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Are Routine Pelvic Exams Necessary for Post-Menopausal Women?

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From doctor visits to medication, healthcare costs can add up quickly. If you have your ear to the ground in the medical field, then you may have noticed a shift in attitudes among healthcare providers, who are beginning to question the wisdom of routine wellness procedures. Women’s health is an area which is of particular interest  specifically whether routine gynecological pelvic exams are really necessary for post-menopausal women who are not displaying any particular symptoms.

By insisting that women have yearly wellness checks and exams, are we being set up for unnecessary medical procedures which can then lead to potentially fabricated health crises? 

These are questions American physician Risa Kagen is asking, and which she has addressed in a recent NAMS Monthly E-Consult article, recently published in Medscape News Today.

According to Dr. Kagen, European countries such as the United Kingdom, Sweden, and the Netherlands have already abandoned routine wellness pelvic exams for post-menopausal women, and only examine women with symptoms.  It is believed this shift is why European countries have fewer hysterectomies and other gynecologic procedures than in the United States.  

Dr. Kagen is careful, however, to address in her commentary some of the obvious reasons why preventative healthcare procedures are advantageous. Ovarian cancer, for example, is known as the ‘silent cancer’ because for many patients, symptoms do not appear until the cancer has progressed to an advanced stage, making it difficult to treat. 

Dr. Kagen also cites the value in annual pelvic exams for post-menopausal women who may experience vaginal atrophy due to low estrogen levels, pelvic organ prolapse, urinary incontinence, and possible sexual dysfunction, all of which can severely affect the quality of a woman’s life if left untreated.

While I can certainly appreciate the value of Dr. Kagen’s observations that too much medical intervention and tinkering tends to lead to even more medical intervention and tinkering, I’m not entirely convinced that annual wellness exams and check-ups are unnecessary. 

Few of us would neglect routine maintenance procedures when it comes to such things as our automobiles and homes, for example, because doing so would only lead to bigger and more costly problems later.

Certainly, given what we know about the value of early detection when it comes to effectively treating certain types of cancer, it seems to me that investing in our health with annual wellness exams is far more cost-effective and worthwhile than waiting until we are displaying symptoms.

I’m also not so sure that the health insurance industry, which is primarily concerned with controlling medical care costs, and which is also the primary proponent of preventative, annual wellness exams, would see the financial benefit of delaying medical intervention until a patient is symptomatic. 

However, Dr. Kagen certainly raises some important questions, though I think it remains to be seen whether they will translate into changes in how we approach our health.

Magnolia Miller is a certified healthcare consumer advocate in women’s health and a women’s freelance health writer and blogger at The Perimenopause Blog.

 

 

 

 

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Tags: Politics of Women's Health

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About the Author

Magnolia is dedicated to empowering women to take responsibility for their own health.

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