Clinical breast and pelvic examinations are commonly accepted practices
prior 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 but
incorrect perception that hormonal contraceptive methods are dangerous.
This article reviews and summarizes the relevant medical literature
and policy statements from major organizations active in the field of contraception.
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 cervical neoplasia
and sexually transmitted infection, while important in their own right, do
not provide information necessary for identifying women who should avoid hormonal
contraceptives or who need further evaluation before making a decision about
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 79
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
The Rational Clinical Examination
Table 42-3 Probability of Pregnancy if Patient Reports Not Using Birth Control
All results at
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.