Blogs     Women's Health    

Confession of a Gynecologist: I Don't Get Yearly Pelvic Exams

Recommendations regarding the usefulness of routine pelvic exams

Dr Padma Garvey/Plant-Based Doctor Mom

Confessions of a Gynecologist:  I Don’t Get Yearly Pelvic Exams

In 2016, the US Preventative Task Force (USPTF) came out with recommendations regarding the annual gynecologic examination in a healthy woman with no complaints or issues.  It is important to stress that the recommendations do not refer to a pelvic exam that is performed in order to evaluate a patient with gynecologic symptoms or complaints.  Essentially the USPTF found no overall benefit to a woman's life expectancy with routine pelvic exams.  Pap smear recommendations are separate.  Nowadays, pap smears can be done every 3-5 years depending on the patient's risk factors and the type of pap smear performed.  Tests for gonorrhea and chlamydia can now be done on urine samples and swabs that the patient collects herself.  So after the USPTF recommendations came out about annual gyn exams, a fair number of patients asked me about the recommendations.  While some women dread the pelvic exam, a significant number find being told “everything is ok” very, very reassuring.   So patients may get something out of a check up besides measurable impacts on life expectancy.  

The USPTF was established in 1984.  Its members are national experts in prevention and evidence-based medicine.  They receive no compensation for their work.  They cannot have any conflict of interests with pharmaceutical companies or with groups that would benefit from the task force’s recommendations. They are independent and unbiased.  They examine all available evidence and research before making recommendations on screening tests and prevention.  Most importantly, the task force does not take cost into consideration.  The USPTF is only concerned with what has been PROVEN TO work and what doesn’t work.  This is slightly different from similar panels in other countries like Canada, the United Kingdom, Switzerland, etc.  Panels in these countries also consider cost in their recommendations.  Anyone can look up all the USPTF recommendations by going to their website:

No big surprise that many of the USPTF recommendations are different from the recommendations of medical groups and medical organizations that may have some bias given the interests of their members.  The USPTF recommendations regarding yearly pelvic exams, in healthy women with no complaints, is that there is no evidence showing an overall benefit in health to the patient.  Of note, they did add that there were a small number of studies that suggested having an annual gyn exam has some drawbacks, mostly false findings that lead to unnecessary testing and surgery.   Basically the USPTF could not find scientific evidence proving that an annual gyn exam (when no pap smear testing is done) is helpful.  The American Congress of Ob/Gyns (ACOG) continues to recommend annual gyn exams to anyone over the age of 21, although they do admit that they, too, cannot find any scientific evidence showing that doing so is beneficial.  ACOG did add that gynecologists can discuss these issues with their patients to help the patient decide what is best for her.  Also, we should remember that ACOG fought very hard to ensure that women have unfettered access to a gynecologist without having to get a referral first.

 In my lifetime, I have seen a gynecologist for specific reasons, such as birth control or pap smear screening.  If I had a gyn problem or concern, I would definitely see my gynecologist.  A check up is no different from a medication, a test, or a procedure.  A patient should know what are the benefits and risks and decide if it is right for her.

Other articles by Padma Garvey