Getting Examined to Get the Pill
May 1, 2001 -- Most women who use birth control pills expect to get a breast exam and pelvic exam each year when they see their doctor to refill the prescription. It's a familiar routine, and it allows the doctor to check for signs of sexually transmitted diseases and other harmful conditions.
For many women, this annual visit to a gynecologist is their most reliable, familiar form of health care. But many experts argue that when pelvic and breast exams are linked to the birth control pill, it reinforces the mistaken idea that the pill increases health risks. Some are concerned that requiring a pelvic exam reduces access to this highly effective contraceptive, especially in at-risk groups like teenagers.
And, there's no scientific reason to link these exams together with the contraceptive prescription, experts say. If a woman wants to obtain a contraceptive today, and postpone the pelvic exam, she should be able to do so.
For more information about contraceptives, check out WebMD's Women's Health board moderated by Jane Harrison-Hohner, RN, RNP.
In fact, in recent years several policy-setting organizations have come out in support of this new approach to contraception. The American College of Obstetricians and Gynecologists says a first visit for oral contraceptives doesn't have to include a pelvic exam if the patient wants to postpone it. Planned Parenthood says a pelvic exam may be postponed for up to 13 months after starting birth control pills.
Felicia H. Stewart, MD, of the Center for Reproductive Health Research and Policy at the University of California, San Francisco, and colleagues, have published a study in the May 2 issue of TheJournal of the American Medical Association that reviews the medical literature on this issue and offers some valuable information for women:
- When you get your prescription refilled, it is only necessary to have your blood pressure taken and your complete medical history reviewed, unless you fall into a high-risk group.
- You don't have to have a pelvic exam during the same visit when you get your prescription. However, pelvic exams are important, and should be done at a convenient time.
- You don't have to have a breast exam during this visit. However, the breast exam is an important way to check for breast cancer, so do get one at a convenient time.
- Another important test is the Pap test. While not necessary to renew your pill, it is an important screening test for cervical cancer, and you should see that you get it done.
"This paper offers important information and hopefully will allay some of women's anxieties about prescription hormones," says Holly Thacker, MD. "Almost half of all pregnancies are unintended, and this occurs not just in teenage women, but also in women over age 40." Thacker is the head of women's health at the Cleveland Clinic Foundation, and assistant professor of medicine at Ohio State Medical School in Columbus.