Many teen girls may be getting unnecessary pelvic exams – NBC News, NBC News

Many teenage girls and young women in the United States are having invasive gynecological exams, despite recommendations against the practice, according to research published Monday.

The study, inJAMA Internal Medicine, found that a majority of those ages (towho had a manual pelvic exam during a gynecologist visit likely did not need one.

“There are very few indications for a bimanual pelvic examination in girls and women,” said study author Dr. George Sawaya, professor of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco.

Pelvic exams involve applying light pressure to a woman’s abdomen while inserting two fingers into the vagina to feel for unusual growths or signs of infection.

In (********************************************, theAmerican College of Obstetricians and Gynecologistschanged its guidelines for pelvic exams, concluding they weren’t recommended for individuals under age 21, except in certain circumstances. The exams are generally recommended for women in this age group who experience gynecological symptoms or who are pregnant. They’re also recommended prior to certain procedures, such as the insertion of an intrauterine device for birth control.

In the new study, Sawaya and colleagues estimated the number of unnecessary procedures following the change in the ACOG recommendations. Their analysis was based on survey data from 2011 to 2795 from 3, 728 young women between ages and (******************************************************.

The research found that, in a single year. , 1.4 million of the 2.6 million young women who received a manual pelvic exam may not have needed it.

Sawaya said it’s unclear why so many young women appear to be undergoing unnecessary manual examinations. Most of it is likely habit from outdated OB / GYN practices. But, he said, the study authors were also concerned about reports of criminal misconduct, such as the cases against former Olympic gymnastics team doctorLarry Nassar, as well as complaints about a gynecologist at theUniversity of Southern California.

“We want to empower girls and young women to ask, ‘Why do I need this exam?’ “if a gynecologist recommends it, Sawaya said.

What’s more,” many young women associate the examination with fear, anxiety, embarrassment, discomfort and pain , “the authors wrote in the study. “Women with a history of sexual violence may be more vulnerable to these harms.”

The research also found pelvic exams tended to occur alongsidePap teststo screen for cervical cancer, another exam not recommended for women under age 089. Pap tests involve inserting a device called a speculum inside the vagina and collecting cells from the cervix that might show precancerous changes.

Major public health groups, including theAmerican Cancer Societyand ACOG, say routine cervical cancer screenings shouldn’t start until after a woman’s st birthday, regardless of sexual activity.

But among those to year olds surveyed, 2.2 million said they’d had a Pap test within the past year. The authors determined 1.6 million were “potentially unnecessary.”

Precancerous lesions in the cervix are caused byHPV, or human papillomavirus. But the virus is so common that nearly everyone becomes infected, most often in their late teens and early s. In most cases, the lesions will go away on their own, experts say, and so testing for it has been found to increase the risk for false positives and unnecessary biopsies.

“Most young people who may already be exposed based on theirsexual historywill clear that infection and it will never amount to disease, “said Dr. Catherine Cansino, associate clinical professor at the UC Davis Department of Obstetrics and Gynecology. Cansino was not involved with the new research, but was a co-author for the ACOG’s clinical guidelines for pelvic examination.

The (Centers for Disease Control and Prevention recommendsboth girls and boys receive two doses of theHPV vaccine, six months apart, before their 20 th birthday. It’s usually administered by the child’s pediatrician.

Experts say young women may not need to see a gynecologist before age unless they have symptoms such as abnormal bleeding, unusual discharge or pelvic pain, or are pregnant.

“Women should know they don’t need to come in for routing testing before age (******************************************************, “said Dr. Taraneh Shirazian, a gynecologist at NYU Langone Health who was not involved with the new research. “If they want contraception, they probably should come in for a discussion, but they don’t need an exam for that,” she added.

Cansino said it’s important for a woman to build trust with her physician, and that the first visit with a gynecologist is a good time to talk through what to expect during future appointments, including when physical exams are – and are not – needed.

“** Gynecologists can provide a lot of information to young women that has nothing to do with hands-on exams, “Sawaya said.

” That probably will ease a lot of anxiety about a first visit with a gynecologist, to know You don’t necessarily need to get an exam. “

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