Clinical breast and pelvic examination requirements for hormonal contraception - Current practice vs evidence

Clinical breast and pelvic examinations are commonly accepted practices pri or to provision of hormonal contraception. Such examinations, however, may reduce access to highly effective contraceptive methods, and may therefore increase women's overall health risks, These unnecessary requirements also involve ethical considerations and unwittingly reinforce the widely held bu t incorrect perception that hormonal contraceptive methods are dangerous. This article reviews and summarizes the relevant medical literature and pol icy statements from major organizations active in the field of contraceptio n. Consensus developed during the last decade supports a change in practice : hormonal contraception can safely be provided based on careful review of medical history and blood pressure measurement. For most women, no further evaluation is necessary. Pelvic and breast examinations and screening for c ervical neoplasia and sexually transmitted infection, while important in th eir own right, do not provide information necessary for identifying women w ho should avoid hormonal contraceptives or who need further evaluation befo re making a decision about their use.