Pelvic Exams, Pap Smears Unnecessarily Linked to Birth Control Prescription


Many physicians require their patients to undergo a pelvic exam and/or pap smear before they will prescribe or renew a prescription of birth control pills. A new article at Time online calls this long-standing practice into question. What’s the harm? Some women, perhaps disproportionately young women and victims of sexual assault, fear or dread pelvic examinations so much that they may not get birth control pills they are otherwise appropriate candidates for, due to avoiding the doctor’s office entirely. This can lead to unintended pregnancy and a lifetime of consequences for woman and baby or an abortion that could have been avoided.

A recent study found that around 400 of 1,200 responding physicians required a pelvic exam before prescribing birth control pills, yet there is often no medical reason to link the two. Pelvic exams and pap smears help physicians detect cervical cancer, human papillomavirus and many other conditions and there is no question they are an important part of every woman’s routine medical care. But forcing women to undergo them in order to receive highly-effective birth control may cause more problems than it corrects, at least for some women. It may also violate their consumer rights regarding health care.

If you desire birth control pills, but are afraid to go because you dread a pelvic examination, seek a physician who will respect your decision. Bear in mind that an annual pelvic examination and pelvic exam is the best way to protect your health.

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"Pelvic exams and pap smears

"Pelvic exams and pap smears help physicians detect cervical cancer, human papillomavirus and many other conditions and there is no question they are an important part of every woman’s routine medical care"

Totally disagree...our doctors and many other countries do not recommend routine pelvic exams at all. They are of poor clinical value in the absence of symptoms and expose the woman to risk - more unnecessary and potentially harmful biopsies, procedures and even surgery. Dr Carolyn Westhoff agrees with our doctors - see her comments at, "Questioning the value of the routine pelvic exam". Also, Dr Robert Hatcher from the Managing Contraception site has some harsh words for doctors who "hold" scripts (in my opinion, it's coercion) - google his name plus pelvic exam and birth control and it should appear. So, asymptomatic women don't need this embarrassing, invasive, painful/uncomfortable and harmful ordeal every year or at all. I'm in my early 50's and have never had one, its never even been suggested - I'd refuse it anyway.

Routine breast exams - same thing - they don't help, but cause biopsies. Our doctors don't recommend them.

"Bear in mind that an annual pelvic examination and pelvic exam is the best way to protect your health."

Totally disagree - American women, please do your reading, this is nonsense! Routine pelvic exams are more likely to harm you. The ONLY screening test pushed by our doctors are pap tests and they are an optional cancer screening test. As a low risk woman my risk of cc is near zero, while the Aussie 2 yearly program condemns 77% of women to colposcopy/biopsies at some stage over their lifetime. This means risk - cervical damage from unnecessary biopsies/procedures can cause cervical stenosis, cervical incompetence and lead to endometriosis, infections, infertility, high risk pregnancy, miscarriages, premature babies and more. The lifetime risk of cc is 0.65% and LESS than 0.45% of women are helped by pap tests. (other factors are naturally reducing the small death rate - more hysterectomies, fewer women smoking, less STD, better hygiene etc and there are also false negative cases) We can't be sure that anyone is helped as there are no randomized controlled trials for pap tests, but if anyone is helped, the numbers are VERY small. Women under 30 don't benefit from testing, but produce lots of false positives (1 in 3 according to Dr Angela Raffle's research) Finland has the lowest rates of cc in the world and sends the fewest women for biopsies - they offer 5 yearly testing from age 30 to 60. Less is more with pap tests, but that's your decision. I passed altogether, far too much risk for a near zero risk. Every woman should assess her level of risk and if she wants testing adopt a schedule that provides some protection from false positives - 3 or 5 yearly from age 30. More information is at Dr Joel Sherman's medical privacy forum under womens' privacy issues parts 1 to 6 and in the side bar you'll find some great references. Also see BlogCritics and Unnecessary Pap smears - more than 4500 posts so far....lots of concerned women. The only things required for the Pill are your medical history and a blood pressure test...if you all start walking out and only using ethical doctors, the other doctors will soon see the light! You don't need to lead a medically controlled life...all of this is very unhealthy and is probably the reason you have huge numbers of unnecessary biopsies and procedures and 1 in 3 of you will have a hysterectomy by age 60 - a whopping 600,000 every year. Protect yourselves from harm - take charge in the consult room and lodge formal complaints and/or speak to your lawyer, if necessary.


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