Contraceptive Pearl: Decoupling Pap and Contraception

Many clinicians require patients to have a recent pelvic exam and pap smear before starting or renewing hormonal birth control. Do women really need a pelvic exam before starting hormonal contraception? According to the WHO, FDA and others, pelvic exams are not necessary for sage prescribing of birth control. Although important for cancer and STI screening purposes, pelvic exams and pap smears reveal little that would exclude a woman from safely using contraception.

Required pelvic exams can pose a significant logistical/financial barrier to obtaining contraception, particularly for adolescent patients. Scheduling the exam may mean a longer wait for contraception, increasing the risk of unintended pregnancy during that interval. Research demonstrates that delaying a pelvic exam does not jeopardize patients’ health and has the added benefit of being preferred by women who want to start contraception sooner.

Consider decoupling pelvic exams and birth control in your own practice – and make sure that your receptionists and nursing staff understand your policy. It’s a safe and easy way to improve your patients’ health.

Helpful Resources

Your Birth Control Choices Fact Sheet 


Cervical Cancer Screening Guidelines for Average Risk Women. Center for Disease Control and Prevention.


The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.

Contraceptive Pearls

This monthly clinical e-newsletter highlights evidence-based best practice for contraceptive care

Latest Blog Post

View More Posts on Topic