Asymptomatic Symptomanic Static on Routine Pelvic Exams

Guidelines for pelvic exams in women has been "updated" again.  Avoiding pelvic exams in asymptomatic, non pregnant adult women is the newest "recommended" guideline.  Could this mean that a woman who meets these criteria should refrain from routine exams until she becomes symptomatic and/ or pregnant?  If this were the case, how many women would be left out of possibly being diagnosed with a disease that was indeed asymptomatic until diagnosed on a routine pelvic exam?

In asymptomatic non pregnant females, my diagnoses have included cervical cancer in an 80 year old, ovarian cancer in a 20 year old, massive uterine fibroid tumor in a 40 year old.  The routine pelvic exam was able to detect these malignant and pre-malignant conditions before they became life threatening.  Early detection allowed these ladies to escape the perilous pitfalls of cancer.  In these cases simple surgery was the cure.  They remained asymptomatic and cancer free by continuing with their routine pelvic exam and checkup.

Without symptoms may appear to indicate a disease free state, but often times it reveals disease.  It is up to patients and their health care providers to include routine exams in their health care plan.  Routine can be yearly, every other year or two, or less frequently depending on the patients medical history.  Routine evaluation and assessment is based on each individual.

Routine pelvic exam guidelines are just that, suggested recommendations that should be considered.  For this doctor and many others, especially women, routine pelvic exams will still be part of a well woman visit as deemed necessary.  The schedule is as follows:

• 18 - 20 first pelvic exam, sooner if sexually active and/or symptomatic
• 20 - 60 pelvic exam every year to every other year unless symptomatic
• 60 - life pelvic exam every 2-3 years unless symptomatic

Routine pelvic exams and pelvic/ transvaginal sonograms together offer earlier detection and diagnosis of more gynecological diseases that can be treated effectively before they affect a woman's quality of life.  In addition, they help avoid "all in your head" misdiagnosis, and can be lifesaving.  As for the concern of "false positives" and unnecessary tests...forget about the asymptomatic symptomatic static.  Most abnormal exams and tests can be repeated and followed on a closer routine schedule that may prevent riskier intervention.  Talk with your doctor about what is best for you.  Best health!