# Bimanual Pelvic Examinations: Temporal Patterns and Imposed Barriers to Contraception Use

> **NIH AHRQ R36** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2021 · $42,210

## Abstract

PROJECT ABSTRACT/SUMMARY
Preventive pelvic examinations, or those performed in asymptomatic, non-pregnant women, have been a
standard component of preventive gynecologic care for decades. Today, more rigorous and less invasive
screening mechanisms have surpassed the preventive pelvic examinations in effectively detecting diseases
such as sexually transmitted infections and cervical cancer, for which preventive pelvic exams were previously
used. Furthermore, preventive pelvic examinations frequently induce fear or embarrassment in young women
and contribute to unnecessary, harmful, and resource-intensive subsequent diagnostic procedures. In light of
this, recent reviews and position statements question the widespread or routine use of preventive pelvic
examinations. More importantly, preventive pelvic exams have been an unnecessary barrier to self-
administered hormonal contraception access. Preventive pelvic exams as a prerequisite to self-administered
hormonal contraception use have been removed from drug labeling and practice recommendations because
these exams are not necessary to facility safe, effective use of these contraceptives. However, against these
requirements and recommendations, most physicians still require a preventive pelvic examination before they
prescribe oral contraceptives. The overall goals of this proposed project are to evaluate the de-
implementation of the use of preventive pelvic exams routinely and as a prerequisite to self-
administered hormonal contraception access, a clinical practice that is ineffective and harmful. This
objective aligns with the AHRQ Research Priority Area to harness data and technology to improve
health care quality and patient outcomes. In Aim 1, we will use a database of medical and prescription
claims data of employer-sponsored commercially insured women to examine the changes in rates of
preventive pelvic exams following the first societal guideline changes recommending the use of routine
preventive pelvic exams, from the American College of Physicians in 2014. In Aim 2, we will use a survey to
understand women’s experiences with and perceptions of pelvic exams as a barrier to contraception use. In
Aim 3, we will use the same database from Aim 1 to evaluate whether women who fill a prescription for a self-
administered hormonal contraceptive method (contraceptive pills, patch, or ring) experience a higher
prevalence of preventive pelvic exams at a recent preventive care visit compared to women who are not using
those methods. Our work will provide evidence to inform interventions that will support and empower providers
and patients for evidence-based gynecologic care related to preventive pelvic exams and access to self-
administered hormonal contraception.

## Key facts

- **NIH application ID:** 10295316
- **Project number:** 1R36HS028539-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Rachel Ann Parry
- **Activity code:** R36 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $42,210
- **Award type:** 1
- **Project period:** 2021-09-30 → 2022-07-10

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10295316

## Citation

> US National Institutes of Health, RePORTER application 10295316, Bimanual Pelvic Examinations: Temporal Patterns and Imposed Barriers to Contraception Use (1R36HS028539-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10295316. Licensed CC0.

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