March 10th, 2011 by Harriet Hall, M.D. in Opinion, Research
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A new article in the Journal of Women’s Health by Westhoff, Jones, and Guiahi asks “Do New Guidelines and Technology Make the Routine Pelvic Examination Obsolete?”
The pelvic exam consists of two main components: The insertion of a speculum to visualize the cervix and the bimanual exam where the practitioner inserts two fingers into the vagina and puts the other hand on the abdomen to palpate the uterus and ovaries. The rationales for a pelvic exam in asymptomatic women boil down to these:
- Screening for chlamydia and gonorrhea
- Evaluation before prescribing hormonal contraceptives
- Screening for cervical cancer
- Early detection of ovarian cancer
None of these are supported by the evidence. Eliminating bimanual exams and limiting speculum exams in asymptomatic patients would reduce costs without reducing health benefits, allowing for better use of resources for services of proven benefit. Pelvic exams are necessary only for symptomatic patients and for follow-up of known abnormalities. Read more »
*This blog post was originally published at Science-Based Medicine*
December 4th, 2009 by Nancy Brown, Ph.D. in Better Health Network, News
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The CDC announced last week that the latest statistics on Chlamydia, gonorrhea and syphilis are still unacceptably high in the United States. The U.S. has some of the highest rates of sexually transmitted infections of any developed country in the world including 1.2 cases of Chlamydia in 2008 and syphilis cases, up 18 percent, are at 13,500. Men who have sex with men accounted for 63 percent of the syphilis cases, but the rate among women also increased 36 percent between 2007 and 2008.
Almost half of the 19 million new sexually transmitted infection cases reported each year are among 15- to 24-year-olds. Clearly marking the shift away from abstinence-only policies, the CDC called for better, more honest and open, sex education including how to use a condom, limiting the number of sexual partners, and avoiding people who have had multiple sex partners. Read more »
This post, Sexually Transmitted Infections Still On The Rise, was originally published on
Healthine.com by Nancy Brown, Ph.D..
