Perimenopause, Menopause, and Post-Menopause Pelvic Exams…..What The Pap?!?!?
Unlike me, your days are probably not consumed with reading everything you can get your hands on that speaks about health issues relating to the vagina! Therefore, you might have missed the ongoing conversation in the medical world regarding pelvic exams.
I always say when it comes to the vagina, dry is out! So brace yourself, this subject is a bit dry!
The U.S. Preventative Services Task Force’s (USPSTF) draft recommendation statement, “Gynecological Conditions: Periodic Screening with the Pelvic Examination” is a follows:
“The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations in asymptomatic, nonpregnant adult women.”
The American College of Obstetricians and Gynecologists (ACOG) responded to the U.S. Preventive Services Task Force’s draft recommendation statement, “Gynecological Conditions: Periodic Screening with the Pelvic Examination” with the following recommendations:
“As the nation’s leading group of physicians providing health care for women, ACOG stresses that women should see their ob-gyns at least once a year. In addition to the screenings, evaluations and counseling that clinicians can provide, the annual well-woman visit is an opportunity for the patient and her ob-gyn to discuss whether a pelvic examination is appropriate for her. ACOG promotes shared communication and decision making between the patient and the physician regarding pelvic examinations.
The USPSTF’s draft recommendation statement concludes that there is not enough evidence to determine the benefits or harms of performing screening pelvic exams in asymptomatic, non-pregnant adult women for four specific conditions: ovarian cancer, bacterial vaginosis, genital herpes, and trichomoniasis.
ACOG is reviewing the USPSTF’s draft recommendation statement and the evidence upon which it is based to assess whether there is a need to update its guidance on the routine pelvic examination. ACOG recommends annual pelvic examinations for patients 21 years of age or older. However, the College recognizes that this recommendation is based on expert opinion, and limitations of the internal pelvic examination for screening should be recognized.
Notably, there are many women who are likely to benefit from a pelvic exam. For example, women who report or exhibit symptoms suggestive of female genital tract problems, menstrual disorders, vaginal discharge, incontinence, infertility or pelvic pain should receive a pelvic examination.”
The North American Menopause Society is urging public comment on the USPSTF routine pelvic exams draft evidence review. JoAnn V. Pinkerton, MD, NCMP, Executive Director of The North American Menopause Society (NAMS), along with the NAMS Executive Committee responded, “The pelvic exam is needed to screen for conditions such as the genitourinary syndrome of menopause that affects more than 50% of postmenopausal women, neoplasias (abnormal growth of tissue), fibroids, pelvic floor conditions, and dermatologic conditions associated with elevated disease risks. The recommendation to perform pelvic exams only if women complain of problems will lead to missed opportunities to diagnose pelvic issues.”
The opportunity for public comment on the draft review evidence expires on July 25, 2016, at 8:00 PM EST. To comment, go to USPSTF draft evidence review.
Here is my personal take on all of this, and it is not because I love putting on that “gown” and saddling up in those stirrups. My annual gynecologic exam is way more than a pap smear. I want to be checked for vaginal atrophy, have my breasts examined by a professional (although David thinks he is qualified!) and also make sure that I am having the proper preventative screening labs and immunizations.
I think a healthy patient-doctor relationship, provides the foundation for a healthier me!
ACOG has some wonderful visuals on their current advice on Annual Well Women Healthcare. They created these visuals with links to further explain each one!
My motto is: Suffering in Silence is OUT! Reaching out is IN!