If you dread visits to the gynecologist because of the vaginal examination it involves, this should reassure you. Several learned societies, including the National College of Obstetrician Gynecologists (CNGOF) and the National College of Midwives (CNSF), have just published recommendations regarding the performance of pelvic examinations during consultations. Through pelvic examwe mean for example the vaginal examination or observation of the cervix by placing a speculum.
Believing that it was time to change clinical practices around pelvic examinations, learned societies have indicated that there are certain cases for which a pelvic examination is neither relevant nor essential.
In detail, the CNGOF judges that it is not not necessary to carry out systematically a pelvic examination for the prescription of hormonal contraception, during pregnancy monitoring of an asymptomatic woman with no risk factors, or as part of screening for ovarian cancer.
In which case the pelvic examination remains recommended, even essential?
On the other hand, this “gynecological examination” remains recommended or even essential in the following cases:
- for the insertion of an intrauterine device (IUD or IUD),
- for cervical cancer screening (carrying out a smear or biopsy),
- in case of suspected endometriosis, fibroid or prolapse,
- in case of urinary incontinence,
- during an emergency consultation, for example because of unexplained pain or bleeding, also requires a gynecological examination.
This pelvic examination always occurs in addition to an interrogation, and is sometimes accompanied by an ultrasound.
An apprehension that can lead to avoiding appointments
These new recommendations come from the freedom of speech around the gynecological violence and consenta context whose medical authorities have visibly grasped the extent.
If the College of Gynecologists has decided to overhaul and question certain practices, it is because it is aware of the problem. “All medical examinations can be difficult to live with and those concerning the pelvic organs can be felt to be intrusive”, can we read in the press kit that we were able to obtain.
“L’apprehension vis-à-vis a routine pelvic examination (particularly for young women on their first appointment, women who have been victims of violence and women with chronic pelvic or perineal pain) can lead to avoid or delay a consultation”, lament the learned societies. This can result in delays in care, diagnosis or screening, add the specialists.
The latter point out that most women accept these “intrusive” examinations “when the need to the procedure is explained and if the examination is carried out by a professional qualified, communicative and cautious”. A know-how and know-how that is part of the skills of health professionals, according to the CNGOF and its peers, who add that these recommendations “are not applicable to all clinical situations and must be able to be individually adapted”.
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