Women Reported Less Discomfort When Pelvic Exams Were Done Without Stirrups
Most women dread their yearly visit to the gynecologist for a pelvic exam. In fact, many women are so averse to this procedure, which involves placing your feet in stirrups while the doctor inserts a speculum into the vagina, that they skip it all together. But skipping the pelvic exam means missing an opportunity to screen for ]]>cervical cancer]]> —which is preventable and curable if caught early—as well as infections and other problems with the reproductive organs.
In an effort to reduce the anxiety and discomfort many women experience during pelvic exams, one research group conducted these exams with and without stirrups. The women examined without stirrups reported significantly less physical discomfort and vulnerability than those examined with stirrups. This study is published in the July 22, 2006 British Medical Journal .
About the Study
Researchers from Eisenhower Army Medical Center in Georgia recruited 197 women over age 18 who came to the medical clinic for their annual pelvic exams. The women were randomly assigned to stirrups or no stirrups for foot support. Women not using stirrups placed their feet on the corners of the exam table. After the exam, the women filled out anonymous questionnaires rating their physical discomfort, sense of vulnerability, and sense of lost control. The quality of the pap smears collected during the exams was also analyzed. The researchers then compared the women’s ratings and the quality of the pap smears between the two groups.
Among the women examined without stirrups, sense of vulnerability was 44% lower and physical discomfort was 43% lower than among the women examined with stirrups. Sense of lost control did not differ between the groups. The quality of pap smears was also similar whether stirrups were used or not.
This study is limited by its size; it was conducted at one center on just 197 women. In addition, the post-exam questions were broad and could not pinpoint specific causes for the women’s feelings.
How Does This Affect You?
The elimination of stirrups in this study was linked to significantly less discomfort and did not interfere with the doctor’s ability to collect an adequate pap smear to screen for cervical cancer.
It’s important to note, though, that at least one previous study reported that stirrup positioning allowed for a greater rate of adequate pap smears than the non-stirrup method. Further research on more women is needed to determine if the non-stirrup exam will consistently allow for adequate pap smears, and therefore, provide the same benefits as the stirrup exam.
If you dread pelvic exams, or avoid them altogether, talk with your doctor about making the procedure less uncomfortable. While the non-stirrup exam is routine in some countries, such as Great Britain and Australia, it is not as common in the US.
You may wish to consider deep breathing techniques to help you relax. Try this calming exercise during your next exam:
- Close your eyes and inhale slowly through your nose, counting to five. Imagine the air filling and expanding your stomach, rib cage, chest, and finally your lungs.
- Slowly exhale, counting backwards from five to one, and imagine the air leaving your lungs, chest, ribcage, and stomach.
- It is helpful to visualize a peaceful place; picture a calm ocean with the waves washing on the shore as you inhale, and the waves retreating out to sea as you exhale.
- Repeat this cycle until the exam is done.
Other means of reducing discomfort currently under study include alternative speculums, positions, and foot rests, as well as various gowns. Don’t let a few minutes of discomfort rob you of the potentially life-saving benefits provided by the pelvic exam.
National Cancer Institute: Cervical Cancer
The Society of Obstetricians and Gynaecologists of Canada
Relaxation techniques. University of Maryland Medical Center website. Available at: http://www.umm.edu/sleep/relax_tech.html. Accessed November 27, 2006.
Seehusen DA, Johnson DR, Earwood JS, et al. Improving women’s experience during speculum examinations at routine gynaecological visits: randomised clinical trial. BMJ . 2006;333:171-173.
A snapshot of cervical cancer. National Cancer Institute website. Available at: http://planning.cancer.gov/disease/Cervical-Snapshot.pdf. Accessed November 26, 2006.
Last reviewed November 2006 by ]]>Richard Glickman-Simon, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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