The effect of physician gender on women's perceived pain and embarrassmentduring pelvic examination

In this article we try to determine if the examiner's gender affects women' s perceived pain and embarrassment during emergency department pelvic exami nation, using a prospective comparative study in a university teaching hosp ital. Test subjects were taken from a convenience sample of female emergenc y department (ED) patients undergoing pelvic examination as part of their e valuation. 100 mm visual analog scales were used to gauge each subject's pe rceived pain and embarrassment. Subject age and complaint, and the examiner 's gender and level of training were collected. Two-tailed Mann-Whitney or Kruskal-Wallis tests were used to test for significant differences among gr oup median pain and embarrassment scores. One hundred and sixty-seven subje cts completed the study (median age = 25 y, interquartile range 20-33 y), S eventy-seven subjects had abdominal or pelvic pain, 49 complained of vagina l bleeding, and the rest had dysuria, pregnancy, genital lesions, or other conditions. Ninety-four examiners were female and 73 were male, The mean pa in scores were similar for female (33.6 mm) and male (38.8 mm) examiners. T he medians were 19.5 mm and 41.0 mm respectively (difference, 21.5 mm; 65% CI, -3.5 to 34 mm; P=0.385). The mean embarrassment score was lower for fem ale (19.6 mm) than for male (37.4 mm) examiners. The medians were 5.0 mm an d 28.0 mm respectively (difference, 23 mm; 95% CI, 11.5 to 40 mm; P= 0.0001 2), The level of examiner training did not appear to affect either score (P > 0.6). Emergency department patients perceive pelvic examination by a mal e examiner as more embarrassing but not more painful than examination by a woman. (Am J Emerg Med 1999;17:635-637. Copyright (C) 1999 by W.B. Saunders Company).