Paper: Exam medically unnecessary to prescribe birth-control pills

women to have a pelvic exam before they can obtain birth-control pills usually is unnecessary and causes delay that can lead to unintended pregnancy, according to a new paper co-authored by Professor James Trussell, associate dean of the Woodrow Wilson School of Public and International Affairs.

While pelvic and breast exams are beneficial to women, they do not help determine who can safely use birth control pills, concluded the paper, which was published Wednesday in the Journal of the American Medical Association .

Measuring a woman's blood pressure and obtaining her medical history are the methods doctors rely on to decide whether to prescribe a hormonal contraceptive, the paper found.

"Medically speaking, there's no greater logic to requiring pelvic and breast exams for women who want to use hormonal contraceptives than there would be for requiring a man who wants to use a condom to have a prostate exam," said Trussell, a longtime advocate for the availability of birth control.

"Having a prostate exam is a good thing, yes, but it's not related to contraception. Because all would agree it's a good thing to have these exams, women are held hostage to them in order to use hormonal contraceptives," he said.

The pelvic exam requirement often means that women wait to get a birth control prescription, and that delay can be harmful, Trussell said.

"Unintended pregnancy has important health risks, and is very common when contraception is not used," he said.

Trussell noted that the annual risk of pregnancy among young women is about 90 percent when contraception is not used, so each extra month of unprotected exposure could mean up to 175,000 additional unwanted pregnancies for every million women. The physical exam requirement itself frightens some women, particularly teens, from seeking birth-control pills, he added.

Contact: Marilyn Marks (609) 258-3601