Many Lack Gynecological Care

More than half of American women avoid going to the gynecologist, a national survey has found, largely due to lack of insurance, lack of money, or language or cultural differences with their physician.

According to the American Social Health Association, which conducted the poll, these results have alarming implications. STDs, such as chlamydia and gonorrhea, often cause no symptoms but can be easily detected by routine tests. Up to 40 percent of women with untreated chlamydia or gonorrhea develop pelvic inflammatory disease (PID), a serious infection that can scar Fallopian tubes and result in infertility. Similarly, HIV doesn't have obvious symptoms initially; and a seemingly innocuous infection such as vaginitis can be an early sign of diabetes.

In a telephone poll of 1,948 African-American, Latina and white women across the country, one out of four admitted they had not received a routine gynecological exam in the last year, and an additional 28 percent said they don't get annual examinations. The biggest barrier was cost and lack of insurance (24 percent). Other obstacles cited included language and cultural differences (20 percent), discomfort with their physician (20 percent), fear of diagnosis (14 percent) and embarrassment (10 percent).

"Cultural fears and taboos play a role, too," says Dr. Luis N. Pacheco, medical director of the California Hospital Medical Center in Los Angeles. "In the Hispanic community, some women believe that they'll lose their virginity if they get a gynecological exam. And certain Middle Eastern cultures frown upon male physicians performing gynecological exams."

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