricians and Gynecologists (ACOG) revamped the guidelines for pelvic exams in 2012, suggesting that pelvic exams were not recommended for women under the age of 21,

However, it can be recommended to women in that age group if they experience any gynecological symptoms or are pregnant. Also, it can be recommended if they should undergo certain procedures, such as IU device for birth control.

Dr. Sawaya and his team found that, in a single year, more than 1.4 million of the 2.6 million young women, who received a manual pelvic exam, were unnecessary.

The team explained that it is unclear why so many are undergoing manual pelvic exams despite the recommendations against the practice. They opined that it could be due to a habit of outdated OB/GYN practices.

Dr. Sawaya said, “We want to empower girls and young women to ask, ‘Why do I need this exam?’ if a gynecologist recommends it.”

“Many young women associate the examination with fear, anxiety, embarrassment, discomfort, and pain,” the authors wrote. “Women with a history of sexual violence may be more vulnerable to these harms.”

The study also found that more than 1.6 million of the 2.2 million women between the ages of 15 and 20 years had a “potentially unnecessary” Pap test within the past year.

Some experts say that young women may actually not need to see an OB/GYN specialist before the age of 21 unless they have symptoms of abnormal vaginal bleeding or discharge, or pelvic pain, or are pregnant.

Gynecologist Dr. Taraneh Shirazian at NYU Langone Health, who was not a part of the new study, said, “Women should know they don’t need to come in for routine testing before age 21. If they want contraception, they probably should come in for a discussion, but they don’t need an exam for that.”

“Gynecologists can provide a lot of information to young women that has nothing to do with hands-on exams,” Dr. Sawaya said. “That probably will ease a lot of anxiety about a first visit with a gynecologist, to know you don’t necessarily need to get an exam.”